Factors affecting the intention to use online mental health services

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Haixia Zhou
Lefei Fang
Longyuan Jiang
Chengcheng Fei
Wei Wu
Haiyan Yu
Cite this article:  Zhou, H., Fang, L., Jiang, L., Fei, C., Wu, W., & Yu, H. (2025). Factors affecting the intention to use online mental health services. Social Behavior and Personality: An international journal, 53(10), e14627.


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Online mental health services have emerged as essential alternatives to traditional care, particularly post-COVID-19, due to their accessibility, anonymity, and convenience. However, user adoption and continued use depend on various factors. We employed the unified theory of acceptance and use of technology (UTAUT) framework to investigate the factors influencing users’ willingness to continue using these services, with performance expectancy as a mediator. A survey of 288 users found positive relationships between continuous behavioral intention and factors such as performance expectancy, effort expectancy, price value, trust level, social influence, and facilitating conditions. Conversely, perceived risk was negatively correlated with intention and trust. Performance expectancy partially mediated the association between effort expectancy and continuous behavioral intention. Furthermore, fuzzy-set qualitative comparative analysis (fsQCA) identified three configuration pathway types: subjective expectation dominant, internal–external interaction, and external condition matching. This mixed-method study provides valuable insights into the sustained behavior of online mental health service users.
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