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There are high rates of mental health needs in children in the United Kingdom, and parents are increasingly seeking help for their children's needs. However, there is not enough access to child and adolescent mental health services and parents are seeking alternative forms of support and information, often from web-based sources. Mumsnet is the largest web-based parenting forum in the United Kingdom, which includes user-created discussions regarding child mental health.
This qualitative investigation aimed to explore the emergent themes within the narratives of posts regarding child mental health on Mumsnet and to extrapolate these themes to understand the purpose of Mumsnet for parents of children and young people with mental health needs.
A total of 50 threads from Mumsnet
In total, 28 themes were extracted and organized into 3 domains. These domains were
This paper discusses the future of health information seeking. Future research is required to establish initiatives in which web-based peer-to-peer support and information can supplement professional services to provide optimum support for parents of children with mental health needs.
Recent years have seen a slight but notable increase in the prevalence of mental health disorders in children over time in the United Kingdom, 9.7% of those aged 5-15 years with a diagnosable condition in 1999, to 11.2% in 2017 [
Fortunately, there are effective treatments for childhood mental health disorders [
To date, no research has been conducted on the role of web-based fora for parents of children with mental health needs. Nonetheless, the purpose of user-driven web-based communities in relation to other health needs has been qualitatively examined by establishing emerging themes within the web-based narratives. Scharett and colleagues [
Similar lessons can be learned from research regarding the use of web-based platforms for other health needs by young people and parents. Kirk and Milnes [
Widemalm and Hjärthag [
The combination of a lack of access to services and the increasing popularity of web-based platforms leaves one questioning the future landscape of mental health support and information for parents of children with mental health needs. Could this popular and accessible method of web-based information and support be proliferated to help parents in need, especially those who desperately require support and information while on CAMHS waiting lists? As no research to date has been conducted on the role of web-based fora for parents of children with mental health needs, exploring the emerging themes within web-based fora for parents could aid our understanding of the reasons why parents of children with mental health needs use these sites. Furthermore, such research could provide evidence as to whether web-based platforms may be used as an adjunct and/or alternative to traditional services.
In summary, there are high rates of mental health problems in young people in the United Kingdom and an increase in help-seeking behaviors for these disorders. Despite effective treatments for these disorders, there is not enough access to CAMHS. Parents are increasingly turning to web-based methods of communication and information seeking, and many studies have highlighted not only the benefits of posting but also the emergent themes within web-based narratives about health care. However, there is a lack of research investigating the reasons why parents of children with mental health needs are turning to web-based sources of information or support seeking. This study aimed to explore the role of an internet forum for parents of young people with mental health needs (Mumsnet). Mumsnet is the largest parenting forum in the United Kingdom [
The study used qualitative methods outlined in Braun and Clarke [
This investigation analyzed posts on the Mumsnet discussion forum
The study received University College London (UCL) ethical approval (ref: 15209/001) and Research and Development approval from the UCL Joint Research and Development Office (19PP05). In line with the recommendations of the Association of Internet Researchers Ethics Working Committee [
The most recent threads of the
Only posts or comments within a thread in which the original post was directly related to child mental health were considered, and posts discussing child physical health or school attainment were excluded from the analysis. Posts had to be written by a person who identified as a parent or carer of a child with a mental health need, rather than professionals, as far as investigators could establish from reading the posts. The investigators excluded threads in which the original message was posted by agents other than parents or carers such as businesses seeking marketing research or professional mental health workers.
Flow chart of eligible threads and reasons for exclusion.
Parsehub was used to extract data from Mumsnet threads. Parsehub is a freely available web-based scraping tool designed to extract internet data. Any original posts or comments including information that could potentially identify the user, such as age, name, or location, were omitted manually by the researchers before the data were analyzed. Following this, the raw data were transferred into word documents for analysis.
All data were analyzed using the framework approach [
Following the application of the inclusion and exclusion criteria, 9 threads were excluded, and 41 threads were deemed eligible for analysis. The flowchart of the eligible threads is displayed in
A total of 28 themes were highlighted within the selected threads on Mumsnet
The number of threads discussing each mental health need.
Mental health need | Number of threads |
Anxiety | 10 |
Multiple | 6 |
Undiagnosed | 6 |
Depression | 5 |
Self-harm | 3 |
Not stated | 3 |
Autistic spectrum condition | 2 |
Attention-deficit hyperactivity disorder | 2 |
Intrusive thoughts | 1 |
Transgender | 1 |
Other | 1 |
Obsessive compulsive disorder | 1 |
Content grouped within this domain demonstrated Mumsnet users expressing a need for support or offering support.
Of 41 selected threads, 10 (24%) expressed a lack of or need for support:
I don’t have any support with this.
I have been looking for a support thread.
Of 41 analyzed threads, 10 (24%) included elements of the web-based community on Mumsnet. This included expressions of camaraderie between users:
You are amongst friends here.
This also included posts in which users updated and kept in touch with each other via the forum by asking questions:
I was just wondering how you are getting on?
