Robotic Telemedicine for Mental Health: A Multimodal Approach to Improve Human-Robot Engagement

COVID-19 has severely impacted mental health in vulnerable demographics, in particular older adults, who face unprecedented isolation. Consequences, while globally severe, are acutely pronounced in low- and middle-income countries (LMICs) confronting pronounced gaps in resources and clinician accessibility. Social robots are well-recognized for their potential to support mental health, yet user compliance (i.e., trust) demands seamless affective human-robot interactions; natural ‘human-like’ conversations are required in simple, inexpensive, deployable platforms. We present the design, development, and pilot testing of a multimodal robotic framework fusing verbal (contextual speech) and nonverbal (facial expressions) social cues, aimed to improve engagement in human-robot interaction and ultimately facilitate mental health telemedicine during and beyond the COVID-19 pandemic. We report the design optimization of a hybrid face robot, which combines digital facial expressions based on mathematical affect space mapping with static 3D facial features. We further introduce a contextual virtual assistant with integrated cloud-based AI coupled to the robot’s facial representation of emotions, such that the robot adapts its emotional response to users’ speech in real-time. Experiments with healthy participants demonstrate emotion recognition exceeding 90% for happy, tired, sad, angry, surprised and stern/disgusted robotic emotions. When separated, stern and disgusted are occasionally transposed (70%+ accuracy overall) but are easily distinguishable from other emotions. A qualitative user experience analysis indicates overall enthusiastic and engaging reception to human-robot multimodal interaction with the new framework. The robot has been modified to enable clinical telemedicine for cognitive engagement with older adults and people with dementia (PwD) in LMICs. The mechanically simple and low-cost social robot has been deployed in pilot tests to support older individuals and PwD at the Schizophrenia Research Foundation (SCARF) in Chennai, India. A procedure for deployment addressing challenges in cultural acceptance, end-user acclimatization and resource allocation is further introduced. Results indicate strong promise to stimulate human-robot psychosocial interaction through the hybrid-face robotic system. Future work is targeting deployment for telemedicine to mitigate the mental health impact of COVID-19 on older adults and PwD in both LMICs and higher income regions.

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Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137067 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7067

Author(s):

Esther García-Esquinas ◽

Rosario Ortolá ◽

Iago Gine-Vázquez ◽

José A. Carnicero ◽

Asier Mañas ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Older Adults ◽

Social Isolation ◽

Community Dwelling ◽

Housing Conditions ◽

Older Individuals ◽

Lifestyle Risk Factors ◽

Increased Risk ◽

Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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Pemberdayaan Siswa SMAN 1 Sumberpucung Dalam Dukungan Kesehatan Jiwa Dan Psikososial Covid-19 Untuk Kelompok Rentan Khususnya Lansia

JURNAL KREATIVITAS PENGABDIAN KEPADA MASYARAKAT (PKM) ◽

10.33024/jkpm.v4i4.4045 ◽

2021 ◽

Vol 4 (4) ◽

pp. 853-866

Author(s):

Berliany Venny Sipollo ◽

Mochamad Ali Sodikin

Keyword(s):

Mental Health ◽

Older Adults ◽

Mental Health Problems ◽

Psychosocial Support ◽

Psychosocial Health ◽

Health Impact ◽

Health Problems ◽

The Body ◽

Vulnerable Groups ◽

Young Generation

ABSTRAK Pandemi COVID-19 merupakan bencana non alam yang berdampak tidak hanya pada kesehatan fisik saja tetapi berdampak pula terhadap kesehatan jiwa dan psikososial masyarakat. Dampak kesehatan jiwa dan psikososial ini dapat menurunkan sistem imunitas tubuh manusia khususnya kelompok rentan yaitu kelompok lansia. Semakin seseorang merasa cemas yang berlebihan, maka tubuh mengalami kegagalan dalam menghasilkan antibodi untuk melawan virus.. Klien yang terdiagnosis positif COVID-19 merasa sangat takut dengan bayangan kematian, dan secara sosial diisolasi yang akan menimbulkan stigma sehingga mungkin terjadi ansietas dan depresi yang bila berlanjut dapat menyebabkan keputusasaan yang akan memperburuk kondisi fisik. Pemberdayaan generasi muda dalam hal ini adalah siswa SMAN 1 Sumberpucung dalam mendukung kesehatan jiwa dan psikosial lansia, yaitu lansia yang berada dalam keluarga siswa. Metode yang digunakan di masa pandemic COVID-19 dengan kegiatan atau pelatihan DKJPS (Dukungan Kesehatan Jiwa dan Psikososial) dievaluasi selama 1,5 bulan berupa melakukan upaya promosi kesehatan (peningkatan imunitas fisik dan imunitas jiwa) dan pencegahan masalah kesehatan (pencegahan penularan dan pencegahan masalah kesehatan jiwa) yang pada akhirnya disebut sebagai Adaptasi Kebiasaan Baru (AKBmelalui virtual menggunakan zoom dan platform Whatsapp Group Chat dengan metode ceramah, Tanya jawab, diskusi dan demonstrasi. Hasil Jumlah audience: 50 siswa dan jumlah lansia dan pra lansia: 11 orang Kata Kunci : Kesehatan Jiwa, Psikososial, Generasi Muda, Lansia ABSTRACT The COVID-19 pandemic is a non-natural disaster that has an impact not only on physical health but also on the mental and psychosocial health of the community. This mental and psychosocial health impact can reduce the immune system of the human body, especially vulnerable groups, namely the older adults. The more a person feels excessively anxious; the body fails to produce antibodies to fight the virus. Clients who are diagnosed positive for COVID-19 feel very afraid of the image of death and are socially isolated which will lead to stigma so that anxiety and depression may occur if it continues. Can cause despair that will worsen the physical condition. The empowerment of the younger generation in this case is the students of SMAN 1 Sumberpucung in supporting the mental and psychosocial health of the older adults, which was the older adults who are in the student's family. The method used during the COVID-19 pandemic with DKJPS (Mental Health and Psychosocial Support) activities or training was evaluated for 4 weeks in the form of health promotion efforts (increasing physical immunity and mental immunity) and prevention of health problems (prevention of transmission and prevention of mental health problems. ) which is finally referred to as New Habit Adaptation (AKB through virtual using zoom and the Whatsapp Group Chat platform with the methods of lecturing, question and answer, discussion and demonstration Results Number of audiences: 50 students and the number of older adults and pre-elderly: 11 people Keywords: Mental Health, Psychosocial, Young Generation, Older Adults

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A study of the effectiveness of MP3 players to support family carers of people living with dementia at home

International Psychogeriatrics ◽

10.1017/s1041610214001999 ◽

2014 ◽

Vol 27 (3) ◽

pp. 471-479 ◽

Cited By ~ 7

Author(s):

Virginia Lewis ◽

Michael Bauer ◽

Margaret Winbolt ◽

Carol Chenco ◽

Francine Hanley

Keyword(s):

Mental Health ◽

Low Cost ◽

Family Carers ◽

Health And Wellbeing ◽

People With Dementia ◽

Mp3 Players ◽

Mp3 Player ◽

High Level ◽

And Coping ◽

Person With Dementia

ABSTRACTBackground:Music can be therapeutic to people with dementia; however, little is known about its effect on the family carers. This project aimed to (1) assess the effects of MP3 player use by a person with dementia on caregivers’ mental health and wellbeing, including their self-care and health-promoting behavior and (2) determine whether MP3 player use increases caregivers’ self-reported capacity to cope with their role.Methods:A pre–post quantitative and qualitative design was used. Carers completed a survey prior to commencing and four weeks after using the player. The survey included validated measures to assess the level of stress and coping among carers. Carers also kept a diary of the way they used the MP3 player. Half of the carers were interviewed about their experiences at the end of the study.Results:Of 59 people who started using the MP3 player, 51 carers completed the four-week study period and surveys. Use of the MP3 player significantly decreased psychological distress, significantly improved the mental health and wellbeing of carers, significantly increased caregiver self-efficacy to manage symptoms of dementia, and was reported to provide valued respite from the high level of vigilance required for caring for a person with dementia.Conclusion:An MP3 player loaded with music can be a low cost and relatively simple and effective additional strategy to support families caring for people with dementia in the community.

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Prison Unhealthy Lifestyle and Poor Mental Health of Older Persons—A Qualitative Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.690291 ◽

2021 ◽

Vol 12 ◽

Author(s):

Félix Pageau ◽

Corinne Devaud Cornaz ◽

Isabelle Gothuey ◽

Helene Seaward ◽

Tenzin Wangmo ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Qualitative Interviews ◽

Mental Healthcare ◽

Poor Mental Health ◽

Medical Conditions ◽

Older Individuals ◽

Unhealthy Lifestyle ◽

Lifestyle Habits ◽

Access To Food

Background: Mental healthcare and lifestyle habits in prison, especially for older individuals, has been shown to be suboptimal. Most psychiatric conditions left untreated worsen food choices, physical inactivity, and substance abuse. In turn, bad habits lead to poorer mental health.Methods: To comprehensively illustrate this downward spiraling, we completed a thorough analysis of data obtained through semi-structured qualitative interviews. There were 50 interviews of aging incarcerated people included in this article. They were analyzed following a classical six-stepped thematic analysis.Results: According to our participants, sports are not well-adapted to aging individuals, nor to people with medical conditions. Prison is even more unadapted for those who both are aging and have medical conditions. Also, food served is less than optimal. According to our interviews, the older imprisoned individual often does not have access to food adapted to his or her medical conditions. Sport is maladapted for older incarcerated individuals and mostly tailored for younger ones. Finally, boredom and lack of responsibility hinder change toward a better lifestyle for older adults in prison.Conclusion: Our paper shows why prison environmental modifications are needed to help older adults with their lifestyle habits. It also exposes an original way to see the relationship between mental health and lifestyle habits.

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Decision making and mental health across adulthood during social distancing

10.31234/osf.io/dr798 ◽

2020 ◽

Author(s):

Kendra Leigh Seaman ◽

Eric Juarez ◽

Addison Troutman ◽

Joanna Salerno ◽

Silvia Samanez-Larkin ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Decision Making ◽

Social Contact ◽

Temporal Discounting ◽

Emotional Impact ◽

Older Individuals ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Social Distancing

Covid-19-related social-distancing measures have dramatically limited physical social contact between individuals of all ages. We wondered how these new societal conditions would impact the choices of individuals of different ages and if social distancing measures would have a differential emotional impact on older individuals. Early media reports suggested that older adults were more likely to ignore social distancing guidelines. We conducted two online studies to examine temporal discounting of monetary, health, and social rewards, COVID-19 beliefs, social distancing behaviors, and mental health symptoms. We used the initial study (N = 233) to form our hypotheses about social distancing behaviors and we ran the second, pre-registered study (N = 243) to determine if these relationships replicated. We found that although older adults were more likely to prefer smaller, sooner (i.e., temporal discount) social and health-related rewards in decision-making tasks, there were no adult age differences in social distancing behavior. The increased motivation for immediate social contact in older age appears to be balanced by a similarly increased motivation for physical health. Although older adults reported being more likely to contract Covid-19 and experience more severe health consequences, they experienced fewer overall Covid-19-related mental health symptoms compared to younger adults. These data contradict media anecdotes and suggest that older adults are not only similarly compliant with distancing guidelines, but also are faring relatively better emotionally during the pandemic while overall mental health issues are higher than normal in the population.

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″Time does not heal all wounds″: Sexual victimisation is associated with depression, anxiety and PTSD in old age

10.1101/2021.06.05.21258397 ◽

2021 ◽

Author(s):

Anne Nobels ◽

Gilbert M.D. Lemmens ◽

Lisa Thibau ◽

Marie Beaulieu ◽

Christophe Vandeviver ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Health Care ◽

Old Age ◽

Suicide Attempts ◽

Mental Health Problems ◽

Later Life ◽

Health Impact ◽

The Past ◽

Self Harm

Background Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e. SV during childhood, adulthood and old age, are lacking. Methods Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12-months. SV was measured using behaviourally specific questions based on a broad SV definition. Results Rates for depression, anxiety and PTSD were 27%, 26% and 6% respectively, 2% had attempted suicide, 1% reported self-harm in the past 12-months. Over 44% experienced lifetime SV, 8% in the past 12-months. Lifetime SV was linked to depression (p =.001), anxiety (p =.001), and PTSD in participants with a chronic illness/disability (p = .002) or no/lower education (p <.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12-months. Conclusions Lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals, and development of clinical guidelines and care procedures are important.

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Impacts of Low-cost Robotic Pets for Older Adults and People With Dementia: Scoping Review

JMIR Rehabilitation and Assistive Technologies ◽

10.2196/25340 ◽

2021 ◽

Vol 8 (1) ◽

pp. e25340

Author(s):

Wei Qi Koh ◽

Faith Xin Hui Ang ◽

Dympna Casey

Keyword(s):

Older Adults ◽

Infection Control ◽

Ethical Issues ◽

Low Cost ◽

Research Question ◽

Well Being ◽

Social Robots ◽

Psychosocial Needs ◽

Live Animal ◽

People With Dementia

Background Older adults and people with dementia are particularly vulnerable to social isolation. Social robots, including robotic pets, are promising technological interventions that can benefit the psychosocial health of older adults and people with dementia. However, issues such as high costs can lead to a lack of equal access and concerns about infection control. Although there are previous reviews on the use of robotic pets for older adults and people with dementia, none have included or had a focus on low-cost and familiarly and realistically designed pet robots. Objective The aim of this review is to synthesize evidence on the delivery and impact of low-cost, familiarly and realistically designed interactive robotic pets for older adults and people with dementia. Methods The Arksey and O’Malley framework was used to guide this review. First, the research question was identified. Second, searches were conducted on five electronic databases and Google Scholar. Studies were selected using a two-phase screening process, where two reviewers independently screened and extracted data using a standardized data extraction form. Finally, the results were discussed, categorized, and presented narratively. Results A total of 9 studies were included in the review. Positive impacts related to several psychosocial domains, including mood and affect, communication and social interaction, companionship, and other well-being outcomes. Issues and concerns associated with its use included misperceptions of the robotic pets as a live animal, ethical issues of attachment, negative reactions by users, and other pragmatic concerns such as hygiene and cost. Conclusions Overall, the findings resonate with previous studies that investigated the effectiveness of other social robots, demonstrating the promise of these low-cost robotic pets in addressing the psychosocial needs of older adults and people with dementia. The affordability of these robotic pets appeared to influence the practicalities of real-world use, such as intervention delivery and infection control, which are especially relevant in light of COVID-19. Moving forward, studies should also consider comparing the effects of these low-cost robots with other robotic pets.

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Experiences and perceptions of using a low-cost pet robot for older adults and people with dementia

Innovation in Aging ◽

10.1093/geroni/igab046.3385 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 945-945

Author(s):

Wei Qi Koh ◽

Pascale Heins ◽

Sally Whelan ◽

Elaine Toomey ◽

Dympna Casey ◽

...

Keyword(s):

Older Adults ◽

Positive Emotions ◽

Qualitative Content Analysis ◽

Low Cost ◽

Demographic Data ◽

The United States ◽

User Reviews ◽

Useful Knowledge ◽

People With Dementia ◽

Textual Data

Abstract Pet robots are a practicable substitute for animal-assisted therapy. They have been shown to have positive impacts on older adults, including people with dementia, such as providing companionship and facilitating social interaction. However, the issue of affordability can hinder equal access to such technology. The purpose of our study was to understand the perceptions and experiences of using a low-cost, commercially available pet robot with older adults and people with dementia. We used a novel methodology of analysing a large volume of user reviews that were collected from 15 consumer websites. A total of 1,327 user reviews that met our pre-specified inclusion criteria were included. Descriptive statistics was applied to characterise demographic data, and inductive qualitative content analysis was used to identify themes in the textual data. Most reviews were obtained from consumer sites in the United States, and most reviewers were family members of the users (i.e., older adults and people with dementia). We found that circumstantial reasons, such the inability to own live animals, prompted reviewers to purchase the pet robot. Most reviewers had positive perceptions of the pet robot, and described various activities that users engaged in with it. Impacts of using the pet robot, such as positive emotions, were also described. Finally, experiences about practical aspects of its use, such as durability and hygiene, were discussed. Overall, this study provides useful knowledge that can help researchers, robot developers and clinicians understand the viability of using low-cost pet robots to benefit older adults, including people with dementia.

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The Impact of Mental Health Stigma and Ageism on Students’ Intention to Work with Older Adults: A Mixed Methods Design

Innovation in Aging ◽

10.1093/geroni/igab046.2312 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 607-607

Author(s):

Cindy Woolverton ◽

Katelind Biccum ◽

Aiping Yu ◽

Lanlan Xin ◽

Jessica Strong

Keyword(s):

Mental Health ◽

Older Adults ◽

Undergraduate Students ◽

Adult Population ◽

Negative Attitude ◽

Qualitative Description ◽

Mental Health Stigma ◽

Older Individuals ◽

Positive Attitudes ◽

The Impact

Abstract Approximately 20% of older adults have a mental or neurological disorder which can cause significant disability. With a growing older adult population, there is a need for providers receiving specialized training in aging to provide quality care. However, there continues to be shortages of students seeking careers in geriatrics and especially in working with older individuals with mental health (MH) concerns. The present study explored the relationship between MH stigma, ageism and intention to work with older adults among undergraduate students. Undergraduate students (N=188) completed a battery of questionnaires including intention to work with older adults, positive and negative attitude towards older adults, and open-ended questions exploring MH stigma views. Regression results indicated that MH stigma, positive, and negative attitudes significantly predicted intention to work with older adults, (F(3, 182) = 8.51, p = .000). Examination of the coefficients revealed that positive attitudes significantly predicted intention to work with older adults (t=4.38, p=.000), and MH stigma demonstrated a trend towards significance (t=1.90, p=.059). Open-ended responses were analyzed using qualitative description methods which revealed themes consistent with negative and positive stereotypes, MH problems going undetected, and need for additional support in recognizing and treating MH conditions among older adults. Positive attitudes are an important predictor in students’ intention to work with older adults, and MH stigma may be an important factor to explore further. Qualitative themes also describe how MH concerns are an important area to focus on among older adults, although there continues to be evidence of aging stereotypes.

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Impacts of low-cost robotic pets for older adults and people with dementia: A scoping review (Preprint)

10.2196/preprints.25340 ◽

2020 ◽

Author(s):

Wei Qi Koh ◽

Faith Xin Hui Ang ◽

Dympna Casey

Keyword(s):

Older Adults ◽

Infection Control ◽

Ethical Issues ◽

Low Cost ◽

Research Question ◽

Well Being ◽

Social Robots ◽

Psychosocial Needs ◽

Live Animal ◽

People With Dementia

BACKGROUND Older adults and people with dementia are particularly vulnerable to social isolation. Social robots, including robotic pets, are promising technological interventions that can benefit the psychosocial health of older adults and people with dementia. However, issues such as high costs can lead to a lack of equal access and concerns about infection control. Although there are previous reviews on the use of robotic pets for older adults and people with dementia, none have included or had a focus on low-cost, familiarly and realistically designed pet robots. OBJECTIVE The aim of this review was to synthesise evidence on the delivery and impact of low-cost, familiarly and realistically designed interactive robotic pets for older adults and people with dementia. METHODS The Arksey and O’Malley framework was used to guide this review. First, the research question was identified. Next, searches were conducted on five electronic databases and Google Scholar. Studies were selected using a two-phase screening process, where two reviewers independently screened and extracted data using a standardized data extraction form. Finally, the results were discussed, categorised and presented narratively. RESULTS A total of nine studies were included in the review. Positive impacts related to several psychosocial domains, including mood and affect, communication and social interaction, companionship, and other well-being outcomes. Issues and concerns associated with its use included misperceptions of the robotic pets as a live animal, ethical issues of attachment, negative reactions by users, and other pragmatic concerns such as hygiene and cost. CONCLUSIONS Overall, findings resonate with previous studies that investigated the effectiveness of other social robots, demonstrating the promise of these low-cost robotic pets in addressing the psychosocial needs of older adults and people with dementia. The affordability of these robotic pets appeared to influence the practicalities of real-world use, such as intervention delivery and infection control, which are especially relevant in light of COVID-19. Moving forward, studies should also consider comparing the effects of these low-cost robots with other robotic pets. CLINICALTRIAL

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