Digital Mental Health - A continuing study of the past, present, and future

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trader32176
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Digital Mental Health - A continuing study of the past, present, and future

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Digital Mental Health - The past, present, and future


The Digital Mental Health Genie Is Out of the Bottle

Dror Ben-Zeev
, Ph.D.

Published Online:24 Jun 2020 https://doi.org/10.1176/appi.ps.202000306

https://ps.psychiatryonline.org/doi/10. ... .202000306


The COVID-19 pandemic has led to unprecedented use of technology in mental health care.
Comprehensive mandates to adopt social distancing measures have been implemented globally, blocking the ability of clinicians to deliver in-person care. Disruption of standard services coupled with a spike in the mental health needs of a population experiencing social isolation, economic upheaval, anxiety, and psychological trauma, have created an untenable crisis. Necessity compelled us to take bold steps, and it was heartening to see health care systems, regulatory agencies, and policy makers mobilize to embrace technological methods to deliver much needed mental health services. Salient examples include widespread implementation of two-way video as the primary alternative tool to conduct tele–mental health sessions in hospital, community, and private mental health practice settings with the government’s waiving of Health Insurance Portability and Accountability Act (HIPAA) penalties to providers who use everyday communication software (1); a surge in the use of clinical messaging services that enable asynchronous texting interactions between patients and remote clinicians (2); deployment of digital mental health applications and loosening of the regulatory restrictions governing their use (3); and mass dissemination of mental health and well-being resources through social media, online streaming services, and other widely accessible platforms. In a few short yet intensive weeks, the coronavirus crisis and the collective rapid response to emergent patient needs have proven to be the greatest singular catalyst for adoption of digital mental health technologies seen to date.

It is unlikely that we will see a full return to traditional in-person mental health service models when the COVID-19 pandemic subsides. Evolving patient preferences, provider attitudes and capacities, and new digital mental health research will facilitate ongoing integration of technology at all levels of care. Patients who transitioned to treatment via digital platforms are now learning, perhaps for the first time, that such options exist. Many of them will have powerful firsthand experiences—whether it is realizing that they can maintain a positive therapeutic relationship with their clinicians remotely or whether it is becoming more cognizant of how much of their time, effort, and resources have been previously spent getting to and from the clinic. Moreover, there will also be a segment of new mental health service users who sought treatment only after the COVID-19 pandemic took hold. For them, stepping away from the only treatment modalities they have ever come to experience would not constitute a return to “normal.” Whether they are new or veteran treatment seekers, we can expect many patients and their family members to advocate for a continuation of technology-supported services.

Clinicians who are trying telepsychiatry for the first time may find that, surprisingly, they are still able to provide high-quality care. Many self-proclaimed “traditionalists” and “technophobes” who were hesitant to experiment with new technological platforms prior to the pandemic are learning that with some trial and error, they too are capable of mastering the use of digital health technologies. Their perceptions of what their patients are willing and able to do may also shift as they see an accumulation of positive treatment outcomes, better treatment engagement, and fewer last-minute session cancellations. These experiences may be particularly surprising for clinicians who treat people with serious mental illness—individuals who are often erroneously perceived by their providers as less capable, savvy, or open to using technology than the evidence suggests (4). Health care administrators are already learning that patient referrals and caseloads can be maintained or even expanded with the efficiencies afforded by technology, especially if evolving policies continue to allow the use of the same billing and reimbursement codes for remote delivery of technology-supported interventions. Health information technology professionals and administrators at hospitals and clinics are realizing that a combination of external demand, internal directives, and appropriate resource allocation serves as a strong motivator for integration of video streaming, chat, and mobile data collection capacities into their electronic health record systems. As a digital health researcher who has multiple collaborations with providers throughout the country, it has been remarkable for me to witness how quickly interoperability issues, patient privacy and data security concerns, and other challenges deemed “intractable” before the pandemic were resolved successfully in response to the political pressure that emerged shortly afterward.

Clinical researchers, treatment developers, and technologists are learning that there are enormous unmet needs and opportunities for leveraging their talents in digital mental research. Researchers who are already active in this space are amplifying their efforts because their expertise and the products of their work (i.e., scientific evidence, digital health software, and treatment guidelines) are currently in high demand by health care systems and policy makers. Major funders such as the National Institute of Mental Health have developed new rapid review mechanisms and allocated set-aside funds to support research designed to help address the challenges associated with COVID-19. It is safe to assume that many of the new treatment development/treatment augmentation grant proposals that are submitted in response to this call for action will have technological applications at their core. Although not all new digital mental health technologies that emerge in the upcoming years will prove to be useful, convenient, and safe, many undoubtedly will.

In 2014, I wrote a piece for this journal entitled “How I Stopped Fearing Technology-Based Interventions” (5). There I described how I came to the field of clinical psychology because of my belief in the healing power of human connection, and how despite my own reservations and skepticism, I came to understand the powerful therapeutic role technology can play in the lives of people with mental illness. I did not anticipate the shift in my own attitudes about the use of technology over the years, and I certainly did not predict how an unfathomable pandemic would thrust a new reality upon us in which technology serves as the primary tool for delivery of population mental health care. Whether by choice or not, many of this journal’s readers will soon find themselves in that same boat with me. That boat has sailed; with all we have learned so vividly and painfully about the vulnerabilities of offering only in-person services, we cannot in clear conscience advocate for or accept a return to “business as usual” when the COVID-19 crisis has subsided. Let us chart a new course toward a future in which technology is an essential and integral tool supporting how we design, deploy, and sustain our mental health care, come pandemic or high water.

BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
Send correspondence to Dr. Ben-Zeev (dbenzeev@uw.edu).

Dr. Ben-Zeev has an intervention content licensing agreement with Pear Therapeutics and has a financial interest in FOCUS smartphone technology and in Trusst Health, Inc. He has consulted for Otsuka Pharmaceutical Co., Ltd., and eQuility.

BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
trader32176
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Re: Digital Mental Health - A continuing study of the past, present, and future

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The Digital Mental Health Revolution: Opportunities and Risks

(Back to the past)

Tal, A., & Torous, J. (2017). The digital mental health revolution: Opportunities and risks.

https://psycnet.apa.org/fulltext/2017-39812-001.html

Psychiatric Rehabilitation Journal, 40(3), 263-265. http://dx.doi.org/10.1037/prj0000285



The promise of digital, mobile, and connected technologies to advance mental health, and especially psychiatric rehabilitation, continues to rapidly evolve. In 2017, 77% of Americans owned a smartphone, and by 2020 there will be 6 billion in use across the globe (Poushter, 2017). But unlike the rapid proliferation of digital technology, the worldwide shortage of mental health clinicians is expected to remain constant (Olfson, 2016). Whereas technology is neither a panacea nor a substitute for personal care, the opportunities to utilize these technologies to advance mental health are tremendous. New sensors and data, such as those derived from increasingly ubiquitous smartphones, offer a new window into the functional, social, and emotional experiences of illness and recovery at a personalized and quantified level previously unimaginable (Ben-Zeev & Badiyani, 2016; Free et al., 2013; Torous, Kiang, Lorme, & Onnela, 2016). These new technologies may also help assess and monitor mental health on a population level and provide early interventions and resources to those in need, regardless of their location (East & Havard, 2015). But regardless of the potential for precision, personalized, or even population care with digital mental health, the world is already exploring and embracing smartphone apps and mobile technology. With more than 10,000 mental health apps available for immediate download today (Torous & Roberts, 2017), there is already strong and expanding consumer interest. In the mental health field, it is now time for clinical investigation and research to also embrace the digital world and help shape this nascent field toward the ideals it offers the global mental health and psychiatric rehabilitation community.


This special issue begins with two papers that not only underscore the potential of mobile health apps but also demonstrate their real-world utility and early effectiveness in identifying early signs of psychotic relapse and enabling those with mental illness to successfully return to work, respectively. Ben-Zeev et al. (2017) present results of a preliminary study investigating a novel app-based multimodal data collection system designed to aid in continuous remote monitoring and early identification of psychotic relapse. In this study, participants with schizophrenia-spectrum disorders engaged with the CrossCheck app for up to 12 months, during which the app offered self-assessment questionnaires and automatically monitored numerous passive data signals from devices such as GPS and accelerometer among many others. For several participants, the authors demonstrate how this smartphone data offers evidence of the ability to detect early warning signs of psychotic relapse. The authors conclude that advancements in mobile technologies will improve the ability to collect even more clinically relevant information for the detection of relapse, but there is also a need to further develop and investigate innovative mobile-based data management, modeling, and signal-detection techniques to advance this technology toward mainstream clinical care.


Nicholson et al. (2017) provide further support toward realizing the potential of mobile apps for clinical use with their investigation of the WorkingWell app. The study of 25 participants in an Individual Placement and Support program explored use patterns, barriers, and attitudes toward using the study app in supporting recovery during different employment stages. The promising feasibility results and supportive focus group comments from participants set the stage for further investigation into the WorkingWell app, and using technology as an empowering person-centered platform to promote employment inclusion of those with psychiatric disabilities.
Smartphone apps are only one of several technologies that can enable psychiatric rehabilitation services, and the following three papers explore novel uses of Web based platforms that are easily accessible on any computer. These studies respectively explore using technology to offer computerized therapy for in psychosis, enhance person-centered decision making, and identify who may most benefit from Web based interventions.

Gottlieb et al. (2017) conducted a randomized controlled trial (RCT) comparing the efficacy of a 10-session Web based cognitive–behavioral therapy for psychosis skills program, called “Coping With Voices” to standard care. This RCT included 37 participants with schizophrenia with moderate-to-severe auditory hallucinations who partook in web CBT program and were followed for three months post intervention. While both the control and study groups improved in severity of auditory hallucinations, interestingly participants in the “Coping With Voices” program showed significantly greater increases in social functioning versus controls. The authors concluded that this CBT program has the potential to enhance access to care for psychosis and promote symptom management and recovery.


Grim, Rosenberg, Svedberg, and Schön (2017) utilized a participatory design study in order to facilitate the development of a consumer-centered Web based decision aid for persons receiving psychiatric services. In each of 4 development cycles outlined in the paper, feedback from potential end-users provided guidance in developing the formation of the Web based decision aid that strengthens the position of people with psychiatric disabilities by integrating access to information regarding alternative supports, interactivity between staff and consumers, and consumers preferences. The results of this participatory design indicate that the Web based decision aids have the potential to strengthen service users’ experience of self-efficacy and control as well as provide staff access to user knowledge and preferences.

Smolenski, Pruitt, Vuletic, Luxton, and Gahm (2017) explored how statistical modeling can help identify subgroups among those with depression who may best respond to tele-therapy compared to traditional in-office care. Utilizing demographic variables and baseline characteristics, the study identified two subgroups with differential responses to these two care modalities. Results that those in the group with higher depression symptom severity at baseline as well as older participants with higher loneliness and anxiety scores at baseline each had less improvement with tele-therapy as compared to in-office care raises interesting discussion points on how to best match digital therapy services with those who will benefit most from them.
The often small sample size and rapid pace of digital mental health research makes review papers essential; and this special edition continues with two literature reviews. These reviews offer insights into the effectiveness of electronic/web versus mobile platforms for people with bipolar disorder and the surprising lack of validating data for clinical utilization of smartphone voice data in mood disorders, respectively.

Gliddon, Barnes, Murray, and Michalak (2017) conducted a systematic review aimed to assess which digital self-management strategies for people with a bipolar disorder are most effective. This paper reviewed electronic/web and mobile health programs across seven self-management strategy categories that were identified in previous studies. The findings indicated that the most commonly digital self-management strategy categories were “ongoing monitoring,” “maintaining hope,” “education,” and “planning for and taking action” and that both electronic/web and mobile programs have the potential to provide valuable self-management strategies for people with bipolar disorder.


The second review evaluated the potential of smartphone audio data to monitor clinical symptoms in those with mood disorders. This comprehensive literature review that was conducted by Or, Torous, and Onnela (2017) and identified seven published studies that used smartphone audio data in various contexts as well as common audio features to assess clinically relevant outcomes among those with depression or bipolar disorder. Results indicated that the utility of smartphone audio data in clinical and research contexts remains relatively unexplored and that despite growing interest, additional research is required to confirm clinical and research uses of smartphone audio data.


Following these literature reviews, the special issue explores innovative commentaries that call attention to the need for new theoretical models based on digital mental health data, new means of using technology with people with psychiatric disabilities, and the need for new educational opportunities for those currently working in the field, respectively. Naslund et al. (2017) highlight the importance of applying human behavior theories and models to developing mental health digital technology interventions. In this commentary, the authors summarize current theories of human behavior, highlight key theoretical constructs, and identify synergistic opportunities to develop digital health interventions based on new theories like behavioral intervention technology model that may promise a wealth of new interventions for people with a psychiatric disability. The authors also argue that future studies must investigate how theoretical models can effectively promote efforts to develop, evaluate, and disseminate digital mental health interventions.


Jonathan, Pivaral, and Ben-Zeev (2017) share in their “Speaking Out” piece the personal experiences of two mHealth specialists providing a 12-weeks smartphone intervention, called “FOCUS”, to people with a psychiatric disability. The paper describes the real world uses of “FOCUS” through three use cases of this app which each illustrate unique advantages and challenges of mHealth apps in promoting rehabilitation and recovery processes in a community-based mental health care setting. Finally, the Education and training column by Nemec and Chan (2017) entitled “Workforce development challenges in the digital health era” describes challenges for hiring, training, and supervising psychiatric rehabilitation service providers in an era of increasingly digital care. The authors highlight the need for providers to remain up-to-date on evolving skills, competencies, and even human rights knowledge needed in the digital health era.


The papers comprising this special issue make important and exciting contributions to the mental health field in general and to digital mental health for psychiatric rehabilitation in particular. These papers illustrate that we are at the beginning of an era that may provide new knowledge and evidence-based tools to better promote mental health diagnosis, treatment, rehabilitation, and recovery. It is important to note that not every paper offered positive results, and learning from negative results is a critical and necessary part of journey toward moving from the potential of digital mental health and toward understanding the true clinical realities, benefits, and risks. As demonstrated in the spirit and scientific studies embodied in this special issue, digital health platforms and tools may significantly improve mental health services and, in turn, the quality of life and social inclusion of people with mental health challenges and their caregivers, worldwide.
trader32176
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Re: Digital Mental Health - A continuing study of the past, present, and future

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The hazards of digital mental health

Why are so few digital mental health tools based in evidence? The answer is complicated.

August 14, 2020


https://www.mobihealthnews.com/news/haz ... tal-health

With the unfolding mental health crisis as a result of COVID-19, investors and entrepreneurs alike are pouring record time and resources into digital mental health. According to Rock Health, behavioral health tech raised $588 million in the first half of 2020. High-profile investments such as Optum’s infusion of capital into AbleTo continue to make headlines. Every day, there is increasingly more focus on behavioral health technology and its promise to deliver fast, seamless care at a time when usual treatment modalities are difficult to access.


Although more mental health services are urgently needed by the American population, there is increasing recognition that innovations in mental health care should be based on sound research or evidence.
In the past week alone, concerns about evidence base have arisen at popular startups such as TalkSpace and Headspace.

Why do so many companies fail to be evidence-based? The answer is complicated, and context around the existing state of mental health treatment can provide some insight into its difficulties.

Evidence-based medicine requires clinical practice to be guided by existing clinical data, but because mental health symptoms are not routinely measured, it is difficult to then collect evidence on whether a treatment actually works. Thus, multiple modalities in usual mental healthcare are routinely recommended and have no clear evidence base – such as 12-step programs for substance use.

There is concern that many digital mental health companies are bringing products to market without clinical pilots to demonstrate that their solutions work. Additionally, many of these same companies may claim they are evidence-based when they are based off of vague translations of existing clinical models.

Furthermore, even if companies are running pilots prior to launch, very few publish their raw data or publish for peer review. This absence reduces health professionals’ ability to review the data and recommend digital health treatments to patients. However, these issues reflect larger concerns regarding evidence-based treatments across the field of mental health.

Another problem is that in the world of digital health, attempting to develop rigorous clinical models does not guarantee success. Lantern, a digital cognitive-behavioral therapy (CBT) company, published promising results on the cost-effectiveness of digital CBT and teamed up with the University of Pittsburgh to design a non-randomized control trial using their platform in 2018. However, Lantern shut down its clinical operations later that year and licensed its technology to other companies.

Conversely, many mental health startups have gained traction in the market with unclear evidence for their products. Unlike clinical medicine, success for digital mental health companies isn’t just about effective treatments, but also about running an operationally and financially sound enterprise.

Moving towards collecting rigorous clinical outcome data poses an enormous challenge across digital mental health. Incorporating outcomes metrics within traditional psychiatric practice has long been difficult. Measurement-based care is defined as assessing the severity of disease symptoms to guide decisions in care. For example, a doctor may use blood pressure measurements to diagnose a patient with hypertension. Despite the existence of validated scales for measuring symptoms (such as in depression and anxiety), which are shown to improve patient outcomes, the use of measurement-based care in mental health is low. Only 18% of psychiatrists use them to measure patient symptoms over time. There are multiple reasons for this, including lack of time or training to administer these scales and a sense that the scales don’t capture the diverse phenotypes of mental illness.

Ultimately, the fact that many companies lack clinical evidence does not fall on just their shoulders. Simply put, clinical research practices have not caught up to the speed of technology. Randomized controlled trials are the gold standards of clinical research but they are very expensive, time-consuming, and difficult to implement, making them nearly impossible for upstart digital health companies to achieve.

Academic medicine would benefit from partnering with digital health companies either to assist with clinical research or help develop new research frameworks specifically for digital health.

Multiple stakeholders need to collaborate to protect customers and encourage high-quality technology in the field of digital mental health.

National organizations such as the FDA, DHS and NIH must focus on innovating digital health assessment and regulation. New funding streams dedicated to digital clinical research can incentivize both academics and industry partners to focus on building the evidence base.

Taking the lead, Germany recently published the Digital Healthcare Act, which offers a national framework for reimbursement, prescription and regulation of digital health apps.

The disconnect between the existing mental healthcare community and the greater technology community is an important barrier to recognize. Because mental health professionals are not educated about digital health, they have difficulty in navigating evidence-based mental health solutions and do not know how to recommend or prescribe them to patients.

Slowly, inroads are being made. The American Psychiatric Association recently launched an app advisor to help psychiatrists navigate the space. Additionally, we should be training psychologists, psychiatrists, social workers and other clinical professionals on digital behavioral health.

If digital mental health is to succeed, tech companies need to include clinicians and researchers in the design of behavioral health technology from its inception. Doing so will enable companies to better consider the nuances of person-centered design in healthcare and to structure their data collection to existing clinical research standards.

In the U.S., opportunities for academic partnerships or other public-private partnerships to spur evidence-based digital healthcare are emerging, such as Hope Lab and Stanford Brainstorm. Consulting groups that specifically focus on helping with clinical research aspects of technology can also offload the difficulty of finding and affording tech-literate clinical talent.

Additionally, mental health treatment in general would benefit from widespread adoption of measurement and evidence-based care. It is not just the burden of digital mental health solutions to prove efficacy, but also mental health treatment at large. In 2018, the Joint Commission required the use of measurement-based care in accredited practices, spurring the field in the right direction.

The COVID-19 pandemic has catapulted digital health into the mainstream. The U.S. populations’ developing mental distress has pushed interest in digital mental health to new heights. As so much of existing care moves to a virtual setting, more work needs to be done to ensure that we are creating effective and helpful digital mental health products. Technologists must collaborate with healthcare researchers and clinicians to commit to a refrain every clinician understands: “Do no harm.”
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Re: Digital Mental Health - A continuing study of the past, present, and future

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Effective digital mental health more necessary then ever during COVID-19 pandemic

September 1,2020


https://medicalxpress.com/news/2020-09- ... ovid-.html


The COVID-19 pandemic has caused worldwide fear, uncertainty and restriction of movement. The physical distancing, socio-economic consequences of quarantine measures, and the loss of social support are a grave threat to public mental health. One way to help counter and resolve some of these issues is the spread of digital mental health. A study published today by the research group of Professor Claudi Bockting (Center for Urban Mental Health, University of Amsterdam) shows that digital psychological interventions can effectively diminish the symptoms of mental disorders including depression and substance use, even in low and middle income countries.

With large proportions of worldwide populations living with the consequences of quarantine measures, mental health fallout from the pandemic has been mounting. Digital psychological interventions can be a useful tool to reach those affected by mental health problem who otherwise have limited human contact. Professor Bockting: "Our study can help to further encourage digital psychological help for those experiencing mental health problems, during and after the COVID pandemic."

Digital technology has, of course, reshaped our life globally, including in the field of psychotherapy. Digital mental health is widely applied in the care settings in Western countries. But nearly 80% of the worldwide population lives in low and middle-income countries, where they face a drastic shortage of mental health professionals. Psychotherapy adapted into a digital format is emerging as a promising compliment to standard in-person care. And this applies more than ever during a global health emergency such as COVID-19.

For the first time, researchers have been able to demonstrate the potential of digital mental healthcare in low and middle-income countries. On aggregate, based on 22 randomized controlled trials globally, digital psychological interventions effectively diminished the symptoms of mental disorders, including depression and addiction. The meta-analysis has been published in The Lancet Psychiatry.

One of the researchers, Zhongfang Fu, explains: "Our meta-analysis demonstrated that internet interventions as delivered by, for instance, a website or a smartphone app have robust effects in treating mental health conditions in low and middle income countries. Thanks to these interventions, in addition to growing internet coverage and expansion of smartphone use, more people suffering from mental health problems can be reached. In particular young people who are familiar with digital technology can easily be reached."
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Re: Digital Mental Health - A continuing study of the past, present, and future

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The Digital Mental Health Revolution

“How do you immediately increase access to medical healthcare in a scalable, reliable way?” asks John Torous, the director of the digital psychiatry division at Beth Israel Deaconess Medical Center. “It really does have to come down to a technology in the smartphone.” Meet the man at the forefront of the digital mental health revolution.


September 17, 2020.

https://www.thecrimson.com/article/2020 ... al-health/


A shadow pandemic has accompanied COVID-19, one of deteriorating mental health. Formerly mundane acts, like buying groceries, now require a complete safety checklist as well as constant hyper-vigilance about one’s body and surroundings. Many are stuck in a crushing isolation. The pandemic itself acts like a vortex, sucking in all thought and conversation and spitting out anxiety over physical and economic health. One study found that the number of adults in the U.S. reporting symptoms of anxiety or depression has almost quadrupled from last year.

John Torous, the director of the digital psychiatry division at Beth Israel Deaconess Medical Center, recognizes the disparity between growing mental health needs and available resources — and believes only technology can help health professionals keep pace. “How do you immediately increase access to medical healthcare in a scalable, reliable way?” Torous asks. “It really does have to come down to a technology in the smartphone.”

The COVID-19 pandemic has accelerated an enormous technological shift in psychiatry: Already, virtual therapy sessions have become the norm, with most clinicians reporting no difference in outcomes compared to in-person visits. Torous hopes he and other doctors can continue to steer this transition — he researches how technology, and mobile devices in particular, offers an opportunity to revolutionize mental health care. “I think we know where we want the field to go,” he says, “but everyone wants to make sure we do it right.”

Smartphones have become ubiquitous, and for many, especially younger generations, they are the primary tool for learning about and communicating with the world. It is in this ubiquity that Torous sees potential: Synchronous telehealth, such as individual or group therapy in real-time, creates lag between the limited pool of clinicians and demand for care, and asynchronous care through mobile devices can fill that gap. Doctors might one day use smartphones to gather information between sessions — passive data such as GPS location, and active data such as daily questionnaires — and provide small, real-time interventions like mindfulness exercises. By working with patients to interpret smartphone-collected data, therapists might improve their practice — by jumping right into problem-solving, for instance, rather than having to collect information a smartphone has already provided. “The visits become more rich, more evidence-based, more data-driven,” Torous says. “In between sessions there’s more feedback, there’s more practicing skills.” The division of digital psychiatry at BIDMC is already experimenting with this hybrid model.

Torous is also developing and testing his own digital mental health app called “mindLAMP” (Learn, Assess, Manage, Prevent). Clicking on the mindLAMP icon — a lightbulb split into four colorful puzzle pieces set against a sky blue background — brings users to a menu with options for daily mental health surveys, tips for stress, breathing exercises, and much more. Based on interviews with 100 college-age students about their preferences for a mental health app, the app is designed to be customizable and secure: Users know the app is used for clinical purposes only. Because it is designed in-house, it doesn’t involve third parties.

Torous researches college students because he believes they show a particular interest in mobile mental health technology. He claims that that age group, undergoing brain maturation and facing new academic and social stresses, is at high risk of developing new mental health conditions. Though colleges try to meet this need, many of the corresponding resources fall short. In a recently-published study of 218 mental health apps recommended by various college counseling services, Torous found that 28 percent were no longer available for download, and 44 percent of the remaining apps had not been updated in over six months. Many of the existing apps either had no privacy policy or shared user information with third parties. Only 16 percent had been studied for efficacy. Just because smartphones have the potential to improve therapy, Torous says, doesn’t mean all apps can do it well. In the same way that it would be “ludicrous” for a college to display a list of medications and ask students to pick, especially if some of those medications were out-of-date or toxic, not all apps can provide the same quality of services. As an alternative, Torous’s team keeps an updated database of mental health apps that people can search to find the best fit for themselves.

The mindLAMP app is designed to avoid these pitfalls. In a study of 100 college students who used the mindLAMP app over the course of one month, Torous found that the results from the app’s mental health surveys correlated closely with “gold standard,” in-person clinical assessments. Although Torous is still analyzing the data, these results suggest that smartphone apps might be an easier way to understand how people are feeling. A few simple questions on a phone can provide that understanding over time, rather than a snapshot at the time of appointment.

Aside from a population-level correlation between erratic sleep schedules and a higher risk of mental health problems, Torous found that other correlations were highly personalized. The effect of time at home on mental health is contextual, and the effect of screen time depends on the types of online activities: Three hours of virtual volunteering and three hours of scrolling through Reddit are not comparable. Of course, more population-level correlations might become apparent with a larger sample. Regardless, these personalized signals, Torous explains, show how smartphones are primarily a tool that patients and psychiatrists must put to use by figuring out what each signal means for each person. “It’s not just the technology,” he says. “That’s one of the factors. It takes the users and the clinical part to make it all work, all of the pieces.”

Despite the potential he sees in this “hybrid model” of telehealth and smartphone care, Torous expresses caution: “Anytime something transitions or is new, there is potential for benefit and potential for harm,” he says. Apps that work through algorithms and artificial intelligence, for instance, have limited evidence to support that they are effective. Privacy concerns abound. And much more work needs to be done to prove the smartphone’s clinical promise. His next step is a similar study of the mindLAMP app with 1,000 college students nationwide. The trial will also test “mental health nudges” — if the app detects that a user may need a mental health intervention, it a small action.

“Sometimes apps are seen as a panacea because technology can solve a lot of problems,” Torous says. “I think we are at the beginning of this journey.”
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Re: Digital Mental Health - A continuing study of the past, present, and future

Post by trader32176 »

COVID-19 Digital Mental Health Resources

FREE digital mental health resources* for the duration of the COVID-19 pandemic



https://nycwell.cityofnewyork.us/en/cov ... resources/


Anxiety


Headspace (in App Library)
New Yorkers across the state can access a specially curated collection of science-backed, evidence-based guided meditations, along with at-home mindful workouts, sleep and kids content to help address rising stress and anxiety

Shine
Resources for anxiety and overall mental health specific to COVID-19

Calm
Mindfulness app that provides free list of curated meditations specific to COVID-19 via video and audio

All Mental Health
App with coping and communication skills specific to COVID-19

Coa
Online therapist-led groups & workshops for anxiety, stress, and connection

Ginger
Strategies, activities, and articles to help users stay grounded during COVID-19

Depression


Litesprite
Clinically-validated mental health video game

Sanvello
Clinically-validated evidence-based mobile application based on cognitive behavioral therapy (plus content related to other conditions)

Sleep

Big Health’s Sleepio
Digital therapeutic for sleep, fully automated yet highly personalized digital sleep improvement program accessible via app and web

Magellan’s Restore
Digital cognitive behavioral therapy for sleep

Peer Support

Supportiv
Peer chat support and resource list

Nod
Resource for students to socially connect and reduce loneliness during COVID-19
Self-care

COVID Coach
Resource for everyone, including veterans and service members, to support self-care and overall mental health

Recovery

Tempest
Online recovery support meetings for women and gender nonconforming individuals who are sober or interested in sobriety
curncman
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Re: Digital Mental Health - A continuing study of the past, present, and future

Post by curncman »

Trader Nice Article...Seems like Campbell Scores will be the NORM as part of regular blood test in the Docs office to identify stress levels in all COVID-19 patients and all youth in USA
trader32176
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Re: Digital Mental Health - A continuing study of the past, present, and future

Post by trader32176 »

that's one
another is mobile blood test strip , and phone app for biological test of suicide risk score
trader32176
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Re: Digital Mental Health - A continuing study of the past, present, and future

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Researchers to use new app data to prevent anxiety, improve wellbeing in young people

11/4/20


https://www.news-medical.net/news/20201 ... eople.aspx

Young people across Europe are being recruited to a trial to put their smartphone addiction to good use, via an app designed to prevent anxiety and depression and improve wellbeing.

Researchers at the University of Exeter are leading a pan-European project to recruit young people aged between 16 and 22 years to use the app.

It brings together the latest research on self-monitoring, self-help techniques and cognitive behavioural therapy so that young people can learn about their own emotions, develop resilience, and build well-being.

Meanwhile, the app's data will help researchers learn more about mood, emotion and mental health in young people. Understanding what influences young people's emotions and wellbeing is particularly relevant now because of the impact of the COVID-19 pandemic on young people.

A recent study by NHS Digital, involving the University of Exeter, found that in July this year, 27 per cent of young women and 13 per cent of young men, aged 17 to 22, had a probable mental health disorder.

The ECOWEB project, which is funded through Horizon 2020, the European Commission's framework programme for Research and Innovation, will roll out from October 2020 to May 2021.

Thousands of young people will be offered free access in the largest trial of its kind, designed to test whether technology can help improve young people's mental health. The project involves 13 collaborators from across 8 countries in Europe: the UK, Germany, Spain, Denmark, Czech Republic, Greece, Switzerland and Belgium.

In the UK, the trial involves the University of Exeter, University of Glasgow and University of Oxford - across Europe, it involves Ludwig Maximilian University, Munich; University of Gent, University Jaume 1, Castellon, Spain, as well as technology companies Monsenso in Denmark and AudEERING in Germany.

The MyMoodCoach app will ask users to log their mood and emotions each day, giving them an overview of their own emotional patterns. The app will also at chance offer 2/3rds of users features and strategies in the app to help directly with emotional well-being.

For example, if the young person reports that they tend to worry a lot, the app could provide him or her with self-help exercises and strategies to reduce worry. If someone feels events are outside of their control, leading to despondency and depression, they will learn ways to judge that they have some control over the situation.

This random allocation will allow researchers to test which elements in the app work best to support young people.



This is the first large-scale trial of its kind. We're aiming to use mobile technology to equip young people to understand and manage their own emotions, to improve their wellbeing and reduce the risk of mental health issues. Crucially, the advice and available tools will be tailored to what is most useful to them.

" Finding scalable ways to help young people is critical right now because we already know that COVID-19 and its disruption on daily life is having a huge impact on the well-being of young people - with recent studies finding the largest increase in self-reported distress in this age group. We are therefore keen to see if a digital self-help approach can help young people stay mentally well in these difficult times."

- Ed Watkins, Professor, University of Exeter

In the UK, a quarter of 17-19 year-olds (1.25 million) experience significant levels of depression and anxiety - yet less than one third of these receive any professional support or treatment.

Rates of common mental health problems are increasing, especially in young women. A recent longitudinal survey comparing mental health in 2018-2019 to April 2019 found that 16-24 year olds reporting clinically meaningful levels of distress increased from 25% to 37%. The most common problem is depression, which is the leading cause of disability in young people and produces major impacts across the lifespan.

To tackle this global challenge, early interventions need to promote well-being and prevent poor mental health that are scalable to large numbers of young people. The app is designed to reach young people via a medium that they frequently use.

Research has shown that helping young people to manage their emotions better, for example, by worrying less, or by adopting more helpful mind-sets can reduce rates of depression and anxiety in high-risk groups by up to 50% over the next year.

Professor Watkins said the majority of the apps currently available for young people had not been rigorously tested and there was little evidence to support their use.

He said: "The ECoWeB project is the first to combine all of these approaches in a mobile app that is both evidenced-based and designed to look great and appeal to younger people. It has the potential to be a breakthrough moment in mental health research, supporting young people to live better lives in their relationships, work and social lives."

Source:

University of Exeter
trader32176
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Re: Digital Mental Health - A continuing study of the past, present, and future

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Study shows patients are more receptive to using mental health and wellness apps

12/17/20

https://www.news-medical.net/news/20201 ... -apps.aspx


Kaiser Permanente physicians and therapists now have the ability to refer their patients to evidenced-based mental health and wellness apps through the organization's electronic health record system.

With a simple referral to an app, Kaiser Permanente patients can begin using it on their own or under the guidance of a clinician -- at no cost.

A new case study shows that patients are more receptive to using mental health and wellness apps and feel better when referred by a clinician. These are among the takeaways published in the January 2021 issue of NEJM Catalyst Innovations in Care Delivery.

This case study provides important learnings to support the integration of mental health apps in care and expand patient engagement with digital tools as part of their overall treatment plan.


" What we're tapping into is the existing relationship people have with their Kaiser Permanente therapist. We know that our patients are more likely to use these digital resources if their provider refers them."

- Don Mordecai, MD, National Leader for Mental Health and Wellness, Kaiser Permanente

"Digital therapeutics such as mental health apps have a clear place in a care plan and it's very exciting to be on the forefront of this."

In 2018, Kaiser Permanente began providing patients access to apps by simply signing in to their kp.org account. The organization also trained clinicians on the use of the apps, workflow, documentation, and evidence-based best practices.

Following the rapid expansion of the app referral effort earlier this year, clinicians referred to 44,000 mental health care patients to the digital tools. More recent data shows app referrals have increased to 115,000, and the number continues to grow.

The role apps play in an overall treatment plan

The pandemic is taking a toll on Americans' emotional well-being. The prevalence of depression symptoms in U.S. adults is 3 times higher than before the COVID-19 pandemic began.

When mental health issues are left untreated, they can get worse. Digital apps for mindfulness, meditation, and cognitive behavioral therapy can offer significant help for patients with mild-to-moderate anxiety or depression.

The case study showed promising results that more patients use the apps when referred by a clinician than if they had to seek out apps on their own.

The apps Kaiser Permanente offers in clinical settings include Calm, Headspace, and Whil -- mindfulness and meditation apps aimed at reducing stress and anxiety, and improving sleep -- and myStrength, SilverCloud, and Thrive -- cognitive behavioral therapy apps providing higher-touch guided support through interactive activities and/or coaching.

All of these apps are secure and confidential and available to Kaiser Permanente members at no cost to them. Adult members can access Calm and myStrength through kp.org without a clinician's referral.

"I suffer from anxiety. I cannot stop thinking," said Kaiser Permanente member Rosa Salguero-Rodriguez. "So, I started using Calm. I practice the sessions like breathing and gratitude, and morning exercises, and stretching. Now, I can relax more and sleep better."

While Kaiser Permanente digital self-care resources do not replace treatment or clinical guidance, they provide additional support.

"It's been amazing to watch patients' progress just by using the apps in between sessions," said Leigh Miller, a Kaiser Permanente clinical social worker who offered feedback during early testing. "We found that these tools really enhanced how we support our patients' mental health and we are thrilled to see the positive changes in our patients."

Ongoing commitment to mental health and wellness

Kaiser Permanente's focus on encouraging members to use self-care apps as part of its ongoing commitment to addressing the mental health and wellness needs of its members and communities.

Kaiser Permanente offers mental health care focused on early intervention, personalized treatment, patient empowerment and support, and the latest innovations in care delivery, including virtual care.
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