Digital disclosures: Exploring the role of online mental health services in supporting young people who disclose violence or maltreatment

Background Mental health practitioners can play a role in identifying and responding to young people at risk of harm and connecting them with appropriate supports. However, little is known about how clinicians providing mental health services through digital platforms support young people disclosing experiences of violence. Objective This study sought to understand the perspectives of clinicians working within digital mental health services on supporting young people disclosing violence. Participants and setting This study recruited 19 practitioners who were currently or had recently worked within The Digital Mental Health Programs of an Australia-wide mental health service, which provides online chat, email, and phone support to young people aged 12–25. Methods Sixteen individual interviews and one focus group were recorded, transcribed, and analysed using a reflexive thematic analysis approach. Findings The analysis generated six themes relating to clinicians' experiences: balancing a client centered and empowering approach with clinicians’ duty of care; systemic or structural challenges; navigating a sense of dilemma and the impacts upon clinicians; tensions around anonymity; differing understandings of violence; and navigating the transparency continuum. Conclusions Mental health clinicians work to reconcile a client centered approach with their professional duty of care and at times legal mandate to report abuse concerns. Clinicians navigate structural challenges, the anonymous nature of an online service, and work to develop common ground with young people and communicate transparently. Despite challenges, online services may provide a space for young people experiencing violence to be heard, provided with information, and connected with supports.