scholarly journals Digital Health Applications in Mental Health Care for Immigrants and Refugees: A Rapid Review

2021 ◽  
Vol 27 (1) ◽  
pp. 3-16 ◽  
Author(s):  
Andrian Liem ◽  
Rifani B. Natari ◽  
Jimmy ◽  
Brian J. Hall
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Digital Health ◽  
Rapid Review ◽  
Immigrants And Refugees ◽  
Health Applications

Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review (Preprint)

2021 ◽  
Author(s):  
Tristan J Philippe ◽  
Naureen Sikder ◽  
Anna Jackson ◽  
Maya E Koblanski ◽  
Eric Liow ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mobile Communications ◽  
Digital Health ◽  
Health Interventions ◽  
Stress Disorders ◽  
Health Conditions ◽  
Rapid Review ◽  
Mental Health Conditions

BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, video conferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a rapid review of the literature to assess the state of digital health interventions for the treatment of several mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010-2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Sixty percent (60%) of research involved the treatment of substance use disorders, 25% focused on mood, anxiety and traumatic stress disorders and 5% or less on other mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective, but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and online forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients, who are marginalized, and may lack access to digital health interventions.

scholarly journals Digital Health Needs of Women With Postpartum Depression: Focus Group Study (Preprint)

2020 ◽  
Author(s):  
Madison E Lackie ◽  
Julia S Parrilla ◽  
Brynn M Lavery ◽  
Andrea L Kennedy ◽  
Deirdre Ryan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Postpartum Depression ◽  
Mental Health Care ◽  
Focus Groups ◽  
Digital Health ◽  
Qualitative Description ◽  
New Mothers ◽  
Focus Group Study ◽  
Psychosocial Skills

BACKGROUND Although approximately 10% of new mothers in Canada develop postpartum depression (PPD), they face many barriers when accessing care. eHealth offers a unique opportunity to provide psychosocial skills and support to new mothers; however, patient populations are not consistently engaged in eHealth development processes. Thus, the diversity of women’s backgrounds and needs are often not reflected in existing tools. OBJECTIVE This study aims to engage women from a variety of backgrounds and locations around British Columbia (BC) who have previously experienced PPD to determine the unmet psychoeducational needs of women with PPD and how a web-enabled platform used to deliver psychosocial skills and education to assist in the management of PPD could fulfill those needs. METHODS Focus groups were conducted in 7 cities across BC with a total of 31 women (mean age 34.5 years, SD 4.9), with each group ranging from 2-7 participants. Focus groups were cofacilitated by the study coordinator and a local service provider in each community using a semistructured guide to discuss participants’ needs, ideas, and opinions as they relate to the use of technology in PPD management. Transcripts were approached inductively using thematic analysis to identify themes and qualitative description to frame what was observed in the data. RESULTS A total of 5 themes were identified: bridging gaps to meet needs; providing validation to combat stigma; nurturing capacity to cope, manage, and/or reach wellness; empowering people to take ownership over their mental health; and offering customization to ensure relevance. Each theme identified a need (eg, combatting stigma) and a way to address that need using a web-enabled intervention (eg, providing validation). At the intersection of these themes was the overarching value of promoting agency for women experiencing PPD. CONCLUSIONS Ultimately, new mothers require accessible mental health care that promotes their agency in mental health care decision making. Our participants believed that a web-enabled intervention could help meet this need. These data will be used to guide the design of such an intervention, with the eventual implementation of this resource as a first-line management option for PPD.

Separate or integrated services?

2021 ◽  
pp. 439-448
Author(s):  
Sofie Bäärnhielm ◽  
Mike Mösko ◽  
Aina Basilier Vaage
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Systems ◽  
Integrated Services ◽  
Explanatory Models ◽  
Post Traumatic Stress ◽  
Immigrants And Refugees ◽  
Care Systems ◽  
Health Promoting

In this chapter, we discuss the pros and cons of separate versus integrated services for immigrants and refugees. Our discussion is based on experiences from three high-income countries: Germany, Norway, and Sweden. All three, regardless of general public insurance systems covering healthcare costs, have barriers to mental health care for migrants and refugees. Additionally, their mental health care systems are unaccustomed to responding to cultural variety in patients’ expression of distress, explanatory models of illness, consequences of pre-migratory difficulties, and post-migratory adversities. Attention to post-traumatic stress and social determinants of mental health is also restricted. To bridge barriers and improve access to mental health care for immigrants and refugees, we will comment on the importance of adapting care, training of professionals, and outreach programmes. Also emphasized is the value of culturally sensitive mental health-promoting strategies to improve mental health literacy and reduce stigma among immigrants and refugees.

