New technology is becoming vital for providing easy-to-access mental health care, says a top mental health expert from London, UK. Writing in the Journal of Mental Health, Professor Til Wykes of King’s College London