Digital exclusion among mental health service users: a qualitative investigation

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Background: Access to internet-enabled technology and online services has grown exponentially in recent decades. This growth potentially excludes some communities and individuals with mental health difficulties, who face a heightened risk of digital exclusion. But it is unclear what factors may contribute to digital exclusion in this population.

Objective: To explore in detail the problems of digital exclusion in mental health service users and potential facilitators to overcome it.

Methods: Semi-structured interviews were conducted with twenty mental health service users who were deemed to be digitally excluded. Participants were recruited from a large secondary mental health provider in South London, UK. Thematic analysis was employed to identify themes and sub-themes relating to historical and extant reasons for digital exclusion, and methods of overcoming it.

Results: Three major themes appeared to maintain digital exclusion:(i) a perceived lack of knowledge, (ii) being unable to access the necessary technology and services due to personal circumstances, and (iii) the barriers presented by mental health difficulties. Specific facilitators for overcoming digital exclusion included intrinsic motivation, and a personalised learning format which reflects the individual’s unique needs and preferences.

Conclusions: Multiple factors contribute to digital exclusion among mental health service users, including material deprivation and mental health difficulties. This means that efforts to overcome digital exclusion must address the multiple deprivations individuals may face in the offline world, in addition to their individual mental health needs. Additional facilitators include fostering an intrinsic motivation to overcome digital exclusion, and providing a personalised learning format tailored to the individual’s knowledge gaps, and preferred learning style.
Original languageEnglish
Article numbere11696
Number of pages9
JournalJournal of Medical Internet Research
Issue number1
Early online date9 Jan 2019
Publication statusPublished - 9 Jan 2019


  • Digital divide
  • Digital exclusion
  • Digital inequality
  • EHealth
  • Mental health
  • Mobile phone
  • Social exclusion
  • Technology


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