scholarly journals Ethical Development of Digital Phenotyping Tools for Mental Health Applications: Delphi Study (Preprint)

2021 ◽  
Author(s):  
Nicole Martinez-Martin ◽  
Henry T Greely ◽  
Mildred K Cho
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Data Protection ◽  
Delphi Study ◽  
Ethical Issues ◽  
Clinical Care ◽  
Personal Data ◽  
Digital Phenotyping ◽  
Consensus Statements ◽  
Health Applications

BACKGROUND Digital phenotyping (also known as <i>personal sensing</i>, <i>intelligent sensing</i>, or <i>body computing</i>) involves the collection of biometric and personal data <i>in situ</i> from digital devices, such as smartphones, wearables, or social media, to measure behavior or other health indicators. The collected data are analyzed to generate moment-by-moment quantification of a person’s mental state and potentially predict future mental states. Digital phenotyping projects incorporate data from multiple sources, such as electronic health records, biometric scans, or genetic testing. As digital phenotyping tools can be used to study and predict behavior, they are of increasing interest for a range of consumer, government, and health care applications. In clinical care, digital phenotyping is expected to improve mental health diagnoses and treatment. At the same time, mental health applications of digital phenotyping present significant areas of ethical concern, particularly in terms of privacy and data protection, consent, bias, and accountability. OBJECTIVE This study aims to develop consensus statements regarding key areas of ethical guidance for mental health applications of digital phenotyping in the United States. METHODS We used a modified Delphi technique to identify the emerging ethical challenges posed by digital phenotyping for mental health applications and to formulate guidance for addressing these challenges. Experts in digital phenotyping, data science, mental health, law, and ethics participated as panelists in the study. The panel arrived at consensus recommendations through an iterative process involving interviews and surveys. The panelists focused primarily on clinical applications for digital phenotyping for mental health but also included recommendations regarding transparency and data protection to address potential areas of misuse of digital phenotyping data outside of the health care domain. RESULTS The findings of this study showed strong agreement related to these ethical issues in the development of mental health applications of digital phenotyping: privacy, transparency, consent, accountability, and fairness. Consensus regarding the recommendation statements was strongest when the guidance was stated broadly enough to accommodate a range of potential applications. The privacy and data protection issues that the Delphi participants found particularly critical to address related to the perceived inadequacies of current regulations and frameworks for protecting sensitive personal information and the potential for sale and analysis of personal data outside of health systems. CONCLUSIONS The Delphi study found agreement on a number of ethical issues to prioritize in the development of digital phenotyping for mental health applications. The Delphi consensus statements identified general recommendations and principles regarding the ethical application of digital phenotyping to mental health. As digital phenotyping for mental health is implemented in clinical care, there remains a need for empirical research and consultation with relevant stakeholders to further understand and address relevant ethical issues.

scholarly journals Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study

2016 ◽  
Vol 13 (5) ◽  
pp. 489 ◽  
Author(s):  
Elisabeta Hiriscau ◽  
Nicola Stingelin-Giles ◽  
Danuta Wasserman ◽  
Stella Reiter-Theil
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Delphi Study ◽  
Ethical Issues ◽  
Mental Health Research

Handling Ethical Dilemmas in Multidisciplinary Teams

2014 ◽  
Author(s):  
Jill Thistlethwaite ◽  
Wendy Hawksworth
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Interprofessional Collaboration ◽  
Ethical Dilemmas ◽  
Multidisciplinary Teams ◽  
Team Members ◽  
Secondary Health Care

This chapter explores the concept and practice of teamwork and interprofessional collaboration in the support and treatment of clients with mental health problems. Mental health care provision is complex, ethically challenging, and frequently delivered via mental health care teams (MHCT) in both primary and secondary health care settings. We consider how such teams may work together optimally using values-based and client-centered approaches. We discuss the nature of and reasons for conflict arising in multidisciplinary MHCTs, focusing on ethical dilemmas that occur where there is diversity amongst team members in respect of personal, professional, and/or organizational values. The specific ethical issues discussed are: boundary issues; receiving gifts; confidentiality, and involuntary treatment and restraint. Three case studies are used to provide examples of values in action.

