The Digital Divide’s Impact on Mental Healthcare Access

Authored by: Shriya Mehta

Art by: Amber Briscoe

Access to mental health care is rapidly becoming a digital privilege, locked behind devices and connections many people still lack. Digital tools such as teletherapy, mental health apps, and artificial intelligence (AI) driven solutions are set to transform the delivery of mental health services.  While technology can help remove barriers, it also risks increasing the gap for those already underserved. Vulnerable groups, such as low-income individuals, rural residents, and the elderly, often miss out on digital advancements due to limited internet access, a lack of digital literacy, and inaccessibility to new technologies. As mental health resources shift online, these disparities threaten to leave these disadvantaged populations without the support they need. This growing divide calls for strategic interventions, including a shift away from overreliance on AI and a stronger focus on public-private partnerships that promote inclusive, user-friendly platforms, ensuring everyone benefits from technological advancements [6].

The digital divide in healthcare is defined as the gap between those who have access to technology and the internet and those who do not [7]. This divide is especially pronounced in mental healthcare, where an increasing number of services, like Better Help and AI-driven therapy platforms, are transitioning to digital-only options [3,8]. Digital health tools can improve healthcare access and efficiency, but they may leave disadvantaged people behind due to socioeconomic, geographic, or generational challenges [10]. 

A major barrier to healthcare access is reliable internet. According to the Federal Communications Commission (FCC), millions of Americans in rural and low-income areas still lack access to high-speed broadband, which teletherapy and real-time virtual conversations rely on [1,7]. As of 2016, the FCC reported that approximately 92.3% of Americans had access to broadband internet speeds of 25mbps/3mbps, leaving roughly 24 million individuals in rural, tribal, and impoverished areas without adequate internet access for telehealth services [7].

Digital literacy further complicates the issue of health care accessibility.  Research shows that older adults with lower income and education levels experience difficulties accessing broadband internet, which leads to decreased health literacy, digital skills, and overall technology adoption [4, 5, 12]. Cognitive decline and physical impairments, such as vision and hearing loss, can also make it difficult for older adults to engage with digital tools[4]. A 2016 PubMed systematic review showed that older adults may resist using technology due to negative perceptions associated with aging, such as concerns about losing dignity and autonomy [2]. When asked about the transition to more digital services, many older individuals expressed fear of being stigmatized as incapable of managing their own care, leading many to reject new technology [2]. While many older adults are open to using digital mental health tools, they often lack the confidence in their ability to use them without judgment [2]. 

The cost of necessary technology, such as smartphones, computers, or reliable internet connections also adds another layer of difficulty to telehealth reliance. For low-income individuals, purchasing devices or paying for an internet plan may be financially unfeasible, even if they’re willing to give digital services a try. Affordable phones or computers may lack compatibility with telehealth platforms, leading to unstable internet connection and a reduced quality of care. For example, in a psychiatric interview, clear communication is essential. If the video or audio freezes, it can lead to confusion surrounding  the patient's mental state, making it harder to provide an accurate diagnosis. These misunderstandings can make patients feel uneasy about sharing sensitive or traumatic information in the future [7, 9]. A 2024 PubMed Central report found that lower-income individuals are more likely to rely on devices that are shared or have limited internet access, making it harder for them to consistently participate in telehealth services [11]. 

Ultimately, limited internet access, low digital skills, poor-quality devices, and lack of technology make it hard for vulnerable groups to access mental health care, worsening existing inequalities. To ensure equitable care, it is crucial to address these barriers by investing in digital education, subsidizing device access, and developing inclusive technologies that all individuals can access and effectively navigate.

References:

1. 2018 broadband deployment report. Federal Communications Commission. (2018, February 2). https://www.fcc.gov/reports-research/reports/broadband-progress-reports/2018-broadband-deployment-report 

2. A;, Y. S. J.-B. (n.d.). Older people, Assistive Technologies, and the barriers to adoption: A systematic review. International journal of medical informatics. https://pubmed.ncbi.nlm.nih.gov/27573318/ 

3. Ai in mental healthcare: How is it used and what are the risks?. Built In. (n.d.). https://builtin.com/artificial-intelligence/ai-mental-health#:~:text=The%20 drawbacks%20of%20 AI%20in,%20 empathy%20as%20human%20 therapists. 

4. Bertolazzi, A., Quaglia, V., & Bongelli, R. (2024, February 16). Barriers and facilitators to health technology adoption by older adults with chronic diseases: An integrative systematic review. BMC public health. https://pmc.ncbi.nlm.nih.gov/articles/PMC10873991/#:~:text=Previous%20studies%20have%20found%20that,adoption%20%5B21–24%5D. 

5. DM;, C. N. (n.d.). The digital divide among low-income homebound older adults: Internet use patterns, eHealth literacy, and attitudes toward computer/internet use. Journal of medical Internet research. https://pubmed.ncbi.nlm.nih.gov/23639979/ 

6. Ganapathy K;Das S;Reddy S;Thaploo V;Nazneen A;Kosuru A;Shankar Nag U; (n.d.). Digital Health Care in Public Private Partnership Mode. Telemedicine journal and e-health : the official journal of the American Telemedicine Association. https://pubmed.ncbi.nlm.nih.gov/33819433/ 

7. Saeed, S. A., & Masters, R. M. (2021, July 23). Disparities in health care and the digital divide. Current psychiatry reports. https://pmc.ncbi.nlm.nih.gov/articles/PMC8300069/ 

8. Team, B. E. (2025, February 26). The implications of Artificial Intelligence and Mental Health in modern society. BetterHelp. https://www.betterhelp.com/advice/current-events/the-implications-of-ai-and-mental-health-in-modern-society/ 

9. Tiwari, B. B., Kulkarni, A., Zhang, H., Khan, M. M., & Zhang, D. S. (2023, December 31). Utilization of telehealth services in low- and middle-income countries amid the COVID-19 pandemic: A narrative summary. Global health action. https://pmc.ncbi.nlm.nih.gov/articles/PMC9946329/ 

10. Vogels, E. A. (2021, June 22). Digital divide persists even as Americans with lower incomes make gains in tech adoption. Pew Research Center. https://www.pewresearch.org/short-reads/2021/06/22/digital-divide-persists-even-as-americans-with-lower-incomes-make-gains-in-tech-adoption/ 

11. Wang, C. P., Mkuu, R., Andreadis, K., Muellers, K. A., Ancker, J. S., Horowitz, C., Kaushal, R., & Lin, J. J. (2024, January 11). Examining and addressing telemedicine disparities through the lens of the Social Determinants of Health: A qualitative study of patient and provider during the COVID-19 pandemic. AMIA ... Annual Symposium proceedings. AMIA Symposium. https://pmc.ncbi.nlm.nih.gov/articles/PMC10785927/ 

12. Wang, D., Liu, S., Wu, J., & Lin, Q. (2020, May 4). Purchase and use of home healthcare devices for the elderly: A pilot study in Shanghai, China - BMC public health. BioMed Central. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08757-8