Trust, Disclosure, and Anticipated Acceptability of Digital Mental Health Support Among Jordanian and Syrian Adolescent Girls: A Qualitative Study

Abstract

Adolescent girls may experience emotional distress within intersecting academic, familial, and social contexts, while anticipated judgment, concerns about confidentiality, and uncertainty about whom to trust may constrain disclosure and help-seeking. This study explored how Jordanian and Syrian adolescent girls understand emotional distress, negotiate disclosure and support, and evaluate the anticipated acceptability of digital mental health support. An exploratory qualitative design was used. Nine focus group discussions (FGDs) were conducted in Arabic with 39 girls aged 15–19 years who were purposively recruited through health, psychosocial, humanitarian, and community-service networks in Jordan. Each FGD included four to five participants. Data were analyzed using reflexive thematic analysis across the full dataset while retaining FGD and participant-group context. Three interrelated themes were developed: (1) distress under academic, familial, and social evaluation; (2) disclosure as calibrated risk management; and (3) anticipated digital support depends on demonstrable trustworthiness and retained control. Participants described disclosure as selective and shaped by the sensitivity of the concern, anticipated judgment, previous interpersonal experiences, confidentiality, and perceived control. Participants considered digital support more acceptable when it offered privacy, professional credibility, institutional legitimacy and accountability, and user control over the pace and extent of disclosure. We conceptualized trust as comprising interpersonal, professional, and institutional/platform dimensions, with privacy and control over disclosure operating as trust-enabling conditions. These findings describe anticipated acceptability rather than actual service uptake or effectiveness and identify empirically informed priorities for the co-design and evaluation of digital mental health services for adolescent girls.