Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2023

Open Access 01-12-2023 | COVID-19 | Research

Digital health literacy and digital engagement for people with severe mental ill health across the course of the COVID-19 pandemic in England

Authors: P Spanakis, B Lorimer, E Newbronner, R Wadman, S Crosland, S Gilbody, G Johnston, L. Walker, E Peckham

Published in: BMC Medical Informatics and Decision Making | Issue 1/2023

Login to get access

Abstract

Background

An unprecedented acceleration in digital mental health services happened during the COVID-19 pandemic. However, people with severe mental ill health (SMI) might be at risk of digital exclusion, partly because of a lack of digital skills, such as digital health literacy. The study seeks to examine how the use of the Internet has changed during the pandemic for people with SMI, and explore digital exclusion, symptomatic/health related barriers to internet engagement, and digital health literacy.

Methods

Over the period from July 2020 to February 2022, n = 177 people with an SMI diagnosis (psychosis-spectrum disorder or bipolar affective disorder) in England completed three surveys providing sociodemographic information and answering questions regarding their health, use of the Internet, and digital health literacy.

Results

42.5% of participants reported experiences of digital exclusion. Cochrane-Q analysis showed that there was significantly more use of the Internet at the last two assessments (80.8%, and 82.2%) compared to that at the beginning of the pandemic (65.8%; ps < 0.001). Although 34.2% of participants reported that their digital skills had improved during the pandemic, 54.4% still rated their Internet knowledge as being fair or worse than fair. Concentration difficulties (62.6%) and depression (56.1%) were among the most frequently reported symptomatic barriers to use the Internet. The sample was found to have generally moderate levels of digital health literacy (M = 26.0, SD = 9.6). Multiple regression analysis showed that higher literacy was associated with having outstanding/good self-reported knowledge of the Internet (ES = 6.00; 95% CI: 3.18–8.82; p < .001), a diagnosis of bipolar disorder (compared to psychosis spectrum disorder – ES = 5.14; 95% CI: 2.47–7.81; p < .001), and being female (ES = 3.18; 95% CI: 0.59–5.76; p = .016).

