Accepted for/Published in: JMIR Mental Health
Date Submitted: Nov 30, 2025
Date Accepted: Mar 17, 2026
Determinants of Digital Health Literacy Among Patients With Serious Mental Illness: A Cross-Sectional Survey
ABSTRACT
Background:
People with serious mental illness are increasingly using digital devices and the Internet for health information and services. However, many face challenges in navigating digital tools, which may limit their ability to benefit from online health resources and digital healthcare services.
Objective:
This study aimed to assess the digital health literacy among patients with serious mental illness and to identify factors influencing this literacy.
Methods:
A multisite cross-sectional survey was conducted using convenience recruitment from 2 psychiatric clinics, 1 day-care center, and 4 halfway houses in Taipei City, Taiwan, between May 2024 and February 2025. Self-reported data were collected using the eHealth Literacy Scale, the Attitudes Toward Computer/Internet Questionnaire, and the Mobile Device Proficiency Questionnaire. Generalized linear modelling was applied to identify factors associated with digital health literacy.
Results:
A total of 255 participants were included in the analysis, of whom 83.5% reported owning at least one digital device. Digital health literacy was significantly lower among individuals reporting greater perceived difficulty in using digital tools (B = −1.533, 95% CI = −2.350 to −0.717, p < 0.001) and higher distrust in online information (B = −0.986, 95% CI = −1.916 to −0.056, p = 0.038). By contrast, higher mobile device proficiency (B = 0.144, 95% CI = 0.008–0.281, p = 0.038) and greater self-efficacy (B = 1.777, 95% CI = 0.376–3.177, p = 0.013) were positively associated with digital health literacy.
Conclusions:
Despite widespread device ownership, patients with serious mental illness exhibited varied and generally suboptimal literacy in digital health. Perceived difficulty and distrust emerged as major barriers, whereas proficiency and self-efficacy served as key facilitators. These findings highlight the need for mental health professionals to integrate tailored digital skills training, confidence-building strategies, and ongoing support when designing digital health interventions for individuals with serious mental illness.
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