Individuals’ Attitudes Toward Digital Mental Health Apps and Implications for Adoption in Portugal: Web-Based Survey (Preprint)

Abstract

BACKGROUND The literature is consensual regarding the academic community exhibiting higher levels of mental disorder prevalence than the general population. The potential of digital mental health apps for improving access to resources to cope with these issues is ample. However, studies have yet to be performed in Portugal on individuals' attitudes and perceptions toward digital mental health applications or their preferences and decision drivers on obtaining mental health care, mental health self-assessment, or mental health and its treatment. Our study aims at bridging these gaps by mapping the expectations of the demand side of digital mental health apps. OBJECTIVE This study aims to understand the determinants of digital mental health applications use in the Portuguese context using the academic community of Porto as a proxy, along with potential adoption barriers and enablers of its use. METHODS A cross-sectional, web-based survey adapted to the Portuguese context was delivered via dynamic email to the University of Porto’s academic community. Data collection occurred between September 20 and October 20, 2022. We used structural equation modeling to build three models, replicating a previously peer-reviewed and published study and producing a full mediation model shaped by the collected data. This allowed us to test the relationships between the use of mental health apps, perceived stress, perceived need to seek help for mental health concerns, perceived stigma, past use of professional mental health services, privacy concerns, and social influence of other people in using digital mental health apps. RESULTS Of the 539 participants, 32 (5.9%) reported using digital mental health apps. Perceived stress was positively associated with mental health app use. A latent variable comprising perceptions of mental health problems and coping strategies in place was also positively related to this use. Privacy concerns regarding one’s information being accessible to others were negatively associated with digital mental health app use. Perceived stigma, need to seek help, and having close relationships did not have a statistically significant direct effect. Financial reasons (37.3%), the helpfulness of these apps (26.9%), uncertainty about the seriousness of one’s needs (26.3%), and waiting time to access mental health resources (24.9%) were the main barriers to access. CONCLUSIONS These findings can inform product and policy development of new, better-targeted digital mental health app interventions that enable the academic community to take a more targeted, evidence-based approach to the mental health needs of its members. The developers of these decisions should consider delivering these apps with low to no financial charges, offering evidence of their helpfulness and with a focus on the timely delivery of care. To further digital mental health app use, there is a need to shape mindsets through mental health literacy, namely regarding self-awareness of one’s conditions, acceptable stress levels, and overall behavior toward mental health. INTERNATIONAL REGISTERED REPORT RR2-#41040 "Attitudes of physicians and individuals toward digital mental health tools: protocol for a web-survey-based research project"