Willingness of Patients With Mental Disorders to Engage in Online Psychotherapy: Multicenter Cross-Sectional Survey.

BACKGROUND

China faces a high prevalence of mental disorders but low treatment uptake, a gap driven by limited awareness and unevenly distributed mental health resources. While online psychotherapy has the potential to expand access, patient willingness remains insufficiently explored.

OBJECTIVE

This study aimed to investigate the willingness of Chinese patients with mental disorders to engage in online psychotherapy and to identify associated factors.

METHODS

A multicenter, cross-sectional survey was conducted using a structured questionnaire to assess the attitudes and willingness of patients with mental disorders in China to engage in online psychotherapy. Willingness to engage in online psychotherapy was assessed using a 0 to 100 rating scale, with higher scores indicating greater willingness. Univariate analysis, correlation analysis, and multivariate linear regression analyses were used to identify factors influencing willingness.

RESULTS

Among 361 eligible participants, the mean willingness score for online psychotherapy was 70 (SD 28.56). In total, 86.4% (n=312) of participants preferred short-term therapy (1 to 10 sessions), while 92.5% (n=334) expected the cost per session to remain less than CNY ¥400 (US $55.50). Participants most preferred therapist-guided online individual therapy (n=142, 39.3%). Convenience (124/361, 34.3%) and perceived anonymity ("no one will know about the illness"; 119/361, 33.0%) were the 2 most commonly reported perceived benefits of online psychotherapy. The leading barrier was concerns about data security and privacy (108/303, 35.6%), followed by difficulty in establishing therapeutic rapport (60/303, 19.8%). The regression analysis revealed that age, self-stigma, satisfaction with current psychiatric medications, and satisfaction with previous online psychotherapy significantly influenced patients' willingness to seek online psychotherapy.

CONCLUSIONS

This multicenter study reveals a high level of willingness to engage in online psychotherapy among Chinese patients, with self-stigma as a key barrier. These findings support the development of tailored services, stigma reduction interventions, and infrastructure investment to enhance mental health care delivery.