Background: Recent systematic reviews suggest mediating factors (barriers and facilitators) of help-seeking for children and young people (CYP) with a range of mental health problems but highlight the need for a more robust methodology underpinned by theoretical frameworks. Emotional abuse and neglect is the most prevalent and pervasive form of abuse, with many CYP remaining unknown to professional services. These CYP are underrepresented in help-seeking research yet seek help from their peers via anonymous online publicly available message communities. Objectives: To sensitively co-develop qualitative methodology to explore ‘real-world’ data to inform our understanding of help-seeking for these CYP, and define potential mediators (barriers and facilitators) and mechanisms of change associated with online peer support. Methods: Co-production with 10 young co-researchers (YCoR; aged 14–18 years) from the NeurOX Young People's Advisory Group (YPAG) included co-development and triangulation to apply different research methods (i.e., interpretative phenomenological, thematic and conversation analyses) to analyse rich ethnographic material from 20 publicly available online message conversations between help-seekers experiencing or questioning emotional abuse and neglect. A theoretical model of adolescent help-seeking proposed by Rickwood et al. was used as a conceptual framework to guide methodological development. Results: The methodological approach facilitated the identification of barriers and facilitators of help-seeking contextualized to the lives of these CYP: understanding and validating of abuse, emotional competence, fears and uncertainties around disclosure, knowledge, motivational factors and connection/trusted relationships. Notably, positive changes in expressed or perceived ‘psychological state’ and/or intention to seek help were noticed in 9 of 10 message threads that included a ‘conversation’ (≥3 posts). Themes associated with change related to connection with supportive peers; compassionate responding and the safeness of the online community. The existing adolescent help-seeking model was found to be too simplistic to account for help-seeking associated with emotional abuse and neglect. Conclusion: The novel methodological approach offers a meaningful way to explore ‘real-world’ data with YCoR, for a population underrepresented in help-seeking research. Proposed relational mechanisms involve connection, compassion and online communities. Further research coproduced with YCoR with diverse care experiences and characteristics is required to upscale the methodology and further validate and extend the findings. Public Contribution: The core study was co-produced with 10 YCoRs from the NeurOX YPAG who have been involved in over 135 h on and offline work. Their roles involved co-deciding the direction of the study, evolving methodology, detailed co-analysis and reflective processes throughout all aspects of the study, interpretation, presentation and discussion of the findings with the NSPCC and Childline, and involvement in all communications. Additional consultation and involvement included further interested members of the NeurOX YPAG for the final online workshop and dissemination outputs.
Bibliographical noteFunding Information:
We acknowledge the valuable contributions of all NeurOX Young People's Advisory Group members who were involved in the research and those involved in the preparation (outlines) of this publication. We wish to acknowledge the support and collaboration with Childline throughout the research and dissemination process. In particular, we are grateful for the knowledge, expertise and input provided by Kirsty Donnelly from Childline. We are also grateful for the support from Jessica Johansson during the project. The authors appreciated the time offered by Prof. Jane Appleton (Oxford Brookes University) for reviews of the draft manuscript. This study was funded by the UKRI Emerging Minds network as a 3‐month cross‐sector research placement with the NSPCC. Reimbursement for YCoR was provided by the NSPCC for the core study. Supplementary funding for participation and dissemination activities was provided by the NSPCC and the Department of Psychiatry.
The research reported in this paper was developed as part of a 3‐month cross‐sector research placement with the NSPCC funded by the UKRI Emerging Minds network and the Department of Psychiatry/University of Oxford. The study involved retrospective analysis of anonymous (pseudonymized) online publicly available ‘data’ from the Childline online peer‐support message boards. The study was approved by NSPCC Research Ethics Committee (R‐20‐189, 2020) with reciprocal approval by the University of Oxford Central University Research Ethics Committee (Ref:R62044/RE001). Confidentiality for members is maintained. Only pseudonyms were known to researchers; these and any names mentioned in messages were changed in all internal and external reporting (further information is published in Bennett et al. ). Direct text from potentially active young service users is not shared to protect their identity, privacy and safeguarding in public reporting of this sensitive research. These data have been through an external blind peer review process conducted by the NSPCC in a full internal NSPCC report. 18
© 2022 The Authors. Health Expectations published by John Wiley & Sons Ltd.
- children and young people
- emotional abuse
- peer support
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health