“I Don’t Trust It, but I Have to Trust It”: Trust vs. Use of Online Technology Across the Mental Health Spectrum in the UK

Use of internet-based technologies (IBTs) and artificial intelligence (AI) via eHealth could enhance mental healthcare delivery and accessibility. However, ethical concerns, perceptions of AI capabilities, past experience, and individual differences can influence acceptance and engagement. We qualitatively explored attitudes and behaviours toward IBTs, AI and eHealth, given the overlapping nature of these digital environments, trust, and the possible role of mental health. This exploratory study conducted semi-structured interviews between March and October 2023 with 22 UK-based participants: eight with lived experience of a mental health problem and 14 without. There was no clear difference in participants’ levels of trust in IBTs across mental health status. Participants reported using IBTs despite privacy concerns. Trust was influenced by perceptions of developer trustworthiness, individual traits, and affective responses to IBTs. Convenience, ease of use, and lack of alternatives often outweighed concerns, driving engagement. Our findings highlight that in this group trust is a key factor in IBT and eHealth uptake, but not the sole determinant, highlighting ethical concerns and responsibilities for both UK healthcare providers and developers. There is a need for transparent, ethically grounded, value-sensitive design and implementation of IBTs and AI-enabled eHealth tools that supports genuine user choice, voluntary engagement, and human interaction.