Computer incursion in psychiatry via e-mental health: Innovation and implications to keep in mind

Journal title RIVISTA SPERIMENTALE DI FRENIATRIA
Author/s Sally Hardy, Fabian Van Essen, Luca Pingani
Publishing Year 2020 Issue 2020/2
Language English Pages 12 P. 33-44 File size 176 KB
DOI 10.3280/RSF2020-002003
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The digital health technologies have gained dramatic levels of interest and offer potential for self-managed, at scale, cost effective e-mental health. In this discussion paper, we aim to outline some of the contemporary issues arising from the computer’s incursion in the field of psychiatry, as the global demand for improved mental wellbeing advances. The authors bring their personal reflections and areas of interest on the subject of e-mental health, taking into consideration both potential pitfalls and therapeutic possibilities. The paper outlines as an introduction what is meant by e-mental health and explores how it is being utilized in areas such as depression, anxiety management, alongside emergent outcome data on, for example, rates of admissions to hospital, as an initial measure of e-mental health’s success. Having undertaken a review of the published evidence from the past five years, it can be seen how the subject is gaining attention, yet results are as yet limited to small numbers, and thus there is a limited evidence base. However, we also consider the implications for inclusion, through the application of e-health strategies for people living with additional neurological aspects such as intellectual disabilities, which as a population tends to limit uptake and exposure to online digital activity to date. We conclude with consideration of two critical questions on how to monitor, evaluate and regulate e-mental health activities, plus the ethical implications of e-exposure.

Keywords: Digital health technologies, e-mental health, intellectual disabilities, e-exposure outcomes.

