Online consultation based on Internet technology is gradually becoming the main way to seek health information and professional assistance. Online user reviews, such as content reviews and star ratings, are an important basis for reflecting users’ views on the effectiveness of health services. Here, we used user reviews related to online psychological consultation services for content feature mining and usefulness analyses. We used a professional online psychological counseling service platform in China to collect user reviews that were liked by users as a data sample for a content analysis. An LDA topic model, dictionary-based sentiment analysis, and the NRC Word-Emotion Association Lexicon were used to extract the topic, sentiment, and context features of the content of 4254 useful reviews, and the influence of these features on the usefulness of the reviews was verified by a multiple linear regression analysis. Our results show that the content of online reviews by psychological counseling users presented a positive emotional attitude as a whole and expressed more views on the process, effects, and future expectations of counseling than on other topics. There was a significant correlation between the topic, sentiment, and context features of a user review and its usefulness: reviews giving high scores and containing topics such as “ease emotions” and “consulting expectations” received more user likes. However, the usefulness of a review was significantly reduced if it was in existence for too long. This research provides valuable suggestions for understanding the needs and emotional attitudes of users with mental health problems in terms of online psychological consultation; identifying the factors that affect the number of likes a review receives can help platform users write better consultation evaluations and thereby provide greater usefulness. In addition, the use of online reviews generated by users for content analysis effectively supplements the current research on online psychological counseling in terms of data and methods.