Internet access is a socioeconomic issue

Editor—The paper by Christensen et al on delivering interventions for depression by using the internet is encouraging.¹ Researchers are starting to probe more deeply into the potential the internet has to offer in medical care. Since the rise and fall of the dotcom bubble over the past few years, much has been promised by this new technology, but the research evidence has been slower to follow.

This paper, however, further confirms my suspicion that use of the internet continues to be socioeconomically determined.² Christensen et al show that the people who gained the most from their internet intervention were well educated women in their late 30s. This is particularly worrying as groups well recognised to be particularly affected by mood disorders—namely, old and poor people—do not seem to be represented.

The explanation may be that old and poor people in Australia have a similar pattern of internet access to that of those in the United Kingdom. In the United Kingdom old and poor people have poor internet access. Of those over 65 years of age, only 7% have ever accessed the internet.³ Of the poorest 10% of the United Kingdom's population, only 12% have ever accessed the internet.⁴

The internet has the potential to offer much, but access to this resource continues to be a problem for those who most need it. Until access issues are addressed, it is hard to imagine that it will ever replace more traditional face to face services, and mental health service providers must resist the temptation to use it as a cut price way of providing their psychological treatments.