Young males in crisis: Pathways, usage and acceptability of an online messenger based psychosocial counselling service

IntroductionBoys and young men face an elevated risk of mental health problems and suicidality, yet they remain less likely than their female peers to seek professional help. Online counselling services such as krisenchat offer low-threshold support and may help reduce gender-specific barriers, but little is known about how young men use these services. ObjectiveThis study investigates male krisenchat users in comparison to other users, focusing on demographics, utilization patterns, satisfaction, chat topics, and barriers to help-seeking behavior, in order to generate insights for improving mental health support for young men. MethodsAnonymized data were obtained from n = 29,387 krisenchat users between January and December 2023. After data cleaning, the final sample comprised of N = 9,584 participants. Demographic information, utilization behavior, suicidality, and use of professional help services were documented by counsellors, while user satisfaction, recommendation rates, and emotional distress were assessed through voluntary surveys following consultation. ResultsYoung males accounted for 19.9% of krisenchat users, were on average older than female users and were less likely to have been in prior treatment. Male users sent fewer messages, accessed the service during late-night hours more often than females, and tended to find the service via search engines rather than institutional or social media channels. Compared to female users, they were less likely to disclose self-harm, family problems, or sexual violence, but more likely to bring up sexuality and LGBTQIA+ topics. Importantly, no gender difference was found for suicidality. Despite differences in some utilization patterns, acceptability outcomes -- including reductions in distress, satisfaction, and likelihood of recommending the service -- were comparable across genders, suggesting equivalent counselling benefits once engaged. ConclusionsDigital crisis services like krisenchat hold potential for reducing gender disparities in mental health support. However, targeted strategies to improve visibility, adapt communication styles, and strengthen follow-up pathways are essential to increase engagement and sustained help-seeking among young men. Study RegistrationDRKS00026671