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Measuring the digital divide among people with severe mental ill health using the essential digital skills framework

Spanakis, P., Wadman, R., Walker, L. ORCID: 0000-0003-2459-7860 , Heron, P., Mathers, A., Baker, J., Johnston, G., Gilbody, S. & Peckham, E. (2022). Measuring the digital divide among people with severe mental ill health using the essential digital skills framework. Perspectives in Public Health, 144(1), pp. 21-30. doi: 10.1177/17579139221106399


Amid the vast digitalisation of health and other services during the pandemic, people with no digital skills are at risk of digital exclusion. This risk might not abate by the end of the pandemic. This article seeks to understand whether people with severe mental ill health (SMI) have the necessary digital skills to adapt to these changes and avoid digital exclusion.

Two hundred and forty-nine adults with SMI across England completed a survey online or offline. They provided information on their digital skills based on the Essential Digital Skills (EDS) framework, sociodemographic information, and digital access. This is the first time that the EDS is benchmarked in people with SMI.

42.2% had no Foundation Skills, and 46.2% lacked skills for daily life (lacking Foundation or Life Skills). 23.0% of those working lacked skills for professional life (lacking Foundation or Work Skills). The most commonly missing skills were handling passwords and using the device settings (Foundation Skills) and online problem solving (Skills for Life). People were interested in learning more about approximately half of the skills they did not have. People were more likely to lack Foundation Skills if they were older, not in employment, had a psychosis-spectrum disorder, or had no Internet access at home.

A significant portion of people with SMI lacked Foundation Skills in this objective and benchmarked survey. This points to a high risk for digital exclusion and the need for focused policy and tailored health sector support to ensure people retain access to key services and develop digital skills and confidence. To our knowledge, this is the first time this has been described using the EDS framework. Services, including the National Health Service (NHS), need to be aware of and mitigate the risks.

Publication Type: Article
Additional Information: © Royal Society for Public Health 2022. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( Request permissions for this article.
Publisher Keywords: digital skills, digital divide, Internet, severe mental ill health, psychosis, bipolar
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
T Technology > T Technology (General)
Departments: School of Health & Psychological Sciences > Nursing
SWORD Depositor:
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