School and Community Stakeholder Perceptions of a Free, Confidential Digital Mental Health Platform (Soluna): Mixed Methods Study Examining Barriers and Facilitators to Real-World Implementation at Scale and Early Impact.

Résumé

BACKGROUND: Mental health disorders are common among adolescents worldwide; yet, access to preventive and early intervention services remains limited. Digital mental health platforms may help bridge this gap, but little is known about how these platforms are perceived, implemented, and adopted by school and community stakeholders during early stages of rollout in real-world youth-serving settings.OBJECTIVE: This study aimed to examine school and community stakeholders' perceptions of a new, free, confidential digital mental health platform for youth (Soluna by Kooth Digital Health) in its first year of rollout, focusing on its features, barriers, and facilitators to early implementation and adoption, and early stakeholder perceptions of its perceived impact on youth mental health.METHODS: Surveys were distributed to 77 stakeholders (54 school staff and 23 community staff) in California from February to April 2025. Eligible participants were frontline staff directly engaging with youth in settings where the platform was offered. Following the survey, 17 stakeholders (12 school and 5 community) participated in semistructured interviews via Zoom (Zoom Communications). Survey data were analyzed descriptively to summarize perceptions and experiences, while interview data were analyzed using inductive-deductive reflexive thematic analysis to explore themes related to implementation, facilitators, and barriers.RESULTS: Most stakeholders (71.4%) agreed that the platform positively contributed to youth well-being, and 89.6% felt comfortable referring youth to it, indicating good acceptability. Free access (91%), availability during nontraditional hours (45%), and ease of use (42%) were identified by stakeholders as the most valuable features for youth. Facilitators of adoption included digital accessibility (87%), confidential peer support (84.1%), and youth choice in engagement (85.7%). Key barriers included stigma around mental health (64.7%) and lack of awareness of the platform's benefits (61%). Qualitative findings revealed three main categories: (1) perceived impact, including support for youth from diverse backgrounds and use as a supplemental resource when traditional services are limited; (2) facilitators to implementation and adoption, such as direct referrals, peer promotion, accessible framing focused on coping and life skills, supportive materials, and engagement from platform staff; and (3) barriers to implementation and adoption, including stigma and phone or internet access challenges in school settings. Stakeholders also emphasized the importance of practical resources and ongoing support to build confidence in using and recommending the platform.CONCLUSIONS: Stakeholders viewed the platform as a valuable and accessible tool to support youth mental health, particularly in underserved communities. Findings suggest that digital mental health platforms should address external barriers to adoption, including stigma around mental health, while also increasing awareness of available resources. Providing tailored implementation support demonstrates progress in these areas and can further strengthen adoption and engagement. These findings offer actionable recommendations for improving the design and delivery of digital mental health platforms in real-world youth-serving settings.