Accepted for/Published in: JMIR Mental Health
Date Submitted: Jun 7, 2019
Date Accepted: Feb 10, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mental health problems and internet access: Results from an Australian national household survey
ABSTRACT
Background:
Mental health support and interventions are increasingly delivered online, and stepped-care systems of mental health services are embracing the notion of a digital gateway through which individuals can access to information, assessment, services and be connected with more intensive services if needed. However, concerns have been raised over whether people with mental health problems are disadvantaged in terms of their access to the internet, thus disproportionally excluding them from accessing these online treatments.
Objective:
The current study examined the relationship between mental health and internet access, and in particular lack of access due to unaffordability.
Methods:
Data from wave 14 of the Household Income and Labour Dynamics in Australia (HILDA) survey was used (n= 15,596) in the analyses. Sample weights available in the HILDA survey were used to calculate the proportion of those with/without internet access, for those with and without mental health problems. These proportions were also calculated for those with/without internet access due specifically to unaffordability. Multinomial regression analyses assessed the relationship between mental health status and internet access/unaffordability adjusting for a range of relevant socio-demographic covariates.
Results:
The weighted proportion of those with internet access was lower for those with mental health problems (87.8%) compared to those without mental health problems (92.2%). The regression models showed that even after adjusting for a broad range of covariates, people with mental health problems were significantly more likely to have no internet access due to unaffordability, than people without mental health problems (RRR = 1.68, 95% CI = 1.11‒2.53). This association was stronger when a more severe form of mental health measure was used (RRR = 1.92, 95% CI = 1.16−3.19).
Conclusions:
As Australia and other nations increasingly deliver mental health services online, the findings from the current study suggest equity and affordability issues need to be considered to ensure those who most need support and assistance are not further disadvantaged. Clinical Trial: N/A.
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