scholarly journals The Use of Digital Phenotyping in Mental Health Services: Opportunities, Ethical and Legal Issues

2021 ◽  
Vol 9 (22) ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Disorder ◽  
Self Report ◽  
Digital Data ◽  
Health Economy ◽  
Essential Information ◽  
Ethical Concerns ◽  
Digital Phenotyping

The widespread use of smartphones, mobile devices, wearable technology, and the increase in time online has provided the opportunity to collect data about users continuously. Several sectors such as health, economy, and entertainment have benefitted from the digital traces left by users due to the tight interactions on digital platforms. Today, it is likely to determine and predict users' moods, behavioral patterns, habits, and personality traits with the use of digital traces that are processed using artificial intelligence techniques. Such use of digital data offers new opportunities for mental health services. Today with this method, it is possible to obtain simultaneous data on the course of the psychological disorder and create a complete and more holistic picture of the disorder by accessing data that can not be obtained from self-report assessment techniques. This new approach, which is called digital phenotyping, can improve the objectivity in diagnosis. Studies have proven digital phenotyping’s potential to determine disorders' recurrence risk and make psychometric predictions. The studies have indicated the promising future of digital phenotyping in mental health services since the initial discussions by Jain et al. in 2015. It is reported that digital phenotyping can be used to diagnose and follow certain mental health disorders such as depression, anxiety, and schizophrenia at an early stage. However, ethical concerns such as privacy, autonomy, data security, and data confidentiality are among the critical issues surrounding the use of digital phenotyping. This paper includes essential information about the digital phenotyping method, discussions about the practical, legal and ethical concerns regarding the use of digital phenotyping in mental health services, and suggestions for future research. Keywords: Digital phenotyping, mental health, smartphone, digital data, mental health services

scholarly journals Nature: the cure we've been looking for

2021 ◽  
Author(s):  
◽  
Sarah Knowles
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Group Therapy ◽  
Health Services ◽  
Effective Treatment ◽  
Behavioural Therapy ◽  
Context Information ◽  
Ethical Concerns ◽  
Cognitive Behavioural ◽  
Western Psychology

Nature-based therapy is a therapeutic lens that utilizes nature as a co-therapist. This approach addresses the disconnect between land and people, a disconnect that negatively impacts the mental health of many of those seeking mental health services. Consequently, this approach is now considered an effective treatment for youth and is used as a standalone approach or integrated with cognitive behavioural therapy, gestalt, or group therapy. In either case, this nature-based lens provides a bridge between traditional Indigenous practices and Western psychology. My project highlights various activities and ideas in order to incorporate nature into one’s practice as a therapist, specifically within a northern context. Information regarding benefits, ethical concerns and various types of nature-based therapy will be discussed and guide the development of the manual. The guidebook will assist those interested in nature therapy by creating a place where tangible and realistic ideas for how to incorporate it into practice are located.

29 Symptoms of PTSD in a Burn Outpatient Clinic: Prevalence and Engagement Challenges for the Burn Team

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S21-S22
Author(s):  
Andrew McAleavey ◽  
Mariel Emrich ◽  
Adina R Jick ◽  
Collette L McGuire ◽  
JoAnn Difede
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Mental Health Services ◽  
Health Services ◽  
Outpatient Clinic ◽  
Stress Disorder ◽  
Psychological Trauma ◽  
Self Report ◽  
Outpatient Mental Health ◽  
Contact Information

Abstract Introduction Psychological distress, including posttraumatic stress disorder, acute stress disorder, and depressive disorders, are common after burn injury. These conditions are major determinants of long-term quality of life and productivity loss among burn patients, yet are generally under treated. Among the many reasons for limited treatment are lack of accessible quality care, limited clinical staff expertise in assessing these conditions, and patient avoidance of effective services. Methods During December 2018 to September, 2019, patients awaiting outpatient visits at an urban burn center were asked to complete brief standardized self-report questionnaires assessing symptoms of posttraumatic distress, anxiety, and depression. Using pre-defined criteria, we attempted to reach individuals with greater than moderate distress using contact information provided voluntarily and engage these patients in outpatient mental health services. Results 747 questionnaires were completed by 511 individuals in the assessment period, and of these 98 (19.2%) individuals had a likely PTSD diagnosis. Visual analog scale assessments for current anxiety, depression and stress all suggested high average distress in the overall group. Using pre-defined criteria to identify potential distress, we identified 195 people (38.2%) to whom we would proactively offer services. Only 159 provided contact information, and several more were not eligible for available clinical services so were not contacted. We called 128 individuals (81%). This led to direct communication with 48 patients (37.5% of those contacted), but only 22 individuals (17.2% of all those contacted) still endorsed distress at the time of the phone call (which was planned to occur within one week of the patients’ report) and 11 individuals were interested in seeking mental health services. Of these, 4 were referred to other services, 3 declined specific offers of service, 4 were scheduled for appointments and only 2 individuals attended appointments with the in-hospital psychological trauma group. Conclusions Psychological distress is highly prevalent in the burn outpatient clinic, with roughly one in five patients likely meeting criteria for PTSD. However, engaging patients in psychological and psychiatric treatment remains a major challenge for the effective care in this population. We discuss strategies tried here and systemic barriers to overcome in future research and care. Applicability of Research to Practice High prevalence of PTSD in outpatient burn clinics and difficulty engaging patients in separate outpatient mental health services suggest co-located and collaborative care models would be highly helpful in this population.

scholarly journals Organizational Wellbeing among Workers in Mental Health Services: A Pilot Study

2015 ◽  
Vol 11 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Federica Sancassiani ◽  
Marcello Campagna ◽  
Francesco Tuligi ◽  
Sergio Machado ◽  
Elisa Cantone ◽  
...  
Keyword(s):  
Mental Health ◽  
Job Satisfaction ◽  
Mental Health Services ◽  
Health Services ◽  
Organizational Development ◽  
Health Workers ◽  
Organizational Health ◽  
Self Report ◽  
Psychosomatic Health ◽  
Deep Meaning

Introduction: Organizational wellbeing in mental health services influences the outcomes of users and their families. Workers should be motivated, have a positive morale and be able to recognize values and the deep meaning of their work. This survey aims to examine the organizational wellbeing of the services provided by the Department of Mental Health (DSM) in Lanusei (Italy) and the correlations between job satisfaction and the psychosomatic health of its workers.Materials and Methodology:Descriptive-correlational study on a population of 43 mental health workers. Organizational wellbeing, as well as workers’ job satisfaction and psychosomatic health, were measured using the “Multidimensional Organizational Health Questionnaire” (MOHQ). It is a self-report questionnaire able to examine 14 dimensions of organizational wellbeing, 14 indicators about individual discomfort, 12 indicators about individual wellbeing, 8 psychosomatic symptoms related to job distress.Results:31 workers (72%) participated in the survey. Regarding the organizational wellbeing of DSM, the general profile mean±sd was 2.66±0.28 (values from 1 to 4: 1=never, 4=often). Job satisfaction was negatively correlated with headaches and concentration difficulties (R=-.584, p=0.001), nervousness, restlessness, anxiety (R=-.571, p=0.001), sense of excessive fatigue (R=-.634, p=0.000) and sense of depression (R=-.558, p=0.001) reported by workers.Conclusions:Data denoted an overall healthy state of the DSM. There were significant correlations between workers’ job satisfaction and their psychosomatic health. The recognition and restitution about the weakness and strengths of the services could be useful to point out some organizational development perspectives.

scholarly journals What is the prevalence, and what are the clinical correlates, of insulin resistance in young people presenting for mental health care? A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025674 ◽  
Author(s):  
Elizabeth M Scott ◽  
Joanne S Carpenter ◽  
Frank Iorfino ◽  
Shane P M Cross ◽  
Daniel F Hermens ◽  
...  
Keyword(s):  
Mental Health ◽  
Insulin Resistance ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Self Report ◽  
Model Assessment ◽  
Cross Sectional ◽  
Younger Age

ObjectivesTo report the distribution and predictors of insulin resistance (IR) in young people presenting to primary care-based mental health services.DesignCross-sectional.SettingHeadspace-linked clinics operated by the Brain and Mind Centre of the University of Sydney.Participants768 young people (66% female, mean age 19.7±3.5, range 12–30 years).Main outcome measuresIR was estimated using the updated homeostatic model assessment (HOMA2-IR). Height and weight were collected from direct measurement or self-report for body mass index (BMI).ResultsFor BMI, 20.6% of the cohort were overweight and 10.2% were obese. However, <1% had an abnormally high fasting blood glucose (>6.9 mmol/L). By contrast, 9.9% had a HOMA2-IR score >2.0 (suggesting development of IR) and 11.7% (n=90) had a score between 1.5 and 2. Further, there was a positive correlation between BMI and HOMA2-IR (r=0.44, p<0.001). Participants in the upper third of HOMA2-IR scores are characterised by younger age, higher BMIs and depression as a primary diagnosis. HOMA2-IR was predicted by younger age (β=0.19, p<0.001) and higher BMI (β=0.49, p<0.001), together explaining 22% of the variance (F(2,361)=52.1, p<0.001).ConclusionsEmerging IR is evident in a significant subgroup of young people presenting to primary care-based mental health services. While the major modifiable risk factor is BMI, a large proportion of the variance is not accounted for by other demographic, clinical or treatment factors. Given the early emergence of IR, secondary prevention interventions may need to commence prior to the development of full-threshold or major mood or psychotic disorders.

Assessment of the Prevalence of Psychiatric Disorder in Young Adults

1995 ◽  
Vol 166 (4) ◽  
pp. 480-488 ◽  
Author(s):  
Robert F. Ferdinand ◽  
Matthias van der Reijden ◽  
Frank C. Verhulst ◽  
Fokko J. Nienhuis ◽  
Robert Giel
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Disorder ◽  
Structured Interview ◽  
Self Report ◽  
Subjective Perception ◽  
Prevalence Rates ◽  
Prevalence Studies

BackgroundThe effectiveness of different assessment procedures for determining prevalence rates of psychiatric disorder in young adults was investigated.MethodIn a two-stage multi-method procedure, the Young Adult Self-Report, the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), the Structured Interview for Personality Disorders (Revised), and the Global Assessment of Functioning (GAF) Scale were used to assess prevalence rates in 706 19–24-year-olds from the general population. Furthermore, individuals' subjective perception of distress and referral to mental health services were assessed.ResultsThe prevalence of any SCAN/DSM–III–R disorder was 19.3% (95% confidence interval: 11.2–27.4%). Most subjects who received a SCAN/DSM–III–R diagnosis were only mildly impaired. The highest prevalence rates of dysfunctioning (GAF score below 61) without referral to mental health services were for dissociative disorder (2.3%), sleep disorder (2.1 %), alcohol dependence (1.3%) and affective disorder (1.8%).ConclusionInstruments that assess functional impairment in addition to DSM–III–R diagnoses are indispensable in prevalence studies.

scholarly journals Transitioning Transdiagnostic CBT from Face-to-Face to Telephone Delivery During the Coronavirus Pandemic: A Case Study

2021 ◽  
pp. 153465012110182
Author(s):  
Jess Saunders ◽  
Chris Allen
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Therapy ◽  
Self Report ◽  
Health Conditions ◽  
Face To Face ◽  
Clinically Significant ◽  
Digital Exclusion

The coronavirus pandemic led to worldwide disruption in the delivery of face-to-face mental health services. This impact was marked for individuals with long-term health conditions and comorbid depression and anxiety. Many face-to-face mental health services switched to remote delivery or paused therapeutic input entirely, despite the lack of research on the efficacy of switching between modalities mid-therapy or having breaks in therapy. This paper presents the case of a patient with long-term health conditions who experienced both breaks in therapy and a switch in modalities from face-to-face to telephone delivery. The intervention used was based on transdiagnostic cognitive behavioral therapy and self-report measures were completed at the beginning and end of the twelve sessions. Despite the shift in modalities, the patient experienced clinically significant recovery on all measures, indicating the efficacy of therapy was not greatly affected by the shift in modalities. Long breaks in therapy were linked to deterioration in mental health, although this could be due to the deterioration in physical health that necessitated these breaks. This case highlights the benefits and challenges of a shifting modality of therapy during treatment and in response to a pandemic for a shielding population. From the work presented here, it seems beneficial for services to be able to work across multiple modalities to suit the needs of the patients and ensure continuity of treatment. It also indicates that pauses in therapy may risk deterioration. Further work is needed to prevent digital exclusion of patients.

Patient-reported outcome measurements (PROMs) and provider assessment in mental health: a systematic review of the context of implementation

2019 ◽  
Author(s):  
David Roe ◽  
Yael Mazor ◽  
Marc Gelkopf
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measurement ◽  
Data Extraction ◽  
National Policy ◽  
Patient Reported Outcome ◽  
Self Report ◽  
Patient Reported ◽  
The Impact

Abstract Purpose To review and integrate the vast amount of literature yielded by recent growing interest in patient-reported outcome measurement and routine outcome measures (PROMs/ROMs), in order to suggest options and improvements for implementation. PROMs are the systematic assessment of service users’ health using standardized self-report measures. Specifically, for ROMs, it includes routine provider or caretaker assessment measures. Both are administered to ascertain routinely, the impact of treatment in mental health settings and to improve care. A review is needed because of the large differences in setting, conceptualization, practice and implementation. Here, we examine the different major projects worldwide. Data sources Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science’s Direct. Study selection We conducted a systematized review of the literature published from 2000 to 2018 on the implementation and sustainability of PROMs and ROMs in mental health services for adults. Data extraction, synthesis and Results We described and characterized the programs in different countries worldwide. We identified 103 articles that met the inclusion criteria, representing over 80 PROMs/ROMs initiatives in 15 countries. National policy and structure of mental health services were found to be major factors in implementation. We discuss the great variability in PROMs/ROMs models in different countries, making suggestions for their streamlining and improvement. Conclusion We extracted valuable information on the different characteristics of the numerous PROMs/ROMs initiatives worldwide. However, in the absence of a strong nationwide policy effort and support, implementation seems scattered and irregular. Thus, development of the implementation of PROMs/ROMs is left to groups of enthusiastic clinicians and researchers, making sustainability problematic.

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