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Abstract Background Mental health problems among university students are prevalent, and the availability of online mental health services in Indonesia has increased. However, implementation strategies are still in their early stages of development. This study aimed to explore the experiences and perspectives of Indonesian university students and psychologists regarding online mental health services. Methods Semi-structured online interviews were conducted with 21 participants (10 university students and 11 psychologists) in Indonesia between September and December 2022. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis to develop an interpretive understanding of patterns of meaning across the dataset. Results Through reflexive thematic analysis, we generated four themes: (1) fostering engagement and autonomy, reflected in participants’ accounts of feeling more control over time and choices and enhancing engagement through digital innovation; (2) therapeutic limits in digitally mediated care, including the missing human touch, disrupted therapeutic space, and barriers to complex care online; (3) challenges in implementation and delivery, comprising infrastructure gaps undermining care and service variation without standardization; and (4) designing for engagement and trust, covering accessible and easy to engage with, feeling supported in digital care, cultural and personal fit, and tailoring therapeutic approaches to individual needs. Across themes, differences in emphasis were observed, with students often highlighting emotional safety, usability, and flexibility, while psychologists tended to emphasize concerns related to assessment limitations, clinical standards, and the provision of comprehensive care. Both groups underscored the importance of culturally responsive and adaptable service models aligned with Indonesian social norms and values. Conclusions The findings suggest that while several factors influencing the implementation of online mental health services in Indonesia align with international evidence, context-specific considerations remain important. Designing culturally responsive, accessible, and supportive services may enhance the relevance and sustainability of online mental health care in Indonesia and other low- and middle-income settings.
Praptomojati et al. (Wed,) studied this question.