۱- Introduction

۲- Methods

۳- Results

۴- Discussion

References

Abstract

As digital interventions are beginning to be developed to support self-management of psychosis, it is important to understand how illness-related and individual factors may affect internet use and engagement with digital mental health resources among people with psychotic disorders. This study aimed to identify demographic, clinical, and personal variables associated with overall and mental health-related internet use in a sample of 189 adult community mental health service users with nonaffective and affective psychotic disorders. Among participants who regularly used the internet (87.3%), most (67.9%) reported using the internet for mental health information. Higher frequency of overall internet use was predicted by younger age, completion of post-secondary education, and less severe negative symptoms. Internet use for mental health information was predicted by younger age, higher levels of overall internet use, current productive employment, and higher loneliness. This study is the first to quantitatively examine how clinical and personal measures relate to overall and mental health-related internet use in people with psychosis. Although cognitive difficulties and negative symptoms impacted overall internet use, these disorder-related difficulties did not further impact internet use for mental health information. Digital mental health resources should be designed to optimise engagement for this population.

Introduction

Internet use and access is increasing among people with severe mental illness (SMI), including those experiencing psychosis (e.g. Record et al., 2016; Robotham et al., 2016). Recent studies suggest that this group endorses the notion of using the internet and digital technology, including mobile devices and social media, for mental health information and/or treatment (Aref-Adib et al., 2016; Berry et al., 2016; Firth et al., 2016; Lal et al., 2015). A growing range of digital mental health tools is available, allowing unprecedented accessibility, personalisation, and interactivity of interventions for people with psychosis (Alvarez-Jimenez et al., 2014; Naslund et al., 2015; van der Krieke et al., 2014). This may be valuable in providing access to specialist selfmanagement resources and interventions to complement face-to-face delivery. Meanwhile, online forums, social networks, and video streaming websites enable people with SMI to connect with peers and mental health experts worldwide (Highton-Williamson et al., 2015; Naslund et al., 2016; Villani and Kovess-Masfety, 2017). Individuals can share their experiences and interact with peers that they may otherwise not have had access to, including those who have progressed further in their own recovery (Naslund et al., 2014). Whilst the evidence base remains in development, accessing online communities offers opportunities for enhancing self-management and empowerment, and accessing positive role models that may challenge pessimistic stereotypes of recovery and inspire hope (Daker-White and Rogers, 2013; Naslund et al., 2015; Thomas et al., 2015; Villani and Kovess-Masfety, 2017).