The intention to adopt mental mHealth services in emergencies: pre-engagement social determinants of PTSD-Coach app use

Trauma-focused mobile health (mHealth) applications, such as PTSD-Coach, hold significant potential to address acute psychological needs following large-scale emergencies, yet adoption remains inconsistent. This study examined associations between psychosocial resources and intention to adopt the Hebrew version of PTSD-Coach in Israel after the October 7, 2023, terror attack, which triggered widespread collective trauma and ongoing war. Survey data from Israeli adults (<i>n</i> = 86) measured trauma literacy, self-efficacy, citizenship (willingness to share/recommend), and adoption intention. Quantitative analyses using multivariable regression identified a sequential pathway: trauma literacy enabled users to recognize symptom relevance, self-efficacy converted knowledge into capability, and citizenship extended adoption intentions into social spaces. Trauma literacy was the only significant predictor of intention in the full model, while demographic and clinical variables including trauma exposure were non-significant. Self-efficacy strongly predicted willingness to recommend the app, and once self-efficacy was included, the direct effect of knowledge diminished, supporting a sequential process: Knowledge → Self-efficacy → Citizenshi<i>p</i> → Intention. Rooted in social psychiatry and trauma-informed public mental health perspectives, this study theoretically interprets how individual psychological resources and social dynamics may shape early digital help-seeking in crisis conditions. Findings suggest that trauma literacy and perceived capability are central correlates of adoption readiness, challenging assumptions that lived trauma experience automatically increases help-seeking. This pattern may reflect how acute stress impairs information uptake and perceived self-efficacy. From a mental health systems perspective, these findings point to the potential importance of proactive psychoeducation, stigma-reduction strategies, and community-based outreach to support digital intervention uptake during collective trauma. Strengthening trauma literacy and self-efficacy may support timely self-management, help-seeking, and community resilience where formal psychiatric services are strained or inaccessible.