Research Snapshot: Youth experiences with virtual mental health and substance use services during COVID-19

Going virtual: Youth experiences with virtual mental health and substance use services during the COVID-19 pandemic

What you need to know

An online survey looked at the experiences and preferences of young people related to virtual services for mental health and substance use (MHSU) during the COVID-19 pandemic. The researchers analyzed survey responses submitted in August 2020, five months after the pandemic was declared. Most youth with MHSU challenges said they would be willing to consider individual virtual services but a smaller number said they would consider virtual group services. Youth are interested in accessing a wide variety of virtual services and other supportive wellness services.


This Research Snapshot is based on the article, “Going virtual: youth attitudes toward and experiences of virtual mental health and substance use services during the COVID-19 pandemic” published in BMC Health Services Research in 2021.

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What is this research about?

Research has started to describe the transition from in-person to virtual health care during the COVID-19 pandemic. However, there is a lack of information on patient experiences in general, and especially those of young people receiving virtual mental health and substance use services (MHSU).

What did the researchers do?

Ontario researchers analyzed responses to an online survey on youth MHSU during the COVID-19 pandemic submitted in August 2020. This was about five months after COVID-19 was declared a pandemic and youth MHSU services started moving to virtual approaches. This data was part of a larger study on this topic the researchers conducted during the pandemic.

The survey sample included two groups: 164 youth who were receiving various MHSU services (the “clinical” sample) and 245 in a community sample of youth from across the province of Ontario (the “non-clinical” sample). Participants were between 14 and 29 years old.

In addition to consulting with young people regularly as the researchers developed the survey, they also brought the results to youth co-researchers to discuss and interpret the findings.

What did the researchers find?

Willingness to consider

The majority of the youth who screened positive for MHSU challenges said they would be willing to use individual virtual services. Fewer of them said they would consider using group virtual services. There was no age difference in willingness to use either type of service.

Youth who were using MHSU services before the pandemic were more willing to consider virtual services than were those who were not previously using services.

Quality of services

Among the youth who were using MHSU services before the pandemic, almost half felt that services were worse during the pandemic. Another 17% said there was no change in quality and the same number said services had improved.

Kinds of virtual activities

Participants said they would like to see various kinds of virtual activities to address MHSU challenges, including mindfulness programs, awareness initiatives, and activities such as fitness, nutrition and educational sessions. Some participants also suggested recreational activities.

Optimal features of virtual services

Young people preferred video calls, followed by phone or voice calls and support using texting or chat technology. Some youth accepted any format. The youth said it was important that virtual services have smooth audio and video, good internet connection and lighting, good camera quality, a mute button, and the ability to turn off their camera and to share files.

The youth also pointed to the importance of receiving clear communication in a non-judgemental environment.

Reasons for not considering virtual

Those who were not willing to consider individual virtual services said they preferred in-person services, mostly because they wanted human connection. Others said they felt anxious or uncomfortable about using virtual platforms, and had concerns about security, privacy and technical problems.

Many youth said they would not consider virtual services because they did not need them or already had the supports they needed.

Advantages of virtual services

The youth said they like virtual services because they are convenient, easy to schedule, and involve no travel time. They appreciated being able to connect with a professional safely during the pandemic and seeing the service provider’s face. Some felt it was uncomplicated to use and it helped their mental health.

Disadvantages of virtual services

Many said they preferred in-person care. Some youth felt that virtual interactions were awkward and missed the human touch. They found it difficult to read body language, establish rapport and talk about sensitive issues. Some had concerns around privacy, distractions and interruptions, as well as technological and scheduling problems.

Limitations of the research

The survey was limited to young people living in the province of Ontario, so it may not be representative of the experiences of youth in other locations. In addition, the study didn’t include interviews with participants, which would have provided a broader understanding of youth’s experiences and feelings. Because the survey was conducted online, it didn’t include young people who don’t use the internet regularly. Also, response rates may have depended on the level of young people’s MHSU challenges.

How can you use this research?

This research may be useful to policymakers and program planners, as well as organizations who are currently providing, or aiming to implement, virtual mental health services for youth. It provides a foundation for providing virtual programs and services that align with the needs and preferences of young people.

About the researchers

Lisa D. Hawke,1,2 Natasha Y. Sheikhan,1 Karen MacCon,1 and Joanna Henderson1,2

  1. Centre for Addiction and Mental Health, Toronto, Ontario
  2. Department of Psychiatry, University of Toronto, Toronto, Ontario