The Digital Revolution in Behavioral Health

2019 ◽  
Vol 26 (1) ◽  
pp. 102-111 ◽  
Author(s):  
Michael J Hasselberg
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Behavioral Health ◽  
Digital Health ◽  
Behavioral Health Care ◽  
The United States ◽  
Care Providers ◽  
Digital Revolution ◽  
The University

BACKGROUND: Technology is disrupting every modern industry, from supermarkets to car manufacturing, and is now entering the health care space. Technological innovations in psychiatry include the opportunity for conducting therapy via two-way video conferencing, providing electronic consultations, and telementoring and education of community health care providers. Use of mobile health applications is also an expanding area of interest and promise. OBJECTIVE: The purpose of this article is to review the evolution and pros and cons of technology-enabled health care since the digital movement in psychiatry began more than 50 years ago as well as describe the University of Rochester’s innovative digital behavioral health care model. METHODS: A review of the literature and recent reports on innovations in digital behavioral health care was conducted, along with a review of the University of Rochester’s model to describe the current state of digital behavioral health care. RESULTS: Given the lack of access to care and mental health professional shortages in many parts of the United States, particularly rural areas, digital behavioral health care will be an increasingly important strategy for managing mental health care needs. However, there are numerous hurdles to be overcome in adopting digital health care, including provider resistance and knowledge gaps, lack of reimbursement parity, restrictive credentialing and privileging, and overregulation at both the state and federal levels. CONCLUSIONS: Digital health innovations are transforming the delivery of mental health care services and psychiatric mental health nurses can be on the forefront of this important digital revolution.

scholarly journals Supporting Clinicians to Use Technology to Deliver Highly Personalized and Measurement-Based Mental Health Care to Young People: Protocol for an Evaluation Study

10.2196/24697 ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. e24697
Author(s):  
Henriette C Dohnt ◽  
Mitchell J Dowling ◽  
Tracey A Davenport ◽  
Grace Lee ◽  
Shane P Cross ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Training Program ◽  
Digital Health ◽  
Youth Mental Health ◽  
Evaluation Study ◽  
Education And Training ◽  
Knowledge And Skills ◽  
And Training

Background Australia’s mental health care system has long been fragmented and under-resourced, with services falling well short of demand. In response, the World Economic Forum has recently called for the rapid deployment of smarter, digitally enhanced health services to facilitate effective care coordination and address issues of demand. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution that incorporates 2 components: a highly personalized and measurement-based (data-driven) model of youth mental health care and a health information technology (HIT) registered on the Australian Register of Therapeutic Goods. Importantly, research into implementation of such solutions considers education and training of clinicians to be essential to adoption and optimization of use in standard clinical practice. The BMC’s Youth Mental Health and Technology Program has subsequently developed a comprehensive education and training program to accompany implementation of the digital health solution. Objective This paper describes the protocol for an evaluation study to assess the effectiveness of the education and training program on the adoption and optimization of use of the digital health solution in service delivery. It also describes the proposed tools to assess the impact of training on knowledge and skills of mental health clinicians. Methods The evaluation study will use the Kirkpatrick Evaluation Model as a framework with 4 levels of analysis: Reaction (to education and training), Learning (knowledge acquired), Behavior (practice change), and Results (client outcomes). Quantitative and qualitative data will be collected using a variety of tools, including evaluation forms, pre- and postknowledge questionnaires, skill development and behavior change scales, as well as a real-time clinical practice audit. Results This project is funded by philanthropic funding from Future Generation Global. Ethics approval has been granted via Sydney Local Health District’s Human Research Ethics Committee. At the time of this publication, clinicians and their services were being recruited to this study. The first results are expected to be submitted for publication in 2021. Conclusions The education and training program teaches clinicians the necessary knowledge and skills to assess, monitor, and manage complex needs; mood and psychotic syndromes; and trajectories of youth mental ill-health using a HIT that facilitates a highly personalized and measurement-based model of care. The digital health solution may therefore guide clinicians to help young people recover low functioning associated with subthreshold diagnostic presentations and prevent progression to more serious mental ill-health. International Registered Report Identifier (IRRID) PRR1-10.2196/24697

