JMIR Publications

ABSTRACT

Background:

Depression and anxiety are the most common mental health conditions and were identified as leading contributors to global disability in 2016. People with these conditions rely on Web-based resources as a source of accurate health-information, convenient and effective treatment, and essential social support. However, a recent systematic review revealed several potentially limiting difficulties that this group experiences online, and also suggested that there is a partial understanding of these difficulties as only difficulties associated with neuro- and no socio-cognitive deficits were identified. Therefore, this study fills this knowledge gap and contributes to a more robust and fuller understanding of the difficulties this group experiences online.

Objective:

The objective of this study was to identify the difficulties people with depression and anxiety experience when using the Web and the Web activities that are most associated with the experience of difficulties.

Methods:

The study employed data triangulation using face-to-face semi-structured interviews with 21 participants affected by depression and anxiety, and a comparison group (7 participants) without mental disorders (study 1), and a persona-based expert online survey with 21 mental health practitioners who treat people with depression and anxiety (study 2). Framework analysis for both studies proceeded through 5 stages: (1) familiarization, (2) identifying a thematic framework, (3) indexing, (4) charting and (5) mapping and interpretation.

Results:

Four themes and 12 sub-themes emerged describing the difficulties people with depression and anxiety experience online. Difficulties related to the sub-theme "Lack of control over access and usage" were most common and affected 90% (19/21) of participants. A comparison of these difficulties with the difficulties reported by participants without mental health conditions revealed that both groups have markedly different experiences of difficulty online. Three themes and 10 sub-themes emerged describing the potential difficulties that people with depression and anxiety may experience online as reported by mental health practitioners. Practitioners linked these difficulties with 22 common impairments, limitations in activities of daily life and diagnostic criteria associated with depression and anxiety.

Conclusions:

People with depression and anxiety also experience difficulties when using the Web that are related to the socio-cognitive deficits associated with their conditions. Mental health practitioners have a good awareness of the difficulties that people with depression and anxiety are likely to experience when using the Web. This investigation has contributed to a fuller understanding of these difficulties and provides innovative guidance on how to remove and reduce them for people with depression and anxiety when using the Web.