Furthermore, posts within this category included instances comparing the use of the web-based community with discussing issues in person:
I’m not really talking to real people about this.
The largest category within the emotional support domain was offering emotional support, which featured in 21 of the 41 posts (51%). Posts within this category included comments in which Mumsnet users offered emotional support to other users. This was evident in the form of empathy and sympathy:
So sorry you’re feeling it too
This was also evident as Mumsnet users discovered that they were not alone in their struggles:
You are not alone.
Furthermore, emotional support was offered through well wishes and encouragement:
Know that things CAN get better.
In addition, praise for the parents by other Mumsnet users provided emotional support:
Your son is fortunate to have you on side and it’s great that you’re seeking advice.
Of 41 threads, 13 (32%) featured emotional support when users highlighted the similarities between their own and another user’s child. Parents shared comments that allowed Mumsnet users to normalize their experiences through learning that other mothers are experiencing similar issues:
He sounds very similar to my son.
The second domain centered around parents using Mumsnet as a platform to express their emotions.
Of 41 threads, 5 (12%) featured expressions of a desire to write about experiences:
I'm just going to use this as a place to vent and write everything down.
The most frequent theme within the emotional expression domain was struggling to cope, which featured in 16 of the 41 threads (39%). Within this theme, Mumsnet users professed their difficulties in managing their child’s mental health problems:
I’m struggling to help him.
This theme encompassed comments in which users blamed themselves for their children’s issues or expressed feelings of guilt about their child’s condition. This theme was apparent in 9 of the 41 selected threads (22%):
I do blame myself – have I broken her?
Parents often used the discussion thread as a platform to express their frustrations with the situation they were facing. This theme was apparent in 5 of the 41 threads (12%). This included posts discussing comparisons with physical health issues, expressing a desire for their child to be 'normal' and wishing for solutions to their children’s complex problems:
Cannot face it anymore, can't face talking to him, just want him to be normal.
Of 41 threads, 7 (17%) featured users’ expressions of desperation as their situation escalated or worsened:
I’m posting out of desperation.
Posts within this theme mentioned the users’ own mental health issues. This theme was found in 7 out of 41 threads (17%):
I have been to the GP very recently because I was too stressed with it all.
This theme also included posts in which users encouraged other users to seek help for their own mental health:
It's also important to look after your own mental health.
The second most common theme within the emotional expression domain was fear and worry, which occurred in 13 of the 41 threads (32%):
I'm absolutely terrified for my son.
Mumsnet users also used the forum to discuss their confusion regarding certain issues. This theme was apparent in 5 of the 41 threads (12%):
What’s OCD, what’s ASD and what is typical teenageryness. It’s impossible to untangle it all.
Mumsnet users often used the discussion forum to not only receive but also offer advice and information on certain problems.
Of 41 threads, 15 (36%) included complaints about services. These complaints were grouped into 3 broad categories.
Mumsnet users used the site to complain about accessing mental health services:
My DS has been referred to CAMHS, but as we all know, it can be a long wait.
It seems ridiculously hard [to find a specialist].
Mumsnet users also complained about the help they had received from mental health services:
The clinician was so disorganised, patronising and incompetent, he ended up making our son's problems worse.
Mumsnet users also complained more generally about the mental health system:
The underfunding has caused a huge mess of the service and this is where the anger should be directed.
The forum was also used as an opportunity to praise services. This theme occurred in 7 of the 41 threads (17%):
All professionals/practitioners are supportive, nice people.
Mumsnet users would often share stories from their own childhoods to allow other users to understand their children’s situations. This theme was found in 9 of the 41 threads (22%):
I suffered from horrible nausea and anxiety at the same age as your child.
Of the 41 threads, 14 (34%) featured instances of users offering advice to others by sharing what worked with their own child who was experiencing similar problems:
It helped us all to take the Psychiatrist’s advice to speak about the OCD as something other than our son and not lump them together.
The most frequently found theme within the advice and information domain was suggesting resources and techniques, which occurred in 21 of the 41 selected threads (51%). This theme incorporates instances in which parents suggested techniques, resources, or general advice on how to help their children, outside of help from professional services:
Look at gentle parenting sites to help him.
Often, parents would signpost other parents to appropriate resources:
Hi there are some useful resources here [shares website].
The second most common theme within the advice sharing domain was suggesting services, which occurred in 18 of the 41 threads (44%):
Ask your gp for a referral to your local camhs service.
Of 41 threads, 11 (27%) featured instances of users providing practical advice to other Mumsnet users on how to get appropriate support within various mental health services:
This is what I've found helps: Read up before your meetings (e.g. nice guidelines) and don’t fill gaps with more words.
As well as offering advice, users often share knowledge about childhood or certain disorders to enable other users to better understand their situation. This theme was found in 15 of the 41 threads (37%):
The NHS suggest that all children be given a vitamin d supplement.
Of 41 threads, 11 (27%) included occasions in which Mumsnet users shared their opinion on the original post. This theme incorporates instances in which users endeavor to aid the primary poster in establishing a diagnosis or reasons for the behavior in the presented case:
Do you think there's any chance she could be on the autistic spectrum?
The most common help-seeking theme was seeking advice, which occurred in 19 of the 41 threads (46%). This was achieved by asking direct questions or asking for advice from other Mumsnet users:
Anybody got any thoughts on how I help and support him?[Thread 30, page 1]
Of 41 threads, 13 (32%) included instances of Mumsnet being used as a platform for users to express that they did not know what to do:
I don't know how to help him.
Of 41 threads, 9 (22%) depicted parents asking for specific services and resources:
Can anyone suggest how to find a consultant who specialises in ADHD in children and who will see patients privately.
Of 41 threads, 6 (15%) contained instances of parents asking for extra services or resources while waiting to receive specialist help:
We are waiting for CAMHS appointment now as life for our family has gotten so intense because of this. In the mean-time I am looking for a parenting course.
This theme also incorporated instances in which users had completed certain interventions with a service and were looking for extra support:
He’s recently just finished a course of therapy for his anxiety in CAMHS, so we’re not too sure who to turn to.
Of 41 threads, 9 (22%) showed Mumsnet users expressing a desire to hear stories from other parents who were experiencing similar situations:
Any thoughts on what I should do from those who might have been through this?
Of 41 analyzed threads, 3 (7%) displayed how Mumsnet was used as a platform for parents to seek reassurance or guidance from other users by asking whether they should be concerned about their child’s behaviors:
Should I be worried about her?
As well as providing a platform to seek resources, the Mumsnet discussion forum also allowed users to ask questions about specific services or resources. This theme occurred in 7 of the 41 (17%) selected threads:
Has anyone's child been offered CBT (or DBT) through CAMHS/NHS? If so what was it for? How did they get it?
This qualitative investigation aimed to explore the role of a web-based forum for parents of young people with mental health needs (Mumsnet). To our knowledge, this is the first investigation of web-based fora by parents of children with mental health needs. The main domains derived from the narratives were
The most common form of assistance featured on Mumsnet was offering and receiving emotional support, which featured in 21 of the 41 threads (51%). This is consistent with the research by Widemalm and Hjärthag [
Of 41 threads, 10 (24%) embodied the nature of a web-based community, including instances of updating other users and expressing statements of camaraderie. This extends previous research on Mumsnet, highlighting the community nature of the forum through a questionnaire survey and discourse analysis of discussions related to belonging on the site [
Although this research has suggested that social support can be meaningfully sought and received on web-based platforms, one must be cautious as, in line with previous research [
Parents expressed concerns regarding not only their inability to help their children but also their confusion over where to look for help. As a lack of knowledge regarding child mental health conditions is a significant barrier to seeking professional help [
Many posts included discussions about services. A proportion included parents asking direct questions about specific resources and services (7/41, 17%), some included information on how to access specialist care (11/41, 27%), some included providing service recommendations (18/41, 44%), and others asked for service recommendations (9/41, 22%). This suggests that Mumsnet serves as a means to gather information about services, rather than being a replacement for CAMHS and other services. This finding supplements previous research, suggesting parents want information about how CAMHS works before their first appointment [
Of 41 threads, 15 (36%) in the discussion forum contained a complaint about mental health services, compared with 17% containing praise. This contradicts a previous cross-sectional study examining parent and child satisfaction with CAMHS using a questionnaire [
Parents offered personal experiences from looking after their child in 14 of the 41 threads (34%) and offered personal experiences from their own childhoods in 9 of the 41 threads (22%). This supports the suggestion that personal expertise shared on web-based platforms is expressed through stories from people who have experienced certain situations that are more accessible to others [
Of 41 threads, 7 (17%) included examples of parents using Mumsnet when their child’s condition had escalated, which adds a new domain to previous research suggesting people seek web-based support at a critical period in their experiences of mental health issues [
On sites such as Facebook, users are conscious of revealing concerns around stigmatizing illnesses because of the identifiable nature of the site [
This study is not without its flaws. There is a lack of demographic data available about Mumsnet users because of both the anonymized nature of the site and ethical restrictions that required any identifiable information such as age or occupation to be removed. Thus, inferences cannot be made about whether sample characteristics may have influenced the results. Nonetheless, Mumsnet census data report that the majority of its users are middle-class, university-educated women, and 74% of users have a household income of over the national average [
As discussed, interventions and resources could be created to cater to the needs of the members of Mumsnet, given the site’s vast popularity and influence among British mothers [
In conclusion, the study suggests that parents of children with mental health needs use Mumsnet discussions to offer and consequently receive emotional support and to suggest general advice, techniques, and resources that could be applied outside of help from professional services. In this study, the need for information and advice was particularly apparent for parents who had yet to begin their journey with CAMHS. Overall, this suggests an important role of web-based support for parents looking after young people with mental health needs that warrants further exploration.
Domains, themes and subthemes.
Child and Adolescent Mental Health Services
National Institute for Health Research
University College London
This work is supported by the National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the National Health Services, the NIHR, or the Department of Health.
None declared.