The Psychological and Behavioral Patterns of Online Psychological Help-Seekers before and during COVID-19 Pandemic: A Text Mining-Based Longitudinal Ecological Study

Online mental health service (OMHS) platforms have contributed significantly to the public’s mental health during the COVID-19 pandemic in China. However, it remains unclear why the public used OMHS platforms for psychological help-seeking (PHS) behavior and how PHS behavior varied across different stages of the COVID-19 pandemic. Based on the ecological PHS behavior data from two OMHS platforms, we extracted population, psychological problems, and influential factors of PHS behavior by text mining and time series analysis methods. Seven top-ranked psychological problems (i.e., depression and anxiety, lack of interest, suicidal tendencies, social phobia, feelings of being worried and afraid, suffering, anger) and seven influential factors (i.e., interpersonal relationships, love, family, work, psychotherapy, personal characteristics, marriage) were found. The online PHS behaviors related to different psychological problems and influential factors remained a growing trend before 2020 and have been increasing significantly due to the COVID-19 outbreak. Four main stages were found during the pandemic according to the changes in the online PHS population: sharp growth, significant decline, slight rebound, and slow decline. This study identified large-scale, spontaneous PHS behaviors among the online public during the COVID-19 pandemic and the various psychological problems and influential factors that varied across different stages of the pandemic, suggesting that the government and health practitioners should adopt effective policies and strategies to prevent and intervene in mental health problems for the online public.