Determinants of Digital Health Literacy Among Patients With Serious Mental Illness: Cross-Sectional Survey

Clinical Snapshot

Key Findings

• P Value: Perceived difficulty P<0.001; Self-efficacy P=0.01; Mobile proficiency P=0.04; Distrust P=0.04

• Effect Size: Perceived difficulty: B=-1.533; Mobile proficiency: B=0.144; Self-efficacy: B=1.777; Distrust: B=-0.986

• Primary Outcome: Digital health literacy scores varied significantly among participants with serious mental illness

• Nnt Or Sensitivity: 83.5% of participants owned at least one digital device, indicating high device access despite literacy challenges

• Confidence Interval: Perceived difficulty: 95% CI -2.350 to -0.717; Self-efficacy: 95% CI 0.376-3.177

Clinical Application

Findings suggest need for structured digital literacy programs integrated into mental health services, which is feasible in Australian community mental health settings Relevant to Australian mental health services under NDIS and PHN frameworks; could inform digital mental health initiatives and telehealth programs supported by Medicare Adults with serious mental illness receiving community-based psychiatric care, particularly those using digital health services

Abstract

BACKGROUND: Individuals with serious mental illness increasingly use digital devices and the internet to access health information and services but often face challenges when navigating digital tools, which may limit the benefits they receive from online health resources and digital health care services. OBJECTIVE: The objective of our study was to assess digital health literacy among individuals with serious mental illness and identify factors influencing this literacy. METHODS: Participants were recruited, using convenience sampling, from 2 psychiatric clinics, 1 day-care center, and 4 halfway houses in Taipei, Taiwan, between May 2024 and February 2025. Self-reported data were collected using a survey that incorporated the eHealth Literacy Scale, the Attitudes Toward Computer/Internet Questionnaire, and the Mobile Device Proficiency Questionnaire. Generalized linear modeling was applied to identify factors associated with digital health literacy. RESULTS: Among 255 participants included in the analysis, 83.5% (n=213) reported owning at least 1 digital device. Digital health literacy was significantly lower among individuals who reported greater perceived difficulty in using digital tools (B=-1.533, 95% CI -2.350 to -0.717; P<.001) and higher distrust in online information (B=-0.986, 95% CI -1.916 to -0.056; P=.04). By contrast, greater mobile device proficiency (B=0.144, 95% CI 0.008-0.281; P=.04) and self-efficacy (B=1.777, 95% CI 0.376-3.177; P=.01) were positively associated with digital health literacy. CONCLUSIONS: Despite widespread device ownership, digital health literacy was varied and generally suboptimal among patients with serious mental illness. Perceived difficulty and distrust emerged as major barriers; proficiency and self-efficacy facilitated higher literacy. These findings highlight the need for mental health professionals to integrate tailored digital skills training, confidence-building strategies, and ongoing support into digital health interventions for individuals with serious mental illnesses.

References

1. 1.Chou, Y. J., Chiang, K. J., Huang, H., Chang, H. A., Hung, Y. L., & Tzeng, W. C. (2026). Determinants of Digital Health Literacy Among Patients With Serious Mental Illness: Cross-Sectional Survey. JMIR Mental Health, 13, e88700. https://doi.org/10.2196/88700