Fostering Information Disclosure in Telemental Healthcare Settings: How Telehealth Can Mitigate the Deleterious Effects of Stigma

Abstract

Insufficient patient disclosure and persistent stigma undermine effective mental health care, a challenge magnified during the COVID-19 pandemic. Telehealth offers a promising avenue to reduce access barriers and improve equity, yet its effectiveness depends on patients’ willingness to disclose sensitive information online. This study develops a middle-range, contextually adapted version of the disclosure processes model (DPM) to explain and predict how stigma and technological features shape online self-disclosure in mental health settings. We conducted a randomized web-based experiment with 309 participants who viewed a video vignette depicting a consultation between a patient and a psychiatrist. The vignette manipulated diagnosis (ADHD vs. schizophrenia) and consultation mode (in-person vs. virtual). Results show that willingness to disclose increases with greater trust in technology, higher perceived social presence, and richer communication media. Initial disclosure goals align with differing levels of technological trust and self-disclosure. However, perceived stigma weakens these positive relationships, reducing patients’ readiness to share sensitive information. The research advances theory by extending the DPM into a context-specific, middle-range information systems framework that integrates stigma and media characteristics in online mental health care. Practically, the findings identify key communication features—such as social presence, richness, and trust in telehealth platforms—that can be calibrated to foster disclosure of stigmatized information. These insights inform the design and implementation of telehealth services that promote open communication and improve treatment engagement in mental health and other stigma-laden domains.