scholarly journals International Interprofessional Collaborative Office Rounds (iiCOR): Addressing Children's Developmental, Behavioral, and Emotional Health Using Distance Technology

2021 ◽  
Vol 9 ◽  
Author(s):  
Jennifer S. H. Kiing ◽  
Heidi M. Feldman ◽  
Chris Ladish ◽  
Roopa Srinivasan ◽  
Craig L. Donnelly ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Services ◽  
Best Practice ◽  
Emotional Health ◽  
Clinical Care ◽  
Learning Technology ◽  
Cultural Variation ◽  
Co Morbidity

Developmental, behavioral, and emotional issues are highly prevalent among children across the globe. Among children living in low- and middle-income countries, these conditions are leading contributors to the global burden of disease. A lack of skilled professionals limits developmental and mental health care services to affected children globally. Collaborative Office Rounds are interprofessional groups that meet regularly to discuss actual cases from the participants' practices using a non-hierarchical, peer-mentoring approach. In 2017, International Interprofessional Collaborative Office Rounds was launched with several goals: to improve the knowledge and skills of practicing child health professionals in high and low resourced settings regarding developmental and mental health care, to support trainees and clinicians in caring for these children, and to promote best practice in diagnosis and management of these conditions. Five nodes, each comprised of 3–4 different sites with an interprofessional team, from 8 countries in North America, Africa, Asia, and South America met monthly via videoconferencing. This report describes and evaluates the first 2 years' experience. Baseline surveys from participants (N = 141) found that 13 disciplines were represented. Qualitative analysis of 51 discussed cases, revealed that all cases were highly complex. More than half of the cases (N = 26) discussed children with autism or traits of autism and almost all (N = 49) had three or more themes discussed. Frequently occurring themes included social determinants of health (N = 31), psychiatric co-morbidity (N = 31), aggression and self-injury (N = 25), differences with the healthcare provider (N = 17), cultural variation in accepting diagnosis or treatment (N = 19), and guidance on gender and sexuality issues (N = 8). Participants generally sought recommendations on next steps in clinical care or management. A survey of participants after year 1 (N = 47) revealed that 87% (N = 41) had expectations that were completely or mostly met by the program. Our experience of regular meetings of interprofessional groups from different countries using distance-learning technology allowed participants to share on overlapping challenges, meet continuing educational needs while learning about different approaches in high- and low-resourced settings. International Interprofessional Collaborative Office Rounds may prove a useful strategy for increasing the work force capacity for addressing developmental, behavioral, and emotional conditions worldwide. More systematic studies are needed.

Daily ward process in inpatient mental health care

2019 ◽  
pp. 187-192
Author(s):  
Katalin Walsby ◽  
Caroline Attard
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Clinical Care ◽  
Therapeutic Relationships ◽  
Inpatient Mental Health ◽  
Safe Environments

This chapter describes regular daily processes within the inpatient mental health ward that form the backbone of the ward’s functioning and underpin the ability of wards to provide therapeutic and safe environments. Precisely because acute inpatient wards can be unpredictable, with changing circumstances generating unremitting challenges to patients, carers, and staff, these daily processes, such as handover, medication, and mealtimes, are crucial to help create a sense of structure as well as safe clinical care. These processes must be followed if inpatient psychiatric wards are going to be able to provide an environment that allows the development of enabling and therapeutic relationships for patients, carers, and staff themselves.

scholarly journals Keeping people with epilepsy safe during the COVID-19 pandemic

Neurology ◽  
2020 ◽  
Vol 94 (23) ◽  
pp. 1032-1037 ◽  
Author(s):  
Jacqueline A. French ◽  
Martin J. Brodie ◽  
Roberto Caraballo ◽  
Orrin Devinsky ◽  
Ding Ding ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Care Pathway ◽  
Clinical Care ◽  
Health Care Facilities ◽  
Urgent Care ◽  
Consensus Recommendations ◽  
Consensus Statements ◽  
Care Facilities ◽  
Strongly Agree