Conclusions

These findings underline the need for training and support among people with SMI to increase digital skills, facilitate digital engagement, and reduce digital engagement, as well as offering non-digital engagement options to service users with SMI.
Appendix
Available only for authorised users
Literature
1.
Strauss GP, Raugh IM, Zhang L, Luther L, Chapman HC, Allen DN, et al. Validation of accelerometry as a digital phenotyping measure of negative symptoms in schizophrenia. Schizophrenia. 2022;8(1):37.CrossRefPubMedPubMedCentral
2.
Depp CA, Bashem J, Moore RC, Holden JL, Mikhael T, Swendsen J, et al. GPS mobility as a digital biomarker of negative symptoms in schizophrenia: a case control study. npj Digit Med. 2019;2(1):108.CrossRefPubMedPubMedCentral
3.
Torous J, Kiang MV, Lorme J, Onnela J-P. New Tools for New Research in Psychiatry: a scalable and customizable platform to Empower Data Driven Smartphone Research. JMIR Mental Health. 2016;3(2):e16.CrossRefPubMedPubMedCentral
4.
Torous J, Larsen ME, Depp C, Cosco TD, Barnett I, Nock MK, et al. Smartphones, sensors, and machine learning to Advance Real-Time prediction and interventions for suicide Prevention: a review of current progress and next steps. Curr Psychiatry Rep. 2018;20(7):51.CrossRefPubMed
5.
Chivilgina O, Wangmo T, Elger BS, Heinrich T, Jotterand F. mHealth for schizophrenia spectrum disorders management: a systematic review. Int J Soc Psychiatry. 2020;66(7):642–65.CrossRefPubMed
6.
Kopelovich SL, Monroe-DeVita M, Buck BE, Brenner C, Moser L, Jarskog LF, et al. Community Mental Health Care Delivery during the COVID-19 pandemic: practical strategies for improving care for people with Serious Mental illness. Commun Ment Health J. 2021;57(3):405–15.CrossRef
7.
Newbronner E, Spanakis P, Wadman R, Crosland S, Heron P, Johnston G et al. Exploring Access to Mental Health and Primary Care Services for people with severe Mental Illness during the COVID-19 restrictions. Front Psychiatry. 2022;12.
8.
Ben-Zeev D. The Digital Mental Health Genie is out of the Bottle. Psychiatric Serv. 2020;71(12):1212–3.CrossRef
9.
Ndayishimiye C, Lopes H, Middleton J. A systematic scoping review of digital health technologies during COVID-19: a new normal in primary health care delivery. Health and Technology. 2023;13(2):273–84.CrossRefPubMedPubMedCentral
10.
Spanakis P, Heron P, Walker L, Crosland S, Wadman R, Newbronner E et al. Use of the internet and Digital Devices among people with severe Mental Ill Health during the COVID-19 pandemic restrictions. Front Psychiatry. 2021;12.
11.
12.
Dickerson F, Origoni A, Rowe K, Katsafanas E, Newman T, Ziemann RS, et al. Risk factors for natural cause mortality in a cohort of 1494 persons with serious mental illness. Psychiatry Res. 2021;298:113755.CrossRefPubMed
13.
Hayes JF, Marston L, Walters K, King MB, Osborn DPJ. Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014. Br J Psychiatry. 2017;211(3):175–81.CrossRefPubMedPubMedCentral
14.
Badcock JC, Adery LH, Park S. Loneliness in psychosis: a practical review and critique for clinicians. Clin Psychol Sci Pract. 2020;27(4):50.CrossRef
15.
Spanakis P, Peckham E, Mathers A, Shiers D, Gilbody S. The digital divide: amplifying health inequalities for people with severe mental illness in the time of COVID-19. Br J Psychiatry. 2021;219(4):529–31.CrossRefPubMedPubMedCentral
16.
17.
Spanakis P, Wadman R, Walker L, Heron P, Mathers A, Baker J et al. Measuring the digital divide among people with severe mental ill health using the essential digital skills framework. Perspect Public Health. 2022:17579139221106399.
18.
Greer B, Robotham D, Simblett S, Curtis H, Griffiths H, Wykes T. Digital Exclusion among Mental Health Service users: qualitative investigation. J Med Internet Res. 2019;21(1):e11696.CrossRefPubMedPubMedCentral
19.
Robotham D, Satkunanathan S, Doughty L, Wykes T. Do we still have a Digital divide in Mental Health? A five-year survey follow-up. J Med Internet Res. 2016;18(11):e309.CrossRefPubMedPubMedCentral
20.
Athanasopoulou CA-O, Välimäki M, Koutra K, Löttyniemi E, Bertsias A, Basta M, et al. Internet use, eHealth literacy and attitudes toward computer/internet among people with schizophrenia spectrum disorders: a cross-sectional study in two distant european regions. BMC Med Inf Decis Mak. 2017;17(1):136.CrossRef
21.
Morton E, Ho K, Barnes SJ, Michalak EE. Digital Health literacy in bipolar disorder: International web-based survey. JMIR Ment Health. 2021;8(10):e29764.CrossRefPubMedPubMedCentral
22.
Galletly C, Lincoln A, Arford T. In: Moore R, Perry D, editors. Health literacy and people with mental illness. Health Literacy: Nova Science Publishers; 2013.
23.
Mackey LM, Doody C, Werner EL, Fullen B. Self-management skills in Chronic Disease Management: what role does health literacy have? Med Decis Making. 2016;36(6):741–59.CrossRefPubMed
24.
25.
26.
27.
Choi NG, DiNitto DM. The Digital divide among low-income homebound older adults: internet use patterns, eHealth literacy, and attitudes toward Computer/Internet use. J Med Internet Res. 2013;15(5):e93.CrossRefPubMedPubMedCentral
28.
Chung S-Y, Nahm E-S. Testing Reliability and Validity of the eHealth Literacy Scale (eHEALS) for Older Adults Recruited Online. CIN: Computers, Informatics, Nursing. 2015;33(4).
29.
Stekhoven DJ, Stekhoven MDJ. Package ‘missForest’. R package version. 2013;1.
30.
Stekhoven DJ, Bühlmann P. MissForest—non-parametric missing value imputation for mixed-type data. Bioinformatics. 2012;28(1):112–8.CrossRefPubMed
31.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA, for the Ambulatory Care Quality Improvement P. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for Problem drinking. Arch Intern Med. 1998;158(16):1789–95.CrossRefPubMed
32.
33.
Kung CSJ, Steptoe A. Changes in internet use patterns among older adults in England from before to after the outbreak of the COVID-19 pandemic. Sci Rep. 2023;13(1):3932.CrossRefPubMedPubMedCentral
34.
35.
36.
Rotondi AJ, Sinkule J, Haas GL, Spring MB, Litschge CM, Newhill CE, et al. Designing websites for persons with cognitive deficits: design and usability of a psychoeducational intervention for persons with severe mental illness. Psychol Serv. 2007;4(3):202–24.CrossRefPubMedPubMedCentral
37.
Rock PL, Roiser JP, Riedel WJ, Blackwell AD. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med. 2014;44(10):2029–40.CrossRefPubMed
38.
Barch DM, Pagliaccio D, Luking K, Moran EK, Culbreth AJ. Pathways to motivational impairments in psychopathology: common Versus Unique Elements Across Domains. In: Neta M, Haas IJ, editors. Emotion in the mind and body. Cham: Springer International Publishing; 2019. pp. 121–60.CrossRef
39.
Hoffman L, Wisniewski H, Fau - Hays R, Hays R, Fau - Henson P, Henson P, Fau - Vaidyam A, Vaidyam A, Fau - Hendel V, Hendel V, Fau - Keshavan M et al. Digital Opportunities for Outcomes in Recovery Services (DOORS): A Pragmatic Hands-On Group Approach Toward Increasing Digital Health and Smartphone Competencies, Autonomy, Relatedness, and Alliance for Those With Serious Mental Illness. (1538 – 1145 (Electronic)).
40.
Camacho E, Torous J. Impact of digital literacy training on outcomes for people with Serious Mental Illness in Community and Inpatient Settings. Psychiatric Serv. 2022;74(5):534–8.CrossRef
Metadata
Title
Digital health literacy and digital engagement for people with severe mental ill health across the course of the COVID-19 pandemic in England
Authors
P Spanakis
B Lorimer
E Newbronner
R Wadman
S Crosland
S Gilbody
G Johnston
L. Walker
E Peckham
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2023
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-023-02299-w

Other articles of this Issue 1/2023

BMC Medical Informatics and Decision Making 1/2023 Go to the issue

Research article

Enhancing efficiency and capacity of telehealth services with intelligent triage: a bidirectional LSTM neural network model employing character embedding

Research

Re-investigation of functional gastrointestinal disorders utilizing a machine learning approach

Research

XGBoost-SHAP-based interpretable diagnostic framework for alzheimer’s disease

Research

Data management system for diabetes clinical trials: a pre-post evaluation study

Research

Prediction of inappropriate pre-hospital transfer of patients with suspected cardiovascular emergency diseases using machine learning: a retrospective observational study

Research

Prostate cancer detection using e-nose and AI for high probability assessment