Preferences for Digital Mental Health Services in Urban China: A Discrete Choice Experiment

Despite the high prevalence of mental disorders in China, most patients do not utilize mental health services. Digital mental health services offer a potential solution, but their full potential remains untapped. Understanding consumer preferences is key to tailoring these services and boosting acceptance and adoption.

This study aims to elicit preferences for digital mental health services in urban China.

A discrete choice experiment was conducted with 867 participants, including both current and potential consumers of mental health services, recruited from urban areas in China. Under the guidance of the Theory of Planned Behavior, attributes relevant to digital mental health services were identified through a multi-stage process including a literature review and in-depth semi-structured interviews with 30 consumers and potential consumers of mental health services, and five professionals from Internet-based healthcare and online psychological counseling fields. Six attributes were identified: (1) professional engagement; (2) intervention type; (3) endorser/recommender; (4) mode of content delivery; (5) monthly costs; and (6) privacy policy. Recruited via a market research company, participants completed a discrete choice experiment survey with 11 option sets online. Participants' choices were analyzed with a mixed logit model and further stratified by experience with mental health services, sex, education, income, age, and risk for mental health conditions. The relative importance score was calculated to interpret the results of the discrete choice experiment. Additionally, the willingness-to-pay approach was used to estimate the monetary value of each attribute level.

The most important influence on the choice of digital mental health services was the level of professional engagement (β = 2.470, β = 1.011), followed by the customized and adaptive intervention (β = 0.508) and data usage solely used for iterative product upgrades (β = 0.492). The relative importance score also revealed the most important attributes for consumers were professional engagement, intervention type, and privacy policy. Considering the professional engagement attribute, consumers were willing to pay an additional ¥3916.5 per month for services provided by mental health professionals throughout. Preferences diverged based on participant characteristics including experience with mental health services, sex, and education.

Our results indicated a consistent preference for services provided by mental health professionals across demographics and regardless of previous mental health service experience. We also found a preference for personalized services, highlighting a shift towards customization in healthcare and emphasizing the need to customize digital mental health services.