Linguistic and cultural barriers to access and utilization of mental health care for Farsi-speaking newcomers in Quebec

2020 ◽  
Vol 16 (4) ◽  
pp. 495-510
Author(s):  
Fahimeh Mianji ◽  
Jann Tomaro ◽  
Laurence J. Kirmayer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Language Barriers ◽  
Cultural Safety ◽  
Cultural Barriers ◽  
Content Type ◽  
Immigrants And Refugees

Purpose In light of the growing number of refugees and immigrants in Canada, this paper aims to identify barriers to mental health services for newcomer immigrants and refugees in Quebec and to examine how mental health services can be improved for these populations. Design/methodology/approach In this qualitative study, semi-structured individual interviews with Farsi-speaking health professionals and focus group interviews with participants from community organizations in Quebec were conducted. Findings Participants, both health-care professionals and community members, reported that mental health services are not readily accessible to Farsi-speaking immigrants and refugees. Structural barriers, language barriers, cultural safety and stigma were identified as obstacles to accessing care. Recommended strategies for improving access to mental health care are discussed. Originality/value Multiple studies have found that language and cultural barriers are associated with health inequalities and under-utilization of mental health services among linguistic and ethnic minorities. However, there are limited data on many groups and contexts, and a need to better understand how language barriers affect health outcomes, service utilization, patient satisfaction or overall costs to the health system or to society. In response to this gap, the present study explores how access to mental health services for Farsi-speaking newcomers may be limited by structural and linguistic barriers and cultural differences and as well as to identify strategies that can reduce the identified barriers.

scholarly journals Supporting Clinicians to Use Technology to Deliver Highly Personalized and Measurement-Based Mental Health Care to Young People: Protocol for an Evaluation Study (Preprint)

2020 ◽  
Author(s):  
Henriette C Dohnt ◽  
Mitchell J Dowling ◽  
Tracey A Davenport ◽  
Grace Lee ◽  
Shane P Cross ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Training Program ◽  
Digital Health ◽  
Youth Mental Health ◽  
Evaluation Study ◽  
Education And Training ◽  
Knowledge And Skills ◽  
And Training

BACKGROUND Australia’s mental health care system has long been fragmented and under-resourced, with services falling well short of demand. In response, the World Economic Forum has recently called for the rapid deployment of smarter, digitally enhanced health services to facilitate effective care coordination and address issues of demand. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution that incorporates 2 components: a highly personalized and measurement-based (data-driven) model of youth mental health care and a health information technology (HIT) registered on the Australian Register of Therapeutic Goods. Importantly, research into implementation of such solutions considers education and training of clinicians to be essential to adoption and optimization of use in standard clinical practice. The BMC’s Youth Mental Health and Technology Program has subsequently developed a comprehensive education and training program to accompany implementation of the digital health solution. OBJECTIVE This paper describes the protocol for an evaluation study to assess the effectiveness of the education and training program on the adoption and optimization of use of the digital health solution in service delivery. It also describes the proposed tools to assess the impact of training on knowledge and skills of mental health clinicians. METHODS The evaluation study will use the Kirkpatrick Evaluation Model as a framework with 4 levels of analysis: Reaction (to education and training), Learning (knowledge acquired), Behavior (practice change), and Results (client outcomes). Quantitative and qualitative data will be collected using a variety of tools, including evaluation forms, pre- and postknowledge questionnaires, skill development and behavior change scales, as well as a real-time clinical practice audit. RESULTS This project is funded by philanthropic funding from Future Generation Global. Ethics approval has been granted via Sydney Local Health District’s Human Research Ethics Committee. At the time of this publication, clinicians and their services were being recruited to this study. The first results are expected to be submitted for publication in 2021. CONCLUSIONS The education and training program teaches clinicians the necessary knowledge and skills to assess, monitor, and manage complex needs; mood and psychotic syndromes; and trajectories of youth mental ill-health using a HIT that facilitates a highly personalized and measurement-based model of care. The digital health solution may therefore guide clinicians to help young people recover low functioning associated with subthreshold diagnostic presentations and prevent progression to more serious mental ill-health. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/24697

scholarly journals Delivery of Compassionate Mental Health Care in a Digital Technology–Driven Age: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Jessica Kemp ◽  
Timothy Zhang ◽  
Fiona Inglis ◽  
David Wiljer ◽  
Sanjeev Sockalingam ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Scoping Review ◽  
Health Professionals ◽  
Digital Technology ◽  
Digital Health ◽  
Digital Technologies ◽  
Compassionate Care

BACKGROUND Compassion is a vital component to the achievement of positive health outcomes, particularly in mental health care. The rise of digital technologies may influence the delivery of compassionate care, and thus this relationship between compassion and digital health care needs to be better understood. OBJECTIVE This scoping review aimed to identify existing digital technologies being used by patients and health professionals in the delivery of mental health care, understand how digital technologies are being used in the delivery of compassionate mental health care, and determine the facilitators of and barriers to digital technology use among patients and health professionals in the delivery of compassionate mental health care. METHODS We conducted this scoping review through a search of Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online (MEDLINE), MEDLINE In-Process and EPub Ahead of Print, PsycINFO, and Web of Science for articles published from 1990 to 2019. RESULTS Of the 4472 articles screened, 37 articles were included for data extraction. Telemedicine was the most widely used technology by mental health professionals. Digital technologies were described as facilitating compassionate care and were classified using a conceptual model to identify each digital intersection with compassionate care. Facilitators of and barriers to providing compassionate care through digital technology were identified, including increased safety for providers, health care professional perceptions and abilities, and the use of <i>picture-in-picture</i> feedback to evaluate social cues. CONCLUSIONS Implementing digital technology into mental health care can improve the current delivery of compassionate care and create novel ways to provide compassion. However, as this is a new area of study, mental health professionals and organizations alike should be mindful that compassionate human-centered care is maintained in the delivery of digital health care. Future research could develop tools to facilitate and evaluate the enactment of compassion within digital health care.

scholarly journals Digital Health Needs of Women With Postpartum Depression: Focus Group Study

10.2196/18934 ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. e18934
Author(s):  
Madison E Lackie ◽  
Julia S Parrilla ◽  
Brynn M Lavery ◽  
Andrea L Kennedy ◽  
Deirdre Ryan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Postpartum Depression ◽  
Mental Health Care ◽  
Focus Groups ◽  
Digital Health ◽  
Qualitative Description ◽  
New Mothers ◽  
Focus Group Study ◽  
Psychosocial Skills

Background Although approximately 10% of new mothers in Canada develop postpartum depression (PPD), they face many barriers when accessing care. eHealth offers a unique opportunity to provide psychosocial skills and support to new mothers; however, patient populations are not consistently engaged in eHealth development processes. Thus, the diversity of women’s backgrounds and needs are often not reflected in existing tools. Objective This study aims to engage women from a variety of backgrounds and locations around British Columbia (BC) who have previously experienced PPD to determine the unmet psychoeducational needs of women with PPD and how a web-enabled platform used to deliver psychosocial skills and education to assist in the management of PPD could fulfill those needs. Methods Focus groups were conducted in 7 cities across BC with a total of 31 women (mean age 34.5 years, SD 4.9), with each group ranging from 2-7 participants. Focus groups were cofacilitated by the study coordinator and a local service provider in each community using a semistructured guide to discuss participants’ needs, ideas, and opinions as they relate to the use of technology in PPD management. Transcripts were approached inductively using thematic analysis to identify themes and qualitative description to frame what was observed in the data. Results A total of 5 themes were identified: bridging gaps to meet needs; providing validation to combat stigma; nurturing capacity to cope, manage, and/or reach wellness; empowering people to take ownership over their mental health; and offering customization to ensure relevance. Each theme identified a need (eg, combatting stigma) and a way to address that need using a web-enabled intervention (eg, providing validation). At the intersection of these themes was the overarching value of promoting agency for women experiencing PPD. Conclusions Ultimately, new mothers require accessible mental health care that promotes their agency in mental health care decision making. Our participants believed that a web-enabled intervention could help meet this need. These data will be used to guide the design of such an intervention, with the eventual implementation of this resource as a first-line management option for PPD.

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