  1. British Medical Association. Breaking down barriers: the challenge of improving mental health outcomes. London: British Medical Association; 2017.
  2. Lal S, Adair CE. E-Mental Health: A Rapid Review of the Literature. Psychiatric Services 2014; 65(1): 24-32.
  3. Little BR. Well-Doing: Personal Projects and the Social Ecology of Flourishing.
  4. In: Vittersø J, ed. Handbook of Eudaimonic Well-Being. Cham: Springer International Publishing; 2016. p. 297-305.
  5. Phillips K. A constructive-critical response to Creative Health: The Arts for Health and Wellbeing (July 2017) by the All-Party Parliamentary Group on Arts, Health and Wellbeing. International Journal of Art Therapy 2019; 24(1): 21-29. DOI: 10.1080/17454832.2018.1491612
  6. Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, et al. Financial crisis, austerity, and health in Europe. The Lancet 2013; 381(9874): 1323-1331. DOI: 10.1016/S0140-6736(13)60102-6
  7. Mattei G, Ferrari S, Pingani L, Rigatelli M. Short-term effects of the 2008 Great Recession on the health of the Italian population: an ecological study. Social psychiatry and psychiatric epidemiology 2014; 49(6): 851-858.
  8. Clough BA, Zarean M, Ruane I, Aliyeva TA, Casey LM. Going global: do consumer preferences, attitudes, and barriers to using e-mental health services differ across countries? Journal of Mental Health 2019; 28(1): 17-25. DOI: 10.1080/09638237.2017.1370639
  9. Torous J, Andersson G, Bertagnoli A, Christensen H, Cuijpers P, Firth J, et al.
  10. Towards a consensus around standards for smartphone apps and digital mental health: Towards a consensus around standards for smartphone apps and digital mental health. World Psychiatry 2019; 18(1): 97–98.
  11. World Health Organization. Global difusion of eHealth: making universal health coverage achievable. Report of the third global survey on eHealth. Geneva: World Health Organization; 2016.
  12. Hilty DM, Yellowlees PM, Myers K, Parish MB, Rabinowitz T. The Effectiveness of e-Mental Health: Evidence Base, How to Choose the Model Based on Ease/Cost/Strength, and Future Areas of Research. In: Mucic D, Hilty DM, ed. e-Mental Health. Cham: Springer International Publishing; 2016. p. 95-127.
  13. Marshall JM, Dunstan DA, Bartik W. The Digital Psychiatrist: In Search of Evidence-Based Apps for Anxiety and Depression. Frontiers in Psychiatry 2019; 10: 831.
  14. Wells MJ, Owen JJ, McCray LW, Bishop L, Eells TD, Brown GK, et al. Computer-Assisted Cognitive-Behavior Therapy for Depression in Primary Care: Systematic Review and Meta-Analysis. The Primary Care Companion for CNS Disorders 2018; 20(2): 17r02196. -- https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12188.aspx.
  15. Musiat P, Tarrier N. Collateral outcomes in e-mental health: a systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health. Psychological Medicine 2014; 44(15): 3137-3150. DOI: 10.1017/S0033291714000245
  16. Christensen LF, Moller AM, Hansen JP, Thuroe Nielsen C, Gildberget FA
  17. al. Patients’ and providers’ experiences with video consultations used in the treatment of older patients with unipolar depression: A systematic review. Journal of Psychiatric and Mental Health Nursing 2019; 44(15): 3137-3150.
  18. Salmoiraghi A, Hussain S. A Systematic Review of the Use of Telepsychiatry in Acute Settings. Journal of Psychiatric Practice 2015; 21(5): 389-393. -- https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpm.12574.
  19. Sansom-Daly UM, Wakefield CE, McGill BC, et al. Consensus Among International Ethical Guidelines for the Provision of Videoconferencing-Based Mental Health Treatments. JMIR Mental Health 2016; 3(2): e17.
  20. Søgaard Neilsen A, Wilson RL. Combining e-mental health intervention development with human computer interaction (HCI) design to enhance technology-facilitated recovery for people with depression and/or anxiety conditions: An integrative literature review. International Journal of Mental Health Nursing 2019; 28(1): 22-39.
  21. Rehm IC, Foenander E, Wallace K, Abbott JM, Kyrios M, Thomas N. What Role Can Avatars Play in e-Mental Health Interventions? Exploring New Models of Client-Therapist Interaction. Frontiers in Psychiatry 2016; 7: 186.
  22. Bell IH, Lim MH, Rossell SL, Thomas N. Ecological Momentary Assessment and Intervention in the Treatment of Psychotic Disorders: A Systematic Review. Psychiatric Services 2017; 68(11): 1172-1181.
  23. Tuikka A-M, Teittinen A, Vesala H. Digital Disability Divide in Finland. Finland: Well-Being in the Information Society. Fighting Inequalities, 7th International Conference; 2018.
  24. Aktion Mensch. Die Medienanstalten -- https://www.die-medienanstalten.de/publikationen/weitere-veroeffentlichungen/artikel/news/mediennutzung-vonmenschen-mit-behinderungen/ (2016).
  25. Reber Frei C. Inklusionschance oder Exklusionsrisiko? Digitale Medien – aktuelle und künftige Herausforderungen für die Sozial- und Heilpädagogik.
  26. Sozial Aktuell 2017; 525-529. -- http://www.sozia-media.ch/uploads/soziamedia/Reber_Sozial_Aktuell_5_2017.pdf.
  27. UN General Assembly. Convention on the Rights of Persons with Disabilities: resolution adopted by the General Assembly. https://www.refworld.org/docid/45f973632.html
  28. (2007). National Disability Authority. What is Universal Design -- http://universaldesign.ie/What-is-Universal-Design/ (accessed April 29, 2020).
  29. Insieme Schweiz, Stiftung “Zugang für alle”, Hochschule für Soziale Arbeit FHNW. Leitfaden Einfach Surfen. EINFACH SURFEN. Internet-Zugänglichkeit für Menschen mit kognitiven Beeinträchti ungen. Ein Leitfaden zur Gestaltung von einfachen Internet-Benutzeroberflächen.
  30. Learning Disability and Autism Engagement Team. NHS England. Guide to making information accessible for people with a learning disability. -- https://www.england.nhs.uk/wp-content/uploads/2018/06/LearningDisabilityAccessCommsGuidance.pdf (2018, accessed April 29, 2020).
  31. W3C - Web Accessibility Initiative. Web Content Accessibility Guidelines (WCAG). -- https://www.w3.org/WAI/standards-guidelines/wcag/ (2020).
  32. Forchuk C, Martin M-L, Corring D, Sherman D, Srivastava R, Harerimana B, et al. Cost-effectiveness of the implementation of a transitional discharge model for community integration of psychiatric clients: Practice insights and policy implications. International Journal of Mental Health 2019;48(3): 236-249. DOI: 10.1080/00207411.2019.164923
  33. Khalifian CE, Beard C, Björgvinsson T, Webb Ac. The Relation between Improvement in the Therapeutic Alliance and Interpersonal Functioning for Individuals with Emotional Disorders. International Journal of Cognitive Therapy 2019; 12(2): 109-125.
  34. Derevensky JL, Gainsbury SM. Social casino gaming and adolescents: Should we be concerned and is regulation in sight? International Journal of Law and Psychiatry 2016; 44: 441-446.
  35. NHS.-- Mental health appsh -- ttps://www.nhs.uk/apps-library/category/mentalhealth/(accessed April 29, 2020).
  36. YoungMinds. Who we are. -- https://youngminds.org.uk/ (accessed April 29, 2020).
  37. Olff M. Mobile mental health: a challenging research agenda. European Journal of Psychotraumatology 2015; 6(1): 27882.

Sally Hardy, Fabian Van Essen, Luca Pingani, Computer incursion in psychiatry via e-mental health: Innovation and implications to keep in mind in "RIVISTA SPERIMENTALE DI FRENIATRIA" 2/2020, pp 33-44, DOI: 10.3280/RSF2020-002003