Adolescents’ needs for psychological assistance hotline services: an exploratory sequential mixed methods study

Adolescents who have used psychological assistance hotlines identified three central service needs: emotional safety, support without judgment and “closed-loop empowerment.” Researchers used these experiences to develop an 11-item questionnaire, the Adolescent Psychological Assistance Hotline Service Need Scale (APAHSNS), and administered it to 386 school-based adolescents in China. The study offers preliminary measurement evidence for describing what adolescents consider useful in hotline interactions, rather than testing whether a particular service improves mental health.

The investigation used an exploratory sequential mixed-methods design, beginning with semi-structured interviews of 12 adolescent hotline users. The researchers analyzed the interviews with Colaizzi’s method and identified emotional safety, non-judgmental support and closed-loop empowerment as the main themes. They then used these findings to construct the APAHSNS and surveyed a school-based sample of 386 adolescents. Participants were randomly divided into two groups of 193, with one group used for exploratory factor analysis and the other for confirmatory factor analysis.

Statistical results supported the proposed three-factor structure in this sample. The scale had a Cronbach’s alpha of 0.883, indicating good internal consistency, and its average scale-level content-validity index was 0.927. Exploratory factor analysis showed that the three factors explained 69.98% of the variance. Confirmatory factor analysis produced a chi-square-to-degrees-of-freedom ratio of 1.39, comparative fit index of 0.980, Tucker–Lewis index of 0.973, root mean square error of approximation of 0.045 and standardized root mean square residual of 0.044. The total APAHSNS score across the sample was 3.73 ± 0.62. These findings support the scale’s internal consistency and factor structure within the studied population, while the researchers described the evidence as preliminary and called for external, longitudinal and clinical validation.

Multiple regression identified four factors associated with higher reported hotline-service need. More frequent negative emotions had a standardized coefficient of 0.329, prior hotline use had a coefficient of 0.258, older age had a coefficient of 0.207 and lower perceived social support had a coefficient of −0.194; all reported P values were below 0.001. Together, these variables accounted for 36.9% of the adjusted variance in need scores. These are statistical associations in the school-based sample and do not show that the characteristics cause adolescents to have greater needs. Separately, 72.3% of participants said they would be willing to consider AI-enabled hotline functions. That finding describes willingness to consider such options, rather than demonstrating the accuracy, safety, effectiveness or actual use of an AI-enabled hotline.

Subject of Research: Preliminary development and validation of a scale measuring adolescents’ psychological assistance hotline-service needs

Article Title: Adolescents’ needs for psychological assistance hotline services: an exploratory sequential mixed methods study

Article References: Han, Y., Yu, Y., Tang, Y., & Miao, Y. (2026). Adolescents’ needs for psychological assistance hotline services: an exploratory sequential mixed methods study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07600-0

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07600-0

Keywords: adolescent mental health, psychological hotlines, service needs, scale development, mixed methods, factor analysis, social support, AI-enabled support, China, Adolescents, needs, psychological