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

2020 ◽  
pp. 33-44
Author(s):  
Sally Hardy ◽  
Fabian Van Essen ◽  
Luca Pingani
Keyword(s):  
Mental Health ◽  
Digital Health ◽  
Evidence Base ◽  
Outcome Data ◽  
Mental Wellbeing ◽  
Discussion Paper ◽  
Health Technologies ◽  
Ethical Implications ◽  
Published Evidence ◽  
The Subject

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.

Supporting mental health during COVID-19 using a digital behaviour change intervention: an open-label, single-arm, pre-post intervention research study (Preprint)

2021 ◽  
Author(s):  
Charlotte Summers ◽  
Philip Wu
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Perceived Stress ◽  
Digital Health ◽  
Mental Wellbeing ◽  
Behaviour Change Intervention ◽  
Open Label ◽  
Post Intervention ◽  
Convenience Sample ◽  
Health Technologies

BACKGROUND COVID-19 is taking its toll on people's mental health, particularly as people are advised to adhere to social distancing, self-isolation measures and government imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and supporting mental health and wellbeing. Particularly in the wake of the COVID-19 pandemic as even before this unprecedented time, mental health and social services were already stretched. OBJECTIVE Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health platform, a digital behaviour change intervention for self-management of mental wellbeing, sleep, activity, and nutrition. METHODS The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. From adults who had joined the intervention and had a complete baseline dataset (GAD-7 Anxiety Test Questionnaire, Perceived Stress Scale, PHQ-9 Patient Health Questionnaire), we followed all users for 12 weeks (N=273), including 33 (12.1%) who reported a positive COVID-19 diagnosis during the study period. Users engagement with the Gro Health platform was tracked by active minutes. RESULTS Of the 347 study participants, 273 (78.67%) completed both baseline and follow up surveys. Change in scores for anxiety, perceived stress and depression was predicted by app engagement with the strongest effect being seen in change perceived stress scores F(1,271)=251.397, p<0.001, with an R2 of .479. CONCLUSIONS A digital behaviour change platform that provides remote mental wellbeing support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. CLINICALTRIAL Approved by Royal Holloway, University of London Ethics Board.

Supporting mental health during COVID-19 using a digital behaviour change intervention: an open-label, single-arm, pre-post intervention research study (Preprint)

2021 ◽  
Author(s):  
Charlotte Summers ◽  
Philip Wu ◽  
Alisdair J G Taylor
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Perceived Stress ◽  
Digital Health ◽  
Mental Wellbeing ◽  
Behaviour Change Intervention ◽  
Open Label ◽  
Post Intervention ◽  
Convenience Sample ◽  
Health Technologies

BACKGROUND COVID-19 is taking its toll on people's mental health, particularly as people are advised to adhere to social distancing, self-isolation measures and government imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and supporting mental health and wellbeing. Particularly in the wake of the COVID-19 pandemic as even before this unprecedented time, mental health and social services were already stretched. OBJECTIVE Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health platform, a digital behaviour change intervention for self-management of mental wellbeing, sleep, activity, and nutrition. METHODS The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. From adults who had joined the intervention and had a complete baseline dataset (GAD-7 Anxiety Test Questionnaire, Perceived Stress Scale, PHQ-9 Patient Health Questionnaire), we followed all users for 12 weeks (N=273), including 33 (12.1%) who reported a positive COVID-19 diagnosis during the study period. Users engagement with the Gro Health platform was tracked by active minutes. RESULTS Of the 347 study participants, 273 (78.67%) completed both baseline and follow up surveys. Change in scores for anxiety, perceived stress and depression was predicted by app engagement with the strongest effect being seen in change perceived stress scores F(1,271)=251.397, p<0.001, with an R2 of .479. CONCLUSIONS A digital behaviour change platform that provides remote mental wellbeing support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic.

The Relationship Between Highly Visual Social Media and Young People’s Mental Health: A Scoping Review (Preprint)

2020 ◽  
Author(s):  
Alanna McCrory
Keyword(s):  
Mental Health ◽  
Social Media ◽  
Young People ◽  
Scoping Review ◽  
Quantitative Methods ◽  
Grey Literature ◽  
Significant Proportion ◽  
Mental Wellbeing ◽  
Published Evidence ◽  
The Impact

UNSTRUCTURED Users of highly visual social media (HVSM), such as Snapchat and Instagram, share their messages through images, rather than relying on words. A significant proportion of people that use these platforms are adolescents. Previous research reveals mixed evidence regarding the impact of online social technologies on this age group’s mental wellbeing, but it is uncertain whether the psychological effects of visual content alone differ from text-driven social media. This scoping review maps existing literature that has published evidence about highly visual social media, specifically its psychological impact on young people. Nine electronic databases and grey literature from 2010 until March 2019 were reviewed for articles describing any aspect of visual social media, young people and their mental health. The screening process retrieved 239 articles. With the application of eligibility criteria, this figure was reduced to 25 articles for analysis. Results indicate a paucity of data that exclusively examines HVSM. The predominance of literature relies on quantitative methods to achieve its objectives. Many findings are inconsistent and lack the richness that qualitative data may provide to explore the reasons for theses mixed findings.

scholarly journals COVID-19 creating challenges in a rehabilitation facility in Australia: A discussion paper

2021 ◽  
Vol 7 (1) ◽  
pp. 44
Author(s):  
Janet Green ◽  
Joanne Vallance ◽  
Rebekah Choong ◽  
Georgina McBride ◽  
Jeyanthi Arockiam ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Wellbeing ◽  
Discussion Paper ◽  
Rehabilitation Care ◽  
Mental Health Patients ◽  
Rehabilitation Facilities ◽  
Communication Challenges ◽  
Mental Health Practices ◽  
The Impact ◽  
Sydney Australia

The COVID-19 pandemic has brought about many challenges and alterations to long-standing procedures within rehabilitation facilities. These updates of the processes undertaken by staff in such settings have been radical and ongoing. COVID-19 impact on the healthcare system should never be underestimated nor under appreciated. The impact that this pandemic has had on rehabilitation care is unique. This has been the catalyst to identifying significant challenges and subsequent changes within rehabilitation and mental health practices. Social measures that have been implemented in the community have had exaggerated and magnified effects both on the physical and mental wellbeing of rehabilitation and mental health patients. Over the course of these adaptations and implementations, impacts on communication, mental health, workload and care efficiencies were identified and explored. This paper is unique because different disciplines have shared their experiences of the impacts of the COVID-19 pandemic and how they provide rehabilitation. The paper will focus on the communication challenges using masks, not being able to engage families and carers, restriction of group therapies, social isolation of patients and healthcare workers while adhering to guidelines set by NSW Health (Sydney, Australia).

scholarly journals Virtual reality as a clinical tool in mental health research and practice

2020 ◽  
Vol 22 (2) ◽  
pp. 169-177 ◽  
Keyword(s):  
Mental Health ◽  
Virtual Reality ◽  
Virtual Worlds ◽  
Ecological Validity ◽  
Evidence Base ◽  
Mental Health Research ◽  
Clinical Settings ◽  
Clinical Tool ◽  
Ethical Implications ◽  
Controlled Environments

Virtual reality (VR) is a potentially powerful technology for enhancing assessment in mental health. At any time or place, individuals can be transported into immersive and interactive virtual worlds that are fully controlled by the researcher or clinician. This capability is central to recent interest in how VR might be harnessed in both treatment and assessment of mental health conditions. The current review provides a summary of the advantages of using VR for assessment in mental health, focusing on increasing ecological validity of highly controlled environments, enhancing personalization and engagement, and capturing real-time, automated data in real-world contexts. Considerations for the implementation of VR in research and clinical settings are discussed, including current issues with cost and access, developing evidence base, technical challenges, and ethical implications. The opportunities and challenges of VR are important to understand as researchers and clinicians look to harness this technology to improve mental health outcomes.

scholarly journals Compulsory Community Treatment? I. Ontario Stakeholders' Responses to “Helping those Who Won't Help Themselves”

1993 ◽  
Vol 12 (1) ◽  
pp. 57-96 ◽  
Author(s):  
Françoise Boudreau ◽  
Philip Lambert
Keyword(s):  
Mental Health ◽  
American Literature ◽  
Community Mental Health Services ◽  
Community Treatment ◽  
Compulsory Treatment ◽  
Specific Question ◽  
Discussion Paper ◽  
Mentally Disordered ◽  
Compulsory Community Treatment ◽  
The Subject

This paper explores the highly controversial issue of compulsory treatment of allegedly mentally disordered persons within the community. In light of American literature on the subject, we examine and contrast the positions and arguments of a variety of Ontario stakeholders. This is done through content analysis of 224 submissions to the Ontario Ministry of Health in response to its “Discussion Paper Towards Community Mental Health Services Legislation of January 1990” which addresses the specific question: “Should the legislation include provisions for out-patient commitment/compulsory community treatment?” Our purpose in this paper is not to determine the desirability or undesirability of compulsory community treatment (CCT) as such, but to examine Ontario positions as a first and necessary step in the process of acquiring perspective on the issue.

Rhyme and Reason: The Relationship between Creative Writing and Mental Wellbeing

1997 ◽  
Vol 60 (12) ◽  
pp. 525-530 ◽  
Author(s):  
Christine M Jensen ◽  
Sheena E E Blair
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Creative Writing ◽  
Health Services ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Mental Wellbeing ◽  
Writing Group ◽  
The Subject ◽  
The Relationship

The relationship between creative writing and mental wellbeing is the subject of much debate and is often founded on conjecture and supposition. The aim of this small study was to explore the relationship between creative writing and mental wellbeing, with the cooperation of 14 adults who had all been users of mental health services and were involved in a creative writing group in the community. Qualitative data were collected from an interview (with the group facilitator), observation (of the group over a period of four group sessions) and the nominal group technique (to elicit the beliefs and opinions of the group itself). The findings of the study were two-fold. Firstly, there was a tension between the cathartic expression of thoughts and feelings and the production of quality writings and, secondly, the notion of stigmatisation as a result of being a user of mental health services emerged. This explorative study, carried out in an urban Scottish context, indicated a covert relationship between creative writing as a product (rhyme) and its therapeutic by-products which affect an individual's mental wellbeing (reason).

scholarly journals The Ethics of Emergent Health Technologies: Implications of the 21st Century Cures Act for Nursing

2020 ◽  
Vol 21 (4) ◽  
pp. 195-201
Author(s):  
Margaret Martin
Keyword(s):  
21St Century ◽  
Digital Health ◽  
Public Awareness ◽  
Health Technology ◽  
The United States ◽  
Practice Research ◽  
Health Technologies ◽  
Ethical Implications ◽  
Systems Research ◽  
21St Century Cures Act

The 21st Century Cures Act, passed in December 2016 by the United States Congress, is a public law aimed at accelerating the time it takes to get pharmaceutical drugs and medical devices into the market, in addition to shifting connected review processes from randomized controlled trials to real-world efficacy tests. As of December 2019, efforts are underway to introduce a “Cures Act 2.0” bill, with particular attention to the implementation of digital health within health systems. Research on the development of emergent health technologies is nascent; research examining health technology implications of 21st Century Cures Act for the health care workforce is nonexistent. This article fills a crucial gap in public awareness, discussing ethical implications of the 21st Century Cures Act and centering nursing. Nursing is a profession frequently acknowledged as practicing on “the front lines of care” and frequently responsible for the trialing of products in clinical settings. The article summarizes and evaluates key components of the 21st Century Cures Act related to health technology development. Discrete health technologies addressed are (a) breakthrough devices, (b) digital health software, and (c) combination products. It then connects these provisions to ethical considerations for nursing practice, research, and policy. The article concludes by discussing the relevance of emerging digital health technologies to the crafting of a “Cures 2.0” bill, with particular attention to this moment in light of digital care precedents set during the COVID-19 pandemic.

