According to the U.S. Census Bureau, in the year 2009, 68 percent of households in the USA had internet access from their home computer. Since the early 1980’s there has been more than a fivefold increase in the proportion of households with computers. Among family households with income of $75,000 or more 88 percent had at least one computer and 79 percent had at least one member who used the Internet. Married-couple households were the most likely to have a computer or Internet access. The presence of a child also influenced whether a household had a computer or Internet access. Two thirds of households with a school age child (6-17 years) had a computer, and 53 percent had Internet access. These statistics opened the door to a new method for collecting data on mental health using either Web based surveys or E-mail surveys.
The initial movement for Web based surveys came from the software industry rather than from the academic research community. In the early days of the World Wide Web, pages were largely static and allowed only one-way communication, from the Web site to the user (Saxon, Garratt, Gilroy & Cairns, 2003). The arrival of the Internet and online communications expanded the potential modes of data collection, as well as the possibility of persons’ completing surveys at a time of their choosing. Thach (2003) claimed that there are three advantages for e-mail survey research over mailed surveys: speed, convenience of responding, and the absence of intermediaries. Other advantages of conducting electronic survey research include lower costs, faster transmission time, and ease of editing. In addition to that, some of the other advantages include the access to previously hidden populations and better data through the reduction of error. The reduction of error is due to the elimination of data entry.
Other advantages of the web survey are a return with a keystroke, and the information is recoded automatically into a database (McMahon, Iwamoto, Massoudi, Yusuf, Stevenson, David. et al, 2003). Schuldt (1994) argued that e-mail survey advantages are the elimination of time zone, not wasting paper (environmentally conscious), fast and easy to use, delivery is certain and the cost is low to reasonable. Aside from the obvious advantages stated above when using either web-based surveys or email surveys, it is essential to remember that from a research or data collection perspective, the ability to generalize findings using these methods is limited to those individuals with computers and Internet access.
One major disadvantage of the method is the lack of anonymity, as e-mail response typically comes back to the researcher with the sender’s information (Daley, McDermott, McCormack and Kittleson, 2003). Especially if we are interested in hidden or hard to reach populations, this could serve as a challenging factor. The “digital divide” (Rhodes, Bowie & Hergenrather, 2003) also presents the challenge of reaching only certain populations from certain socio-economic status. By and large, being able to retrieve and obtain data on mental health on populations with limited financial resources would be difficult to impossible.
Because most if not all measures to assess mental health relies on the ability of the person to report thoughts, feelings and behaviors, individuals who are interested in obtaining such information must take into account both the literacy level of the target individuals as well as any potential issues related to learning and developmental disabilities. A disability, for example, can possibly cause more missing data as compared with interviews administered online. The missing data can occur as a consequence of an individual’s particular learning disability which may impact his/her ability to process written information and to respond to it appropriately.
One of the biggest concerns of researchers and practitioners is the ability of the person who is responsible for the data collection to observe and respond to information presented by a respondent. If a respondent reports on suicidal thoughts or severe depressive symptoms that may be linked to harm to self or others, in a virtual world, the person who is collecting data has very limited resources to address such matters. Practitioners as well as researchers have an ethical responsibility towards clients or patients as well as research participants. Being conscious of vulnerable populations as well as effectively planning how to assist individuals who are reporting on mental health issues online needs to take center stage when considering contemporary methods for data collection on mental health.
Oren Shtayermman, PhD, MSW, is Assistant Professor of Mental Health Counseling and is Mental Health Counseling Program Coordinator and Research Associate to the VIP program at New York Institute of Technology, School of Health Professions, Behavioral and Life Sciences, in Old Westbury, New York.