Internet use for health-related needs: Implications for developing online mental health interventions for veterans

Promising treatment interventions for some mental disorders are now available over the Internet. Recently Veterans Health Affairs (VHA) added suicide prevention to their portfolio of Internet-based mental health interventions. However, there is no research on how Veterans use the Internet for health-related needs – Veteran-specific data do not exist. General population data on Internet use could provide useful information leading to new treatments. In this paper we examine health-related Internet use in a general population sample for Non-urban and Urban individuals with and without mental health symptoms. We used the 2007 Health Information National Trends Survey (HINTS) and evaluated Internet users (5044/7674,65.75%). We grouped respondents by Region (Northeast, Midwest, South, West) and Urbanicity (Non-urban vs. Urban) and compared mental health symptom (sadness, nervousness, restlessness, worthlessness, hopelessness), demographic, health, and Internet-related variables. We found South and Northeast users most disparate, and Midwest and West not significantly different from other regions. Southern users had lower education, lower income, and the least likelihood of Internet use (n=1816, 64.1%, ÷2=27.7,p=0.001). They reported the highest levels of mental health symptoms (sadness 16.0%, hopelessness 12.6%, worthlessness 9.5%, and overall distress 5.0%) but had the highest use of Internet support groups (6.1%), rate of looking for healthcare providers (39.6%), and likelihood of visiting social networking sites (24.5%). Non-urban areas had the highest prevalence of dial-up connections. Logistic regression showed younger age, lower education and income, renting, dial-up connection, and South region were significant predictors of Internet use for health-related needs. Characteristics around Internet use and users vary significantly between North and South but not the Midwest nor West. Although non-urban South had more dial-up and higher symptom prevalence, their health-related use of the Internet was more robust. Augmenting these data with Veteran-specific census and surveillance data may provide essential information for developing future online mental health interventions.