Objective Up to half of India’s college-going emerging adult (18-25-year-old) population experience psychological distress but few seek mental health support. To improve service access and adoption in this population, our study explores language used to communicate mental health concerns, identifies availability and accessibility barriers, and explores digital mental health delivery as a potential solution. Methods An exploratory-descriptive qualitative design guided 20 focus group discussions with 106 participants in two underserved states in India. Thematic analysis identified 275 initial codes, through line-by-line, inductive coding grounded in participants’ language. These were later distilled into 63 distinct first-level codes, 12 categories, and four final themes. Results Findings suggest that emerging adults balance everyday stress through self-regulation and often trivialize their mental health concerns due to fear of stigma and labeling, contributing to barriers in service access. Findings also indicate that emerging adults perceive digital mental health services to be an accessible, low-risk option, but prefer hybrid models that could include in-person sessions after trust in confidentiality and privacy are established within the therapeutic relationship. Additionally, the findings further suggest that hybrid services should be tailored for this population, and should reflect their colloquial language, hesitancy toward help-seeking, and everyday stressors. Conclusion Mental health service uptake among emerging adults in underserved regions can be improved through flexible, user-driven, and context-dependent hybrid care models that combine digital and in-person support. Foregrounding everyday language and its role in stigma and help-seeking, our study points to new directions for designing more responsive mental health interventions.
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