Wadman Ruth, Walker Lauren, Taylor Olivia, Heron Paul, Newbronner Elizabeth, Spanakis Panagiotis, Crosland Suzanne, Peckham Emily Jane
Department of Health Sciences, University of York, York, United Kingdom.
School of Medical and Health Sciences, Bangor University, Wrexham, United Kingdom.
J Med Internet Res. 2025 Mar 28;27:e55072. doi: 10.2196/55072.
People with severe mental illness (SMI) face profound health inequalities, which may be exacerbated by increased rates of digital exclusion, especially as health services move to online provision. The activities that people carry out online can affect how they feel about the internet and may determine whether a person has a positive or negative experience when using the internet. This, in turn, could affect their mental health. To support people with SMI in using digital technology and the internet safely, it is important to understand the internet and digital technology use of those with SMI and their perceived positive or negative impact on their mental health.
This study aimed to explore the internet and digital technology use of those with SMI, with particular focus on any association between greater use of the internet and poorer self-reported mental health.
We carried out a qualitative interview study with 16 people with SMI. The sample was drawn from a wider investigation of the impact of the pandemic and its restrictions on the health and well-being of 367 people with SMI. We purposively sampled from the wider study based on age, gender, frequency of internet use, and self-reported mental health. The data were analyzed by 2 researchers using framework analysis.
Participant experiences fell into 3 broad categories: those who had a positive or neutral internet-based experience, those who had negative or difficult experiences, and low users or those with poor digital literacy. Those who had positive or neutral experiences could be broken down into 2 subcategories: first, those with positive or neutral experiences of the internet who were similar in terms of the activities participated in, feelings reported, and their concerns about the internet, and second, conscious users who were mindful of their interaction with the internet world. Participants with difficult experiences fell into 2 categories: those with worries and fears related to using the internet and those who had difficulty limiting their internet use.
People with SMI, similarly the general population, are expected to conduct more of their activities of daily living online in the postpandemic world. This research shows that most internet users with SMI have positive or neutral experiences. However, our typology reveals subgroups of the population with SMI for whom there is a relationship between internet use and difficult feelings. These subgroups can be identified by asking questions about online activities; time spent online; feelings, difficulties, or issues experienced; and use of gambling, dating, adult content, and conspiracy theory websites. Our findings point to further work in collaboration with people with lived experience to modify and test this typology.
重度精神疾病（SMI）患者面临着严重的健康不平等问题，而数字排斥率的上升可能会加剧这种情况，尤其是随着医疗服务转向在线提供。人们在网上开展的活动会影响他们对互联网的感受，并可能决定一个人在使用互联网时体验是积极还是消极。反过来，这可能会影响他们的心理健康。为了支持重度精神疾病患者安全使用数字技术和互联网，了解重度精神疾病患者的互联网和数字技术使用情况以及他们认为其对心理健康产生的积极或消极影响非常重要。
本研究旨在探讨重度精神疾病患者的互联网和数字技术使用情况，特别关注更多地使用互联网与自我报告的较差心理健康之间的任何关联。
我们对16名重度精神疾病患者进行了定性访谈研究。该样本取自对367名重度精神疾病患者的疫情及其限制措施对其健康和福祉影响的更广泛调查。我们根据年龄、性别、互联网使用频率和自我报告的心理健康状况，从更广泛的研究中进行有目的抽样。数据由两名研究人员使用框架分析法进行分析。
参与者的经历分为三大类：有积极或中性互联网体验的人、有消极或困难体验的人，以及低用户或数字素养差的人。有积极或中性体验的人可细分为两个子类别：第一，在参与的活动、报告的感受以及他们对互联网的担忧方面相似的有积极或中性互联网体验的人；第二，有意识地与互联网世界互动的有意识用户。有困难体验的参与者分为两类：与使用互联网相关存在担忧和恐惧的人，以及难以限制互联网使用的人。
在疫情后的世界中，重度精神疾病患者与普通人群一样，预计会更多地在网上开展日常生活活动。这项研究表明，大多数重度精神疾病互联网用户有积极或中性体验。然而，我们的类型划分揭示了重度精神疾病患者群体中的一些子群体，对他们而言，互联网使用与困难感受之间存在关联。通过询问有关在线活动、上网时间、经历的感受、困难或问题，以及对赌博、约会、成人内容和阴谋论网站的使用等问题，可以识别出这些子群体。我们的研究结果表明，需要进一步与有实际生活经验的人合作，对这种类型划分进行修改和测试。
