Digital exclusion among Individuals with severe mental illness: a scoping review protocol
This scoping review protocol outlines a comprehensive study using Arksey and O'Malley's framework and PRISMA-ScR guidelines to map the definitions, manifestations, causes, and consequences of digital exclusion among individuals with severe mental illness across health and non-health domains, aiming to inform future research and service design.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In the modern world, digital technology has become the primary gateway to essential life. It is how people book doctor appointments, manage bank accounts, apply for jobs, and stay connected with family. For most, these tools are invisible utilities, but for some, the inability to access or use them creates a wall that separates them from society. This separation is known as digital exclusion. While it is often discussed as a simple lack of internet access or a missing smartphone, the reality is far more complex. It involves a tangled mix of financial hardship, lack of skills, cognitive challenges, and the way services are designed. When this exclusion happens to people living with severe mental illness, the stakes are particularly high. These individuals, who may be navigating conditions like schizophrenia or bipolar disorder, often face a unique set of barriers that go beyond just owning a device. They might struggle with the focus required to navigate a complex website, the financial means to afford data, or the trust needed to engage with digital systems. Understanding exactly how this exclusion manifests for this specific group is crucial, because without that understanding, efforts to help them may miss the mark entirely.
This is the precise gap that a new research plan, authored by Soo Yeon Lee, Miran Jung, and Kuem Sun Han, aims to fill. The team is not conducting a new experiment with patients; instead, they are embarking on a comprehensive map-making exercise known as a scoping review. Their goal is to gather every piece of existing research that discusses digital exclusion among adults with severe mental illness and organize it into a clear picture. They want to answer fundamental questions that have so far been scattered across different studies: How do researchers define this exclusion? How is it measured? What does it actually feel like for the people experiencing it? And what factors, from personal struggles to societal structures, contribute to the problem? By bringing together evidence from health domains and non-health areas like employment and housing, the researchers hope to see the full scope of the issue rather than just isolated fragments.
The researchers have designed a rigorous process to ensure their map is accurate and complete. They will search through a vast array of scientific databases, looking for published studies, unpublished reports, and policy documents. They are casting a wide net to include quantitative data, which counts numbers, as well as qualitative research, which captures personal stories and experiences. The team will focus specifically on adults aged eighteen and older who have severe mental illnesses, including conditions like schizophrenia, bipolar disorder, and psychotic depression. They will carefully filter out studies that mix these groups with people who have different conditions, such as dementia or substance use disorders, unless the data for the severe mental illness group can be separated out. This precision is vital because the challenges faced by someone with a psychotic disorder may differ significantly from those faced by someone with a different type of cognitive impairment.
Once the relevant studies are identified, the researchers will extract and organize the data using a structured approach. They will look for how different authors have defined digital exclusion, noting that some might call it a "digital divide" or "digital inequality" while others use different terms. They will chart the specific ways exclusion shows up, such as the inability to use a banking app, the lack of confidence to click a link, or the absence of a suitable device. The team will also examine the consequences of this exclusion, tracking how it affects a person's health, social connections, and economic stability. Crucially, they will look for the strategies that have been proposed to fix these problems, evaluating what has been tried and what gaps remain. The entire process will be conducted by two reviewers working independently to ensure that no single person's bias skews the results, with a third person stepping in to resolve any disagreements.
It is important to understand what this review will and will not do. The authors are not trying to prove that one specific solution works better than another, nor are they calculating a single number to represent how many people are affected. Because they are gathering studies that use very different methods and definitions, they cannot simply add the results together to create a statistical average. Instead, their work will serve as a detailed inventory of the current knowledge landscape. It will highlight where evidence is strong and where it is missing, showing which areas of life are most affected and which populations are most overlooked. The researchers acknowledge that by limiting their search to English-language texts, they might miss some valuable insights from other parts of the world, and they will not be able to determine the cause-and-effect relationships between digital exclusion and other life outcomes.
The value of this work lies in its ability to bring clarity to a confusing and fragmented field. By laying out exactly how digital exclusion is currently understood and experienced by people with severe mental illness, the review will provide a foundation for future research and better service design. It will help policymakers and service providers see that the problem is not just about handing out smartphones, but about addressing the complex interplay of clinical symptoms, financial constraints, and social support that keeps people on the wrong side of the digital divide. The findings will not offer a magic bullet, but they will offer a clear direction, pointing the way toward strategies that are truly inclusive and effective for a population that has too often been left behind.
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