What shapes basic digital competence in people with mental illness beyond internet usage: the influence of experience, illness severity and self-efficacy

Ongoing digitalization, particularly in healthcare, offers opportunities for people with mental illness – provided they possess the necessary digital competencies. This cross-sectional study investigated basic digital competencies in N=104 individuals (aged 21–93) receiving inpatient, outpatient, or day clinic treatment at a psychiatric university hospital in Berlin. Basic digital competence was measured using the Computer Proficiency Questionnaire (CPQ-12) , cognitive abilities were assessed with the Montreal Cognitive Assessment (MoCA) , and symptom severity with the Brief Psychiatric Rating Scale – Expanded (BPRS-E) . Technology-related anxiety was captured with the Abbreviated Technology Anxiety Scale (ATAS) , and self-efficacy with the Short General Self-Efficacy Scale (ASKU) . In addition, participants provided information on their average daily internet usage. A five-step hierarchical regression identified cognitive ability, daily internet use and self-efficacy as significant predictors of basic digital competence. Age, symptom severity or anxiety about technology did not independently contribute to the model. These findings suggest that differences in basic digital competence among individuals with mental illness are related to their experience with digital technologies and cognitive abilities, rather than their age or illness severity. Programs aimed at fostering digital skills in clinical populations may therefore benefit from tailoring interventions to individuals with limited prior digital experience and those with cognitive impairments. Such approaches could represent a promising step toward strengthening equity in digital healthcare and reducing the risk of digital exclusion among people with mental illness, including the very old and those with severe illness.