Mental Health Problems and Internet Access: Results From an Australian National Household Survey.

Lay San Too,Liana Leach,Peter Butterworth

doi:10.2196/14825

Abstract

BackgroundMental health support and interventions are increasingly delivered on the web, and stepped care systems of mental health services are embracing the notion of a digital gateway through which individuals can have access to information, assessment, and services and can be connected with more intensive services if needed. Although concerns have been raised over whether people with mental health problems are disadvantaged in terms of their access to the internet, there is a lack of representative data on this topic.ObjectiveThis study aimed to examine the relationship between mental health and internet access, particularly lack of access because of affordability issues.MethodsData from wave 14 of the Household, Income, and Labour Dynamics in Australia survey were used (n=15,596) in the analyses. Sample weights available in the survey were used to calculate the proportion of those with or without internet access for those with and without mental health problems and more severe long-term mental health conditions. These proportions were also calculated for those with and without internet access due, specifically, to affordability issues. Multinomial logistic regression analyses assessed the relationship between mental health status and internet access/affordability issues, adjusting for a range of covariates.ResultsAccess to the internet was poorer for those with mental health problems (87.8%) than those without mental health problems (92.2%), and the difference was greater when a measure of more severe mental health conditions was used (81.3% vs 92.2%). The regression models showed that even after adjusting for a broad range of covariates, people with mental ill health were significantly more likely to have no internet access because of unaffordability than those without mental ill health (mental health problems: relative risk ratio [RRR] 1.68; 95% CI 1.11-2.53 and severe mental health conditions: RRR 1.92; 95% CI 1.16-3.19).ConclusionsAs Australia and other nations increasingly deliver mental health services on the web, issues of equity and affordability need to be considered to ensure that those who most need support and assistance are not further disadvantaged.

Highlights

BackgroundIn Australia, as in many other countries, access to and use of the internet has become commonplace [1,2,3]
60% of respondents had a partner, 31.0% had children under 15 years old, 3.9% were unemployed, about half lived in a household with an annual gross income of more than Aus $100,000 (US $63,868), 21.7% experienced financial hardship, and 71.4% resided in major cities
In the analysis of the 2014-2015 National Health Survey, the Australian Bureau of Statistics (ABS) identified 11.7% of Australian adults with high or very high levels of psychological distress assessed using K10, a measure that is comparable with 5-item Mental Health Inventory OR (MHI-5) [34]

Summary

Introduction

BackgroundIn Australia, as in many other countries, access to and use of the internet has become commonplace [1,2,3]. It must be acknowledged that some research have raised concerns that various web-based interventions appear to be effective in research trials, their real-world efficacy may be limited by low adherence [9], the severity of patients’ illness, lack of support, and inadequate personalization of program content [10,11]. Sample weights available in the survey were used to calculate the proportion of those with or without internet access for those with and without mental health problems and more severe long-term mental health conditions These proportions were calculated for those with and without internet access due, to affordability issues. Conclusions: As Australia and other nations increasingly deliver mental health services on the web, issues of equity and affordability need to be considered to ensure that those who most need support and assistance are not further disadvantaged

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Conclusion