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  • Anthony McCosker

Mental health & digital inclusion - joining the dots

Over the last 6 or 7 years I’ve been working with mental health and wellbeing support services to better understand the role online communities play in the service ecosystem.


As a researcher of social media and digital cultures, I have been curious about why ‘old tech’ like online forums can offer a more supportive environment than Facebook, Twitter or TikTok.


At the same time, I also study digital inclusion (and exclusion). I’ve just finished a project working with government and agencies assisting disconnected older adults to gain internet access and develop digital skills and literacies.


Strangely, in academic research and in policy, these two big social problems — mental health and digital inclusion — are rarely considered together. To me it feels like it has taken a year of COVID-19 lockdowns to prompt researchers, governments and service providers to question the troubled links between mental ill-health and digital exclusion.


On a recent webinar panel for the Australian Digital Inclusion Alliance, I was trying to formulate what I’ve seen to be an underlying issue that cuts across both mental health support and digital inclusion.


I’m calling this the issue of precarious connection.


By connection here, I mean the technical kind (internet access and online interaction), the inter-personal and social kind, and the service-client relationship.


Image by Danielle MacInnes on Unsplash



Precarious connection

Of course, people who experience ill-health can be among the most innovative technology and internet users. They can be first adopters of all the interesting new tech and tools for accessing health information and support.


But sometimes the abundance of apps, tools and supportive online groups expanding health participation masks the underlying and persistent problem.


Whether in online health support forums, during clinical telehealth consultations, in neglected mood tracker apps, or across social media where mental health is discussed and supported, I have seen this consistent issue of connection being fragile and easily broken.


And the consequences of disconnection and isolation are huge for those who are already marginalized or socially excluded and disadvantaged. Mental health is particularly affected by the strength or precarity of connection with others and with mental health services and supports.


What makes this issue increasingly urgent is the rapid change we’re seeing in the way we connect to others and to services, particularly after social and physical distancing and disrupted service provision. But there’s not a lot of evidence detailing the problem or informing solutions.



Social connection and digital support

In research partnership with SANE Australia, Beyond Blue and ReachOut, we’ve been looking at connection through online forums across rural and remote Australia, and identifying the resilience-building work happening there.


We’re seeing abundant evidence of the relationship between isolation, service breakdowns and deepening mental health issues, including the problems that follow broken relationships.


We also see the importance of digital social connection in managing mental health and reaching beyond the immediate social context in seeking and receiving support. Online forums are community-oriented digital interventions. They’re a different form of care to clinical telehealth services. But they fill massive service gaps through the 24/7 access they provide.


With Beyond Blue I studied the use of a particular sub-forum on Suicidal Thoughts & Self-Harm. A key takeaway from that research was the work involved in encouraging people who are in deep distress to come back; keeping them engaged, over time, supporting them toward recovery.


This is a community effort — but is always threatened by precarious connection.

There are many other kinds of precarious connection.


On Instagram I’ve tracked and studied young people communicating their experiences of mental ill-health through memes and other creative techniques. At the same time, they’re battling platform moderation systems. Facebook confusingly sees mental health content as ‘problematic’ and often shuts it down or blocks access to it.


There is no single platform, app or web tool that solves the problem of precarious connection completely.


Image by Sigmund on Unsplash


Digital inclusion is really just about inclusion

Social connection, isolation and loneliness are key issues across the population, but especially among older Australians.


In my research with the Department of Social Services, looking at the effectiveness of the national Be Connected program — which is aimed at getting over 50-year-olds online — there were some stand-out findings around the link between wellbeing and digital social connection


We saw that participation in Be Connected correlated with reduced loneliness. Digital confidence was significantly higher for those in better physical and emotional health. And vice versa — those who were less confident with digital technologies felt lonelier.


Social connection — connecting with family and friends — is a key motivator for improving digital skills. These are concerns that are first and foremost about social inclusion. But the social and digital components are equally important, intertwined.


We’ll make inroads into these issues when we address digital inclusion and mental health and wellbeing simultaneously. There are a lot of good programs bringing these elements together, but there’s more work to do.


Selected references

McCosker, A., Tucker, J., Critchley, C., Hiruy, K., Walshe, J., Suchowerska, R., & Barraket, J. (2020). Improving the digital inclusion of older Australians: the social impact of Be Connected. Swinburne University of Technology, Melbourne. https://www.dss.gov.au/evaluation-of-be-connected.


McCosker, A., & Gerrard, Y. (2020). Hashtagging depression on Instagram: Towards a more inclusive mental health research methodology. New Media & Society, 1461444820921349


McCosker, A. (2018). Engaging mental health online: Insights from beyondblue’s forum influencers. New Media & Society, 20(12), 4748–4764. https://doi.org/10.1177/1461444818784303


McCosker, A. (2017). Networks of advocacy and influence: peer mentors in beyondblue’s mental health forums. Melbourne, VIC, Australia: Swinburne Social Innovation Research Institute. https://apo.org.au/node/97236


Shaw, F., & McCosker, A. (2019). Mental health support apps and ‘proper distance’: relational ethics in mHealth. Media International Australia, 171(1), 9–22. https://doi.org/10.1177/1329878X19848789

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