Negative Online Experiences and Reporting Rates in Youth With Mental Health Conditions.

OBJECTIVE

Growing engagement with digital spaces among children and adolescents increases the risk of negative online experiences (NOE). This study examined the prevalence, risk factors, and reporting barriers for NOE among youth with mental health and neurodevelopmental conditions.

METHOD: A cross-sectional, mixed-methods study between January and July 2023 was conducted using a community-based sample from the Child Mind Institute's Healthy Brain Network. A total of 1,009 youth aged 9 to 15 years (58.4% male; mean age = 11.79 years, SD = 1.71 years) completed a quantitative survey. A subsample (n = 109) participated in a qualitative follow-up involving a 3-day moderated online bulletin board.

RESULTS

Of the 1,009 participants, 26.6% experienced NOE in the previous year, with 68.7% reporting multiple incidents; however, 80% did not report them. Factor analyses identified 3 key reporting barriers: reporting process, reporting policy, and emotional barriers. Social aptitude, mental health symptoms, and parenting style predicted youths' likelihood of encountering NOE and key reporting barriers. Qualitative findings indicated that reporting decisions involved assessing malice, perpetrator intent, and NOE type; ambiguity in these areas contributed to reporting uncertainty.

CONCLUSION

This study highlights the gap between the high prevalence and low reporting rates of NOE among youth with mental health and neurodevelopmental conditions. Identified demographic, clinical, and family factors were associated with increased risk of experiencing NOE and the 3 reporting barriers. Findings underscore the need for targeted, developmentally appropriate strategies involving policymakers, technology developers, clinicians, and educators to support safer online environments for at-risk youth.

CLINICAL GUIDANCE: • Educate children and families about online reporting processes using developmentally appropriate, clear, and accessible language.• Encourage parents to adopt consistent, supportive involvement in their children's online activities, as positive parenting was associated with lower risk and reporting barriers.• Address emotional barriers by normalizing help-seeking, validating fears of embarrassment or retaliation, and connecting youth with safe peer or adult support.• Collaborate with schools and digital platforms to advocate for user-friendly reporting tools and resources tailored to younger or more vulnerable users.