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

Introduction Boys 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.

This 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.

Anonymized 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.

Young 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.

Digital 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 Registration DRKS00026671 Competing Interest Statement JH, EK, KJE, ASP and CR-K confirm no conflicts of interest. ME, and RW, SS and JP are paid employees at krisenchat gGmbH. Funding Statement This study was conducted to evaluate aspects of the Jungenarbeit (Work with Boys) project at krisenchat, which was funded by the Techniker Krankenkasse health insurance company. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The publication was funded by the Open Access Publishing Fund of Leipzig University, supported by the German Research Foundation within the Open Access Publication Funding program. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethics Committeee of the Medical Faculty, Leipzig University, gave ethical approval for this work (file reference: 372/21-ek) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors.