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Exploring use and views about online mental health support: A study of users of a Complex Depression, Anxiety and Trauma Service. (Preprint)


 BACKGROUND
 Digital technology has been proposed to support health and wellbeing in those with complex mental health needs.
 
 
 OBJECTIVE
 The aim of this study was to investigate use of the internet by a group of service users with complex depression, anxiety and trauma and their attitudes and perspectives towards online help
 
 
 METHODS
 Mixed methods cross-sectional design using a survey and thematic analysis of individual semi-structured interviews.
 
 
 RESULTS
 66 of 575 (11.5%) service users completed the survey. Most were female (63%), from a White British background (61.5%) and identified English as their first language (77%). 52% had more than one mental health diagnosis and on average had been in contact with mental health services for over 10 years. 67% had regular access to a smartphone and 64% to a laptop or desktop. Participants were reasonably confident using digital devices and had previously looked at mental health information online. Of those who had not 57% said they would consider doing so. Most had not accessed psychological treatment online, and 52% said they would not consider doing so. 
27 service users participated in the interviews. Two main themes were derived: 1) motivators and 2) de-motivators of health-related internet use. Motivators included previous positive experiences online, perceived advantages, good website design and branding and individual enablers such as IT skills and improved mental state. De-motivators included previous unhelpful experiences resulting in negative emotions, unreliable or contradictory information and barriers such as poor design and interference due to mental health symptoms and avoidance.
 
 
 CONCLUSIONS
 Clinicians should routinely enquire about internet use in assessments and provide information to service users regarding recommended websites or apps. Education and support for service users to improve their e-health literacy may also be beneficial. Research including service users with severe and complex mood and anxiety disorders may help in improving the accessibility and use of online interventions by this group.
 
 
 CLINICALTRIAL
 Health Research Authority (IRAS 214069).
