E-MENTAL HEALTH NICE TO HAVE OR MUST HAVE? Exploring attitudes toward e-mental health in the general population

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1 E-MENTAL HEALTH NICE TO HAVE OR MUST HAVE? Exploring attitudes toward e-mental health in the general population Jennifer Apolinário-Hagen & Viktor Vehreschild FernUniversität, Dep. of Health Psychology, Germany Oral communication 6 th May :00 17:30 h 3 rd IPLeiria International Health Congress Session OC.B-6

2 BACKGROUND & OBJECTIVES What we already know In the present research literature, e-mental-health is associated with benefits such as improved access and reduced barriers (e.g. stigma) to mental health care including online self-help services and psychotherapy [1]. However, despite the slow implementation of e-mental health service into health care, the evidence base on acceptability and attitudes toward e- therapies from (potential) users perspective is very limited [1,2]. Objectives To explore attitudes towards e-mental health in the general population. To identify the status of utilisation of publicly available online health services. How are the public s views on web-based psychological treatments? How aware is the public of online self-help and web-based treatments? 2

3 Table 1. Attitudes toward e-therapy ( At-E-Therapy ) Self-Report Measure Measure: Self-developed 17-item-measure to assess attitudes toward e-therapies using a 5-point-rating scale ranging from 1 strongly disagree to 5 strongly agree (statements reflecting commonly proposed benefits and risks) Rationale: Literature review, expert interviews (psychotherapist), and components of different frameworks such as the Unified Theory of Acceptance and Use of Technology (UTAUT [3]) Feasibility was confirmed by a recent pilot study with a beta-version of the measure (N = participants; n = excl. n = 103 Paper-pencil with n = 26 outpatients) (1) Perceived comparabitly (to face-to-face therapies) 2. Internet therapies are able to replace conventional psychotherapies in the future. (e.g. acceptability, compatibility with social norms) 8. Trust in a therapist can be just as easily built on the internet as in conventional psychotherapies. (2) Perceived usefulness / helpfulness (of e-therapies) 6. Health insurance should cover the costs for Internet therapies. 12. Internet therapies will reach more patients and help them. The two-dimensionstructure was identified through Factor Analysis (Maximum Likelihood; extraction method: Promax) in both studies E-Preference: see Appendix Note. Data was collected via a German-language online survey. The final sample size is N = 646 (20th April 2016). 3

4 RESULTS Table 2. SAMPLE CHARACTERISTICS (N = 436) N = 436 mostly healthy participants (~¾) l general population + students Age: M = years; SD = 10.19; Median: 27 years Sex: 78 % female (n = 338), 22 % male (n = 94) Education: German Abitur (51 %), University degree (33 %) Employment: student (53 %), employed (27 %) Marital status: single (53 %), married or in close relationship (42 %) Region of residence: mostly metropolitan (49.8 %) Distress: 7 % were currently seeking for help for mental problems Current stress level: M = 5.6, SD = 2.7; Median = 6 (visual scale ranging from 0 not at all to 10 maximal ) 4

5 RESULTS Awareness of and experience with e-mental health (N = 436) E-Awareness: The majority (57 %) of participants was not aware the existence of web-based therapies (14 % was not sure; 29 % was aware). For comparisons (own surveys): 54 % were not aware of e-therapies in the final sample (N = 646); 83 % were not aware in the pilot study (online sample; n = 1456) Use of online self-help: 11 % previously attended psychosocial e-counselling Seeking health information online (frequency): Most participants (57 %) reported seeking for health information online only occasionally. Only 2 % indicated seeking information online on a daily base. Trust in health information websites as sources (multiple answers): Websites of physicians or psychologists (67 %) were viewed as the most trustworthy health information sources. The least trusted sources were social media networks (4 %). 14 % indicated not trusting any website principally. 5

6 RESULTS Attitudes toward E-Therapies (N = 436) Comparability (of e-services): M = 2.35; SD = 0.80 (Min = 1; Max = 5) Usefulness / Helpfulness: M = 3.70; SD = 0.77 (Min = 1; Max = 5) Items with the highest agreement 1. Internet therapies are in line with our modern times. (M = 3.83, SD = 1.06; Usefulness / Helpfulness) 6. Health insurance should cover the costs for Internet therapies. (M = 3.75, SD = 1.16; Usefulness / Helpfulness) Items with the lowest agreement 2. Internet therapies are able to replace conventional psychotherapies in the future. (M = 1.89, SD = 0.89; Comparability) 4. It makes no difference to me whether a psychotherapy takes place on the internet or in a psychotherapist s practice. (M = 1.67, SD = 0.93; Comparability) 6

7 CONCLUSIONS Public views on e-mental health nice to have or must have? Attitudes toward guided e-therapies were overall neutral or partially positive ( usefulness ) or tended to be rather pessimistic or in part neutral ( comparability ). Low awareness (29 %) of e-mental health treatments in the population. Research with the scope on attitudes toward e-mental health is at an early stage. However, there is preliminary evidence that text information may improve attitudes [2] Limitations: The results might be biased due to the selective sample. Implications The further development and validation of measures is strongly recommended. Applying of mixed-methods might be the key to an in-depth understanding of (potential) service users and help-seeking persons in the general population. The Person-Based Approach (PBA) can serve as guidance for researchers [4] 7

8 THANK YOU MUITO OBRIGADA So, what the future of digitalisation in mental health care will bring let s us better be cautious with tech predictions "There is no reason anyone would want a computer in their home." Ken Olsen, Digital Equipment Corporation,

9 REFERENCES [1] Musiat P, Goldstone P, Tarrier N. Understanding the acceptability of e-mental health attitudes and expectations towards computerised self-help treatments for mental health problems. BMC Psychiatry, 2014; 14:109. doi: / X [2] Casey LM, Joy A, Clough BA. The impact of information on attitudes toward e-mental health services. Cyberpsychology, Behavior, and Social Networking, 2013; 16(8): Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. MIS Quarterly, 2003; 27(3): [4] Morrison LG. Theory-based strategies for enhancing the impact and usage of digital health behaviour change interventions: A review. Digital Health, 2015; 1. DOI: /

10 CONTACT Dr. Jennifer A. Apolinário-Hagen, Dipl.-Psych. Office: Viktor Vehreschild, Dipl.-Math., M.Sc. Psychology viktor.vehreschild@fernuni-hagen.de FernUniversität in Hagen, Institute for Psychology, Department of Health Psychology, Universitätsstraße 33, D Hagen, Germany 10