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

Psychological assistance hotlines provide low-threshold crisis support, but evidence is limited on how Chinese adolescents define useful hotline care. To identify adolescents’ hotline-service needs and develop a preliminary context-specific scale. In an exploratory sequential mixed methods study, 12 adolescent hotline users completed semi-structured interviews analyzed with Colaizzi’s method. The resulting 11-item Adolescent Psychological Assistance Hotline Service Need Scale (APAHSNS) was administered to 386 school-based adolescents. The sample was randomly divided for exploratory factor analysis (EFA; n = 193) and confirmatory factor analysis (CFA; n = 193). Group comparisons, correlations, and multiple regression were conducted. Qualitative analysis identified emotional safety, non-judgmental support, and closed-loop empowerment needs. The APAHSNS showed good internal consistency (Cronbach’s α = 0.883) and content validity (S-CVI/Ave = 0.927). EFA explained 69.98% of variance, and CFA supported the three-factor structure (χ²/df = 1.39, CFI = 0.980, TLI = 0.973, RMSEA = 0.045, SRMR = 0.044). The total score was 3.73 ± 0.62. More frequent negative emotions (β = 0.329), prior hotline use (β = 0.258), lower perceived social support (β=−0.194), and older age (β = 0.207) were associated with higher need scores (adjusted R²=0.369; all P < 0.001). Overall, 72.3% were willing to consider AI-enabled functions. In this regional school-based sample, adolescents’ hotline needs formed a three-dimensional structure. The findings provide preliminary measurement evidence and hypotheses requiring external, longitudinal, and clinical validation.