Background Adolescence is a critical period for the onset of mental health problems, a situation further exacerbated by recent global crises. This underscores the importance of low-threshold, anonymous online counseling services. Krisenchat , founded in Germany in 2020 following the COVID-19 outbreak, provides such support. While prior research has offered cross-sectional insights, little is known about changes in user characteristics and measures of the service's feasibility over time, especially regarding the chat topics addressed and in recognition of all gender identities. Objective This study examined the long-term feasibility and scalability of krisenchat over three years (2020–2023) and explored changes over time in user characteristics, service feasibility and satisfaction, emotional distress, and counseling topics. Methods This cross-sectional study analyzed retrospective, naturalistic, anonymous data on sociodemographic variables, utilization behavior, and user satisfaction from krisenchat users over three selected, consecutive time periods (Oct 2020–Mar 2021, N = 4,029; Oct 2021–Mar 2022, N = 6,647; Oct 2022–Mar 2023, N = 5,218). χ 2 tests were used to identify associations between users’ sociodemographic characteristics and chat topics over time. Kruskal–Wallis H tests examined measures such as age, emotional distress, user satisfaction, and perceived helpfulness. This was followed by an exploratory analysis of chat topics across time and genders. Results Users reported significantly reduced emotional distress after chat sessions. Across all periods, the average user was 17 years old and female, while engagement among males and gender-diverse individuals increased over time. krisenchat remained feasible and well-received in all time points. Key chat topics included psychosocial distress, mental health symptoms and emotional distress. Chat topics evolved, towards more psychosocial concerns. Conclusion This study highlights the robustness of krisenchat from 2020 to 2023, underscoring its sustained relevance in both pandemic and post-pandemic contexts. By integrating gender analyses and exploring chat topics over time, the study reveals novel insights into shifting user needs, such as increased psychosocial distress and relational concerns in post-pandemic periods. Observed trends, such as increased engagement among males and diverse users, emphasize the importance of tailored outreach efforts. These findings enrich the evidence base for digital mental health services and offer insights for future interventions. Study Registration DRKS00026671
Hug et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: