For many people, going online is an important way to get news and information, and connect with friends and family. Yet, up to 1 in 5 people with psychosis do not use the internet and are excluded from online support and health services, according to a new King’s College London survey published in the Journal of Medical Internet Research.

Encouraging, however, the size of this digitally excluded group has declined substantially since 2011 when King’s College London first began to study the digital divide in mental health. In that survey, around 1 in 3 people with psychosis did not use the internet.

Official figures confirm the picture the survey paints. Although worldwide internet use has risen 900% in the last 10 years, around 10% of the UK population—or around 6.4 million people—still don’t use it at all. What’s more, over three-quarters of the UK population go online every day compared to just over half (56%) of participants with psychosis in this 2016 survey.

In the latest Kings College London analysis, researchers questioned 241 people with depression or psychosis to gather information about internet use including access, familiarity, motivation, and confidence, as well as barriers to use like cost.

Overall, results showed that less than 1 in 10 participants were digitally excluded. The majority (over 80%) of these had psychosis as opposed to depression. Similar to the 2011 survey, people most at risk of digital exclusion were aged 35 years or older with psychosis, had used mental health services for longer, and came from black and minority ethnic backgrounds. However, those who are digitally excluded seem more motivated to get online than 5 years ago, particularly via computers (rather than mobile phones).

“The good news is that over the last 5 years the offline population has been shrinking,” says lead author Dr Dan Robotham from King’s College London, UK. “The bad news is that digital inequality still exists. Most of the people in the sample who did not use the internet say it’s because they don’t know how, are concerned about security, or lack the money and resources, rather than a lack of willingness. The NHS needs an evidence-based digital inclusion strategy to help this digitally excluded minority develop the skills and confidence to access the growing number of digital NHS services.”