Introduction
Electronic health literacy (eHL) has become increasingly important as more people rely on digital sources for health information. For adults receiving mental health services, these skills influence not only how well they understand online material but also how confidently they take part in conversations about their care. Models of patient engagement and shared decision-making (SDM) underline that individuals need adequate understanding and appraisal skills in order to express preferences and participate meaningfully in treatment decisions. This study examined the level of eHL among mental health service recipients and explored how it relates to functional ability and basic personal characteristics.
Methods
A three-month cross-sectional study was conducted at the Psychiatric Hospital of Attica. A convenience sample of 200 adults from outpatient units, the “Meleti” Cognitive Rehabilitation Clinic, and community mental health centres completed the WHODAS 2.0 for functional assessment and the eHEALS questionnaire for eHL. Demographic information and ICD-10 diagnoses were also collected. Validated Greek versions of both instruments were used with appropriate permissions.
Results
Most participants had F20 diagnoses. Higher eHL scores showed a moderate relationship with better functional performance on WHODAS 2.0. Education demonstrated a clear positive association with eHL, and women reported greater confidence in locating and evaluating online information. Age displayed a weak negative relationship, and diagnostic category was not a strong predictor. Although internet use was common, many participants were unsure of how to judge the reliability of online sources—an important skill for engaging in discussions about treatment options.
Conclusions
Supporting the development of eHL, especially appraisal skills, may strengthen the foundations needed for patient engagement and SDM. Individuals with higher eHL and better functional ability are generally better equipped to understand treatment information, express informed preferences, and collaborate more effectively with clinicians. Tailored digital literacy interventions could contribute to more participatory and equitable mental healthcare.
