NEWS Mental Health News Digital Divide Could Make Online Therapy Less Accessible to Older People By Sarah Fielding Sarah Fielding LinkedIn Twitter Sarah Fielding is a freelance writer covering a range of topics with a focus on mental health and women's issues. Learn about our editorial process Updated on January 13, 2021 Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Rich Scherr Fact checked by Rich Scherr LinkedIn Twitter Rich Scherr is a seasoned journalist who has covered technology, finance, sports, and lifestyle. Learn about our editorial process Share Tweet Email Print Getty Images Key Takeaways Older people may not have the access or know-how to use technology for online therapy.About 15% of people over 60 years old have a mental disorder.Individuals over 55 report attending fewer telehealth appointments during the pandemic than those below that age. With the COVID-19 pandemic forcing everything from get-togethers to doctors appointments online, those with less knowledge of or trust in technology are at a disadvantage. A new study from the JAMA Network Open found that older people were among those who reported fewer telehealth visits during the COVID-19 pandemic. Individuals over 55 reported fewer telehealth appointments overall, and it was less likely for this older demographic to actually complete an appointment over a video call in instances when they did have a virtual appointment. A total of 148,402 patients who had scheduled a virtual appointment towards the pandemic’s onset made up the study. While the study focused on telehealth as a whole, it stands to reason that online therapy also is less accessible for older people. As a critical form of telehealth, therapy is an important resource for all ages, especially during a time of such loss and turmoil. According to the World Health Organization (WHO), 15% of individuals aged 60 and over have a mental disorder. Impact of the Digital Divide The digital divide is the separation of people who do and don’t have access to the internet and the understanding of how to use it fully. “There are two main reasons seniors find themselves unable to access valuable online mental health therapy and other healthcare,” says Sarah Johnson, an RN and the health ambassador for Family Assets. One reason is pure happenstance. They find themselves on the wrong side of the digital divide, which is to say they are not digital natives and are therefore often both unaware of or unskilled with much of the technology required to take advantage of these new healthcare options. The other is access and basic ownership of necessary technology. In a 2017 report from Pew Research, adults aged 65 to 69 were twice as likely to go online and four times as likely to own a smartphone than those 80 or older. Out of all individuals over 65, 34% reported little confidence in themselves to use any electronic device for online tasks, and 48% said they typically need someone else to set up and provide instruction on a new device. Brian Wind, PhD Many seniors are reluctant to use telehealth if they are not convinced that it can be as effective as in-person consultations or are not confident in making use of digital devices. — Brian Wind, PhD “Online therapy requires a strong Wi-Fi or broadband connection, access to technology, and a certain willingness to use telehealth which can come from their perception of the effectiveness of telehealth,” says Brian Wind, PhD, the chief clinical officer of Journey Pure and former co-chair of the American Psychological Association's advisory committee for employee assistance. In a 2017 report from Frontiers In Psychology, researchers asked adults aged 65 to 76 about the perceived and actual barriers they faced in using tablet computers, a form of technology none of them had used before. Common issues included a lack of instruction, feelings of inadequacy, health-related barriers, and cost. How to Transition From In-Person to Online Therapy Socioeconomic Barriers Johnson explains that socioeconomic status is another barrier to online therapy for older people. “In developing countries around the world, a large number of seniors live in poverty. They simply don't have the resources to purchase the hardware required to take advantage of these new healthcare opportunities,” she says. In the U.S., as well, older people may not be able to afford the technology necessary for conducting online therapy sessions. According to the National Council on Aging, 25 million Americans over the age of 60 are economically insecure, meaning they live at or below the poverty line. One-third of senior households end the month with no money or even in debt. As of 2013, 61.3% of households led by someone 60 years of age or older were in debt. If a person doesn’t have enough to pay—or can just cover—their bills, buying new or used technology isn’t possible. In the Pew Research report, 87% of seniors with yearly earnings of at least $75,000 had broadband at home, compared with only 27% of seniors making less than $30,000 per year. Telehealth Challenges Other Demographics Older people weren’t the only ones identified in the JAMA study to be less likely to schedule a telehealth appointment. Being female, Black or Latinx and having a lower household income were all linked to a lower frequency of video calls. As for scheduling fewer appointments of any kind, being Asian, on Medicaid, or not fluent in English were all reported factors. “Language barriers can reduce the accessibility of online therapy to patients,” says Wind. “There may also be a lack of understanding of which conditions can be addressed by telehealth and which conditions need to be addressed in an in-person consultation.” As of 2018, 67.3 million people spoke a language other than English at home in the United States. How COVID-19 Has Changed Our Mental Health World Increasing Accessibility to Online Therapy With the convenience of online therapy probably lasting far longer than the pandemic, society must address any lack of access or understanding of technology. “To increase accessibility, we may need broader policies that equip disadvantaged groups with access to digital devices and broadband,” says Wind. Wind continues, “Education schemes will be required both to get these groups and seniors comfortable with the use of digital devices for their healthcare needs and the health conditions that can be effectively and completely treated via telehealth.” Sarah Johnson, RN Increasing awareness of and discussion around online therapy is also necessary. This includes educating nurses, physicians, and other caregivers so that they can pass on valuable information and help seniors navigate the technology. — Sarah Johnson, RN Boosting the profile of online therapists who speak a variety of languages is another crucial step. “We also need broader measures such as diversifying the pipeline of physicians and nurses, reducing bias and translation services that will improve the accessibility to healthcare for both telehealth and physical consultations,” says Wind. Online therapy doesn’t have to be a permanent switch, but can help older people and other at-risk groups safely receive the mental health care they need during this challenging time. “It's unlikely that we'll ever be able to fully transition to telehealth even for medical conditions where a physical consultation is not necessary at all,” says Wind. "There will be a group of people who will prefer physical consultations even if they have access to digital devices, have technological knowledge and understanding, and a strong Wi-Fi connection.” What This Means For You Learning an unfamiliar task, technology or not, can be hard for anyone. If you're struggling to understand how to use a device to access online therapy, ask a loved one or your medical provider.Know someone who may need help navigating a digital appointment or doesn't have access to a device? Offer your assistance or even loan a piece of equipment if possible. Working together can ensure more people have access to the therapy they need as the pandemic continues. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Eberly LA, Kallan MJ, Julien HM, et al. Patient characteristics associated with telemedicine access for primary and specialty ambulatory care during the COVID-19 pandemic. JAMA Netw Open. 2020;3(12):e2031640. doi:10.1001/jamanetworkopen.2020.31640 World Health Organization. Mental health of older adults. Anderson M, Perrin A. Tech adoption climbs among older adults. Pew Research Center. Vaportzis E, Giatsi Clausen M, Gow AJ. Older adults perceptions of technology and barriers to interacting with tablet computers: A focus group study. Front Psychol. 2017;8:1687. doi:10.3389/fpsyg.2017.01687 National Council on Aging. Economic security for seniors facts. Zeigler K, Camarotaon SA. 67.3 million in the United States spoke a foreign language at home in 2018. Center for Immigration Studies. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.