Action needed to address digital divide in mental health

Mental Health Reform in partnership with the HSE Mental Health Engagement and Recovery Office have today published a new report entitled ‘Digital Inclusion and Access to Mental Health Services.’

Digital mental health encompasses various services including online video therapy sessions, mental health apps, psychoeducation and online Cognitive Behavioural Therapy (CBT) programmes.

The report addresses the barriers and inequalities that create a “digital divide” which prevents disadvantaged socio-economic groups from accessing digital mental health services.

The digital divide has a disproportionate impact on older people, migrants and refugees, travellers, homeless people, prisoners, young people and people with vision or hearing impairment. Barriers arise from a lack of suitable connectivity and access to devices, costs and low digital literacy. Evidence indicates that people in these groups are also at a higher risk of experiencing mental health difficulties which creates further inequality. 

The report draws on a survey of 76 counsellors and psychotherapists who shared their experience of digital inclusion issues in their work with clients. Results show that the digital divide is a substantial issue, with almost one-half (46.7%) of practitioners rating it as having more than a little impact. This was considerably more likely amongst non-profit practitioners (61.6%) compared to private practitioners (37.2%).

Older people were most commonly mentioned as disadvantaged in their use of online channels, due to their lower digital confidence and skills. Individuals living in shared living arrangements were also frequently mentioned including people living in crowded households and those living in direct provision.

Practitioners working in the non-profit sector reported a higher likelihood of digital divide issues among clients compared to practitioners working in the private sector. Common barriers include lack of access to a private space, lack of equipment, poor confidence, connectivity issues, and the costs of connecting to a mobile plan.

The survey also asked practitioners whether they felt various specific actions or initiatives would help to reduce digital divide barriers and increase access to digital mental health services.  Over 70% of practitioners said that access to Wi-Fi in client settings and digital literacy training would be effective. Practitioners also endorsed initiatives such as community-based hubs where digital services could be accessed, free or low-cost devices and access to low-cost/free mobile data packages.

Commenting on the report, Fiona Coyle, CEO, Mental Health Reform said: 

“During the COVID-19 pandemic, the mental health sector rapidly switched to online mental health services to ensure access to support for those in need. As we emerge from the pandemic, remote therapy provision and other digital approaches will remain an important component of the mental healthcare system.

Technology has significant potential to improve access to mental health services. Digital mental health services can better reach and support disadvantaged groups typically underserved by traditional mental health services. While online approaches bring numerous benefits, certain population groups may face disadvantages if their needs are not addressed.

Digital mental health inclusion must be a key priority for the health sector to leverage the positive potential of digital mental health while reducing barriers to access.  The Department of Health and the HSE should give digital mental health inclusion high visibility and importance in current and forthcoming strategies on mental health. The report also recommends measures to provide public financial support towards the costs of broadband connectivity and devices to improve access and affordability for low-income groups.

It is evident that digital mental health inclusion can be a driver of better performance and enhanced outcomes for the mental health sector but increased funding and prioritisation are needed to fully realise its potential.”

Michael Ryan, Head of the HSE Mental Health Engagement and Recovery Office said: 

“We are delighted to launch this report on digital inclusion in partnership with Mental Health Reform. The purpose of the Mental Health Engagement and Recovery Office (MHER) is to support developing and driving core service improvement programmes in mental health services. As part of this, we aim to place the voice of lived experience at the heart of mental health service delivery and improvement.

The analysis and recommendations in the report provide a positive and concrete framework to strengthen digital mental health inclusion in the mental health sector. The research highlights the need to directly engage with service users on their experience of digital mental health inclusion and the importance of involving them in developing solutions and service co-design.

We look forward to working with our colleagues in the HSE and the voluntary and community sector to leverage the recommendations and insights in the report within the context of our national mental health policy, Sharing the Vision.”

Digital Inclusion and Access to Mental Health Services is available here.


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