scholarly journals Digital mental health in China: a systematic review

2021 ◽  
pp. 1-19
Author(s):  
Xiaolong Zhang ◽  
Shôn Lewis ◽  
Joseph Firth ◽  
Xu Chen ◽  
Sandra Bucci
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Problems ◽  
Digital Health ◽  
Meta Analysis ◽  
Chinese Language ◽  
Health Problems ◽  
Future Research ◽  
The West ◽  
Health Technologies

Abstract Mental health problems are highly prevalent in China; however, China's mental health services lack resources to deliver high-quality care to people in need. Digital mental health is a promising solution to this short-fall in view of the population's digital literacy. In this review, we aim to: (i) investigate the effectiveness, acceptability, usability, and safety of digital health technologies (DHTs) for people with mental health problems in China; (ii) critically appraise the literature; and (iii) make recommendations for future research directions. The databases MEDLINE, PsycINFO, EMBASE, Web of Science, CNKI, WANFANG, and VIP were systemically searched for English and Chinese language articles evaluating DHTs for people with mental health problems in mainland China. Eligible studies were systematically reviewed. The heterogeneity of studies included precluded a meta-analysis. In total, 39 articles were retrieved, reporting on 32 DHTs for various mental health problems. Compared with the digital mental health field in the West, the Chinese studies targeted schizophrenia and substance use disorder more often and investigated social anxiety mediated by shame and culturally specific variants, DHTs were rarely developed in a co-production approach, and methodology quality was less rigorous. To our knowledge, this is the first systematic review focused on digital mental health in the Chinese context including studies published in both English and the Chinese language. DHTs were acceptable and usable among Chinese people with mental health problems in general, similar to findings from the West. Due to heterogeneity across studies and a paucity of robust control trial research, conclusions about the efficacy of DHTs are lacking.

scholarly journals Integration of eMental health technologies into traditional community-based interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Turmaine ◽  
C Picot Ngo ◽  
A Le Jeannic ◽  
J L Roelandt ◽  
K Chevreul ◽  
...  
Keyword(s):  
Mental Health ◽  
Digital Technology ◽  
Digital Health ◽  
Local Level ◽  
World Health ◽  
Local Network ◽  
Local Health ◽  
Community Based ◽  
Health Technologies ◽  
Health Programmes

Abstract Background Very little research has been conducted to appraise the merits of including municipalities and their local health providers in the promotion of digital health programmes. While more and more municipalities have locally implemented a health strategic plan and have focused on building local network of professionals, how do the latter react to the implementation of innovative e-mental health community-based programmes? Methods In 2018, 42 French municipalities volunteered to promote StopBlues, a digital health tool aimed at preventing mental distress and suicide. In each municipality, a local delegate was responsible for the promotion of the tool. Using observations, questionnaires and interviews with the delegates, we analysed how the promotion of StopBlues® was conducted in each setting. 2/3 of these municipalities started the promotion directly, and in 2019, a second wave of municipalities launched the promotion with a stronger support from the research team backed by the French World Health Organization Collaborating Centre for Research and Training in Mental Health (WHOCC). Results The use of digital technology in the implementation of a mental health programme received a mixed reception from the local health professionals because of its innovative aspect. 2/3 of the delegates declared that they were struggling to create a stronger network of local partners including private medical practioners. 63% of the respondents stated that their municipalities got involved in the programme for networking purposes. Conclusions Digital technologies have initiated a paradigm shift in the way community-based health programmes are set up but need to strengthen their territorial anchorage in order to be accepted and used at the local level. Key messages Digital technology can be a strong lever against health inequities but its effectiveness has to be studied carefully. Digital technolgy has to be implemented in local settings with the collaboration of local actors in order to be accepted and used.

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