Abstract
BACKGROUND: Rising rates of anxiety among teens necessitate innovative approaches for implementing evidence-based mental health support. Public libraries, seen as safe spaces for patrons with marginalized identities, offer free public services such as broadband internet access. Many teens spend significant amounts of time in their local libraries due to the safety of this space as well as the trusted adults working there. The American Library Association has shifted its priorities to focus more on mental health through employing social workers and providing mental health programs. As such, public libraries may be promising sites for the implementation of digital mental health (DMH) programs for teens. OBJECTIVE: This study aimed to examine how teens who attended their local public library experienced and managed their anxiety, what mental health supports they were interested in receiving, and how DMH programs and public libraries can meet their needs. METHODS: We interviewed 16 teens aged 12-18 (mean 15.2, SD 2.0) years who used the library frequently at the time of the interviews. Of these teen patrons, 56% (9/16) identified as female, 31% (5/16) identified as male, and 12% (2/16) identified as nonbinary. Most (11/16, 69%) identified as either White or Black or African American individuals, with the remainder (5/16, 31%) identifying as Hispanic or Latino or Chinese American individuals or with ≥2 races. The interviews were individual and semistructured, designed to elicit recommendations for designing and implementing digital tools in libraries to improve teen mental health. Interview transcripts were coded by multiple coders using thematic analysis to synthesize key themes. RESULTS: Teens reported experiencing uncontrollability, unpredictability, and anger related to their anxiety, which they managed using strategies such as guided breathing, distress tolerance, and social connection. They also talked about other helpful management techniques (eg, progressive muscle relaxation, journaling, and mood tracking). Teens underscored the importance of pairing mood tracking with daily activities to reveal patterns. They also stressed the significance of context and anxiety severity when choosing anxiety management strategies. Teens underscored the centrality of the public library in their lives and their view of it as a safe space where they can easily access resources and connect with friends and trusted adults. When considering the design of a DMH program implemented in libraries, they suggested including personalization for different identities, gamification, and simple navigation. Teens emphasized the importance of protecting their privacy within digital programs and that their end goal was to use the skills learned in the DMH program offline. CONCLUSIONS: Teens who frequently used their local public library expressed interest in receiving digital tools via libraries to help them manage anxiety. Their recommendations will help inform future research on the adaptation and implementation of DMH programs for teens in public libraries.