Recent health policies encourage electronic messaging with providers to potentially improve health care. It is unclear whether the same potential exists for individuals with mental health symptoms. Whereas these individuals appear interested in such technologies, they may also be concerned about privacy and security risks. To clarify this ambiguity, we conceptualize electronic messaging as an impression management tool for individuals with depressive symptoms, who risk devaluation from others. Consequently, factors that increase the perceived risk of devaluation in face-to-face clinical encounters may increase the likelihood of electronically messaging providers. We empirically examined two factors: depressive symptom severity and trust in physician confidentiality, which is the expectation that one’s regular physician uses personal health information appropriately. We found that reporting severe depressive symptoms increased the likelihood of electronically messaging providers but only among respondents who lacked trust in physician confidentiality. Electronic messaging is potentially a means to reach this underserved population.
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