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数字包容倡议对促进心理健康服务获取的影响:服务使用者访谈研究。

Impact of Digital Inclusion Initiative to Facilitate Access to Mental Health Services: Service User Interview Study.

机构信息

Camden and Islington NHS Foundation Trust, London, United Kingdom.

Division of Psychology and Language Sciences, University College London, London, United Kingdom.

出版信息

JMIR Ment Health. 2024 Jul 26;11:e51315. doi: 10.2196/51315.

Abstract

BACKGROUND

Digital exclusion, characterized by a lack of access to digital technology, connectivity, or digital skills, disproportionally affects marginalized groups. An important domain impacted by digital exclusion is access to health care. During COVID-19, health care services had to restrict face-to-face contact to limit the spread of the virus. The subsequent shift toward remote delivery of mental health care exacerbated the digital divide, with limited access to remote mental health care delivery. In response, Camden and Islington National Health Service Foundation Trust launched the innovative Digital Inclusion Scheme (DIS).

OBJECTIVE

This study aimed to examine the impact of facilitating digital inclusion in mental health access. Camden and Islington National Health Service Foundation Trust implemented the trust-wide DIS for service users who were digitally excluded, that is, were without devices or connectivity or reported poor digital skills. The scheme provided access to a loan digital device (a tablet), internet connectivity devices, and mobile data, as well as personalized digital skills support.

METHODS

The DIS went live in October 2021 and received 106 referrals by June 2022. Semistructured interviews were conducted with 12 service users to ask about their experience of accessing the DIS. A thematic analysis identified themes and subthemes relating to the extent of their digital exclusion before engaging with the scheme and the impact of accessing a scheme on their ability to engage with digital technology and well-being.

RESULTS

There were 10 major themes. A total of 6 themes were related to factors impacting the engagement with the scheme, including digital exclusion, relationship to the trust, the importance of personalized digital support, partnership working, device usability and accessibility, and personal circumstances. The remaining 4 themes spoke to the impact of accessing the scheme, including improved access to services, impact on well-being, financial implications, and a greater sense of empowerment.

CONCLUSIONS

Participants reported an increased reliance on technology driving the need for digital inclusion; however, differences in motivation for engaging with the scheme were noted, as well as potential barriers, including lack of awareness, disability, and age. Overall, the experience of accessing the DIS was reported as positive, with participants feeling supported to access the digital world. The consequences of engaging with the scheme included greater perceived access to and control of physical and mental health care, improved well-being, and a greater sense of empowerment. An overview of the lessons learned are provided along with suggestions for other health care settings that are looking to implement similar schemes.

摘要

背景

数字排斥现象表现为无法获得数字技术、网络连接或数字技能,这严重影响了边缘化群体。受数字排斥影响的一个重要领域是获得医疗保健。在 COVID-19 期间,医疗保健服务不得不限制面对面接触,以限制病毒的传播。随后,远程提供精神保健服务的转变加剧了数字鸿沟,远程精神保健服务的获取受到限制。为应对这一问题,卡姆登和伊斯灵顿国民保健服务基金会信托基金推出了创新的数字包容计划(DIS)。

目的

本研究旨在考察促进精神健康获取方面的数字包容所产生的影响。卡姆登和伊斯灵顿国民保健服务基金会信托基金为那些被数字排斥的服务使用者(即没有设备或网络连接,或报告数字技能较差的人)在全信托范围内实施了 DIS。该计划提供了贷款数字设备(平板电脑)、网络连接设备和移动数据,以及个性化的数字技能支持。

方法

DIS 于 2021 年 10 月上线,并在 2022 年 6 月前收到了 106 份转介。对 12 名服务使用者进行了半结构化访谈,以了解他们使用 DIS 的体验。主题分析确定了与参与计划前的数字排斥程度以及参与计划对他们使用数字技术和幸福感的能力的影响相关的主题和子主题。

结果

有 10 个主要主题。其中 6 个主题与影响参与计划的因素有关,包括数字排斥、与信托的关系、个性化数字支持的重要性、伙伴关系工作、设备可用性和可访问性以及个人情况。其余 4 个主题则涉及获取该计划的影响,包括服务获取的改善、对幸福感的影响、经济影响以及更大的赋权感。

结论

参与者报告称,对技术的依赖程度增加,导致对数字包容的需求增加;然而,参与者参与计划的动机存在差异,潜在障碍包括缺乏意识、残疾和年龄。总体而言,参与者报告说,使用 DIS 的体验是积极的,他们感到得到了支持,可以访问数字世界。参与该计划的后果包括对身体和心理健康护理的获取和控制的感知增强、幸福感提高以及更大的赋权感。本文提供了所吸取经验的概述,并为其他希望实施类似计划的医疗保健机构提出了建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc87/11316150/2072455fad8f/mental_v11i1e51315_fig1.jpg

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