Young People's Satisfaction With and Perceived Impact of a Multichannel Mental Health Helpline During and After COVID-19 Pandemic: Mixed Methods Analysis of Cross-Sectional Survey Data.

Background: In the United Kingdom, there was an increased demand for young people's mental health helpline services during COVID-19 pandemic, when face-to-face services were often inaccessible. Despite this, there is scant research examining young people's experiences with these helplines during the pandemic and postpandemic periods. Objective: Using a cross-sectional survey, this mixed methods study aims to examine young people's (aged 16-25+ years) experiences with the multichannel helpline provided by The Mix (Mental Health Innovations), the United Kingdom's leading online mental health support service for young people during and after the pandemic. Methods: From February 2020 to October 2023, approximately 16,000 users aged 16-25+ years contacted The Mix's helpline. All users were sent an email by The Mix following helpline contact to answer their user survey. Of these, 796 participants aged 16-25+ years answered the survey, representing a response rate of 5%, with a survey completion rate of 65.3%. To address potential nonresponse bias and missing data concerns, a multiple imputation procedure using the Multiple Imputation by Chained Equations (MICE) package in R (R Core Team) provided a final imputed sample for both the pandemic (n=295) and postpandemic (n=501) periods. Open-ended survey responses from users were also explored. Of the 796 participants who responded to the survey, there were 1183 open-ended responses from 486 respondents. Of these, a total of 731 open-ended responses (approximately 60% of the total responses) were coded. The criteria for inclusion were applied by 2 independent coders. Excluded responses focused on single words (eg, "thanks"), irrelevant text, or duplicated entries, ensuring only responses containing substantive feedback were analyzed. Results: During the pandemic, young people who contacted the helpline reported greater satisfaction after the first lockdown and a stronger perceived impact on their well‑being after the first lockdown and during the second and third lockdowns, compared with those who contacted the helpline during the gradual easing period; phone users reported higher satisfaction than those using the contact form. Postpandemic, helpline users who identified as "other" in terms of their gender reported less satisfaction, while male users reported a greater impact on their well-being compared to female users. Qualitative analysis revealed how the participants felt supported by the helpline, such as "feeling heard" and "being empowered," and areas for improvement across service delivery, protocol, and technicalities. Conclusions: The findings highlight the important role that helplines play in supporting young people's mental health, particularly in crises like the pandemic. This study underscores the need for service improvements to ensure young people continue to feel supported by helplines, highlighting key areas for improvement in service delivery, protocols, and technical infrastructure. Future research should explore channel preferences and minority experiences, often underrepresented in helpline studies.