ObjectivesTo provide information on the effect of the coronavirus disease of 2019 (COVID-19) pandemic on people with epilepsy and provide consensus recommendations on how to provide the best possible care for people with epilepsy while avoiding visits to urgent care facilities and hospitalizations during the novel coronavirus pandemic.MethodsThe authors developed consensus statements in 2 sections. The first was “How should we/clinicians modify our clinical care pathway for people with epilepsy during the COVID-19 pandemic?” The second was “What general advice should we give to people with epilepsy during this crisis? The authors individually scored statements on a scale of −10 (strongly disagree) to +10 (strongly agree). Five of 11 recommendations for physicians and 3/5 recommendations for individuals/families were rated by all the authors as 7 or above (strongly agree) on the first round of rating. Subsequently, a teleconference was held where statements for which there was a lack of strong consensus were revised.ResultsAfter revision, all consensus recommendations received a score of 7 or above. The recommendations focus on administration of as much care as possible at home to keep people with epilepsy out of health care facilities, where they are likely to encounter COVID-19 (including strategies for rescue therapy), as well as minimization of risk of seizure exacerbation through adherence, and through ensuring a regular supply of medication. We also provide helpful links to additional helpful information for people with epilepsy and health providers.ConclusionThese recommendations may help health care professionals provide optimal care to people with epilepsy during the coronavirus pandemic.

scholarly journals COVID-19 mental health care toolkit: an international collaborative effort by Early Career Psychiatrists section

2020 ◽  
Vol 33 (5) ◽  
pp. e100270
Author(s):  
Frances Adiukwu ◽  
Laura Orsolini ◽  
Drita Gashi Bytyçi ◽  
Samer El Hayek ◽  
Jairo M Gonzalez-Diaz ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Clinical Care ◽  
Outpatient Setting ◽  
Early Career ◽  
Collaborative Effort ◽  
Risk Patients ◽  
International Research Team ◽  
Health Field

The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use, quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic. This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals, regardless of their expertise within the mental health field with minimal training. It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints, we will be able to bridge the mental health gap present in our society.

scholarly journals Evolving Ethical Issues in Health and Mental Health

2017 ◽  
Vol 53 (03) ◽  
pp. 121-130
Author(s):  
Shridhar Sharma
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Ethical Issues ◽  
Health Care Institution ◽  
Self Determination ◽  
Human Beings ◽  
Basic Principles ◽  
Care Institution ◽  
Human Conduct ◽  
The Right

ABSTRACTEthics is the Science of morals in human conduct. However, ethics and morals are not same. The ethics is based on certain principles, which include 'Respect for Person and Justice'. This principle is not in total conformity with Hippocratic tradition, where Physician is given a 'Position of Paternalism'. The basic idea of 'justice' is that all human beings are equally valuable. Similarly, the principle of liberty is the right to self determination but what is the use of this right that can not be fulfilled. These basic principles are evolving and are constantly posing problems in every health care institution and are a challenge to every Physician.

scholarly journals From impact factors to real impact: translating evidence on lifestyle interventions into routine mental health care

2019 ◽  
Vol 10 (4) ◽  
pp. 1070-1073 ◽  
Author(s):  
Jeroen Deenik ◽  
Louise Czosnek ◽  
Scott B Teasdale ◽  
Brendon Stubbs ◽  
Joseph Firth ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Care ◽  
Premature Mortality ◽  
Impact Factors ◽  
Future Research ◽  
Lifestyle Interventions ◽  
Routine Clinical Care ◽  
Effective Interventions ◽  
Limited Effectiveness

Abstract The scandal of premature mortality in people with serious mental illness is well established. Despite an increase in studies evaluating the efficacy of lifestyle interventions, translating this evidence into routine clinical care and policies is challenging, in part due to limited effectiveness or implementation research. We highlight the challenge of implementation that is increasingly recognized in clinical practice, advocate for adopting implementation science to study the implementation and systematic update of effective interventions in practice and policy, and provide directions for future research.

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