Digital health interventions for the management of mental health in people with chronic diseases: a rapid review

ObjectiveDetermine the effectiveness of digital mental health interventions for individuals with a concomitant chronic disease.DesignWe conducted a rapid review of systematic reviews. Two reviewers independently conducted study selection and risk of bias evaluation. A standardised extraction form was used. Data are reported narratively.InterventionsWe included systematic reviews of digital health interventions aiming to prevent, detect or manage mental health problems in individuals with a pre-existing chronic disease, including chronic mental health illnesses, published in 2010 or after.Main outcome measureReports on mental health outcomes (eg, anxiety symptoms and depression symptoms).ResultsWe included 35 reviews, totalling 702 primary studies with a total sample of 50 692 participants. We structured the results in four population clusters: (1) chronic diseases, (2) cancer, (3) mental health and (4) children and youth. For populations presenting a chronic disease or cancer, health provider directed digital interventions (eg, web-based consultation, internet cognitive–behavioural therapy) are effective and safe. Further analyses are required in order to provide stronger recommendations regarding relevance for specific population (such as children and youth). Web-based interventions and email were the modes of administration that had the most reports of improvement. Virtual reality, smartphone applications and patient portal had limited reports of improvement.ConclusionsDigital technologies could be used to prevent and manage mental health problems in people living with chronic conditions, with consideration for the age group and type of technology used.

Characteristics of Confidence and Preparedness in Paramedics in Metropolitan, Regional, and Rural Australia to Manage Mental-Health-Related Presentations: A Cross-Sectional Study

Mental-health-related presentations account for a considerable proportion of the paramedic’s workload in prehospital care. This cross-sectional study aimed to examine the perceived confidence and preparedness of paramedics in Australian metropolitan and rural areas to manage mental-health-related presentations. Overall, 1140 paramedics were surveyed. Pearson chi-square and Fisher exact tests were used to compare categorical variables by sex and location of practice; continuous variables were compared using the non-parametric Mann–Whitney and Kruskal–Wallis tests. Perceived confidence and preparedness were each modelled in multivariable ordinal regressions. Female paramedics were younger with higher qualifications but were less experienced than their male counterparts. Compared to paramedics working in metropolitan regions, those working in rural and regional areas were generally older with fewer qualifications and were significantly less confident and less prepared to manage mental health presentations (p = 0.001). Compared to male paramedics, females were less confident (p = 0.003), although equally prepared (p = 0.1) to manage mental health presentations. These results suggest that higher qualifications from the tertiary sector may not be adequately preparing paramedics to manage mental health presentations, which signifies a disparity between education provided and workforce preparedness. Further work is required to address the education and training requirements of paramedics in regional and rural areas to increase confidence and preparedness in managing mental health presentations.

“Companion, friend, four-legged fluff ball”: The power of pets in the lives of LGBTQ+ young people experiencing homelessness

Experiences of homelessness are challenging for lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) young people. LGBTQ+ young adults without stable housing endure mental health struggles stemming from multiple structural disadvantages. In navigating stressors, LGBTQ+ young people may develop bonds with companion animals, or pets. Demonstrating the diverse ways LGBTQ+ young adults manage mental health challenges while homeless, we qualitatively analyzed the narratives of 17 LGBTQ+ young adults (18–25) surrounding their pet relationships. Participants emphasized the positive power of pets in their lives to help offset stressors. These findings illustrate how marginalized young people manage their mental health through informal resources. Incorporating companion animals could potentially enhance services for LGBTQ+ youth experiencing marginalization.

Beyond clicks and downloads: a call for a more comprehensive approach to measuring mobile-health app engagement

Downloading a mobile health (m-health) app on your smartphone does not mean you will ever use it. Telling another person about an app does not mean you like it. Using an online intervention does not mean it has had an impact on your well-being. Yet we consistently rely on downloads, clicks, ‘likes’ and other usage and popularity metrics to measure m-health app engagement. Doing so misses the complexity of how people perceive and use m-health apps in everyday life to manage mental health conditions. This article questions commonly used behavioural metrics of engagement in mental health research and care, and proposes a more comprehensive approach to measuring in-app engagement.