JMIR Publications

ABSTRACT

Background:

Digital exclusion, characterised by a lack of access to digital technology, connectivity, or digital skills, disproportionally affects marginalized groups. An important domain impacted by digital exclusion is access to healthcare. During Covid-19, healthcare services had to restrict face-to-face contact to limit the spread of the virus. The subsequent shift towards remote delivery of mental health care exacerbated the digital divide with limited access to remote mental health care delivery. In response, Camden & Islington NHS Foundation Trust (C&I NHS FT) launched an innovative Digital Inclusion Scheme.

Objective:

To examine the impact of facilitating digital inclusion in mental health access, C&I NHS FT through a trust-wide Digital Inclusion Scheme (DIS) for service users (SUs) who were at risk of digital exclusion without devices, connectivity, and/or reported poor digital skills. The scheme provided access to a loan digital device (a tablet), internet connectivity devices and mobile data, as well as personalised digital skills support.

Methods:

The Digital Inclusion Scheme went live in October 2021 and received 106 referrals by June 2022. Semi-structured interviews were conducted with 12 SUs to ask about their experience of accessing the Digital Inclusion Scheme. A thematic analysis identified themes and subthemes relating to the extent of their digital exclusion prior to engaging with the scheme and the impact of accessing a scheme on their ability to engage with digital technology and well-being.

Results:

There were ten major themes in total. Six major themes related to factors impacting on engagement with the scheme, including digital exclusion, relationship to Trust, the importance of personalised digital support, partnership working, device usability and accessibility and personal circumstances. Four major themes spoke to the impact of accessing the scheme, including improved access to services, impact on well-being, financial implications and a greater sense of empowerment.

Conclusions:

Participants reported an increased reliance on technology driving the need for digital inclusion; however, differences in motivation for engaging with the scheme were noted, as well as potential barriers, including lack of awareness, disability, and age. Overall, the experience of accessing the DIS was reported as positive, with participants feeling supported to access the digital world. The consequences of engaging with the scheme included greater perceived access to and control of physical and mental health care, improved wellbeing and a greater sense of empowerment. An overview of the lessons learned are provided along with suggestions for other health care settings who are looking to implement similar schemes.