Usefulness of self-guided digital services among mental health patients : The role of health confidence and sociodemographic characteristics

Background: Remote services provided via telephone or the internet have become an essential part of mental health provision. Alongside services involving healthcare personnel (HCP), self-guided digital services hold great promise for improved self-management and health outcomes without increasing the burden on HCP. Therefore, better understanding of patients’ use and experienced benefits of these services are needed. This study investigated how health confidence and sociodemographic background are associated with mental health patients’ experiences of self-guided digital services. Methods: This cross-sectional survey study was performed in 2022 at a Finnish Mental Health and Substance Abuse Services (MHSAS) unit of a regional public service provider that serves a population of about 163 000 people. All patients who had visited the unit up to 6 months before the study were invited to respond to an online survey on their experiences with the remote MHSAS. We report the average subjective usefulness of telephone, guided digital and self-guided digital services. Regression models were fitted to study the associations of patient characteristics with use of any digital service, and with experienced usefulness of self-guided digital services. Findings: The respondents (n = 438) rated the usefulness of telephone, guided digital and self-guided digital services similarly (4.0/5.0, 3.9/5.0, and 3.9/5.0, respectively). Health confidence was associated with not using digital services at all as well as with high perceived usefulness of self-guided services. While elderly patients were more likely to avoid using digital services, age was not associated with experienced usefulness of self-guided digital services. No association between unemployment status and experiences of digital services was found. Conclusions: Different types of remote services are perceived as beneficial by mental health patients. To ensure effectiveness and equity, patients’ health confidence should be considered when directing them to self-guided services. Elderly mental health patients who use digital services are equally able as younger patients to benefit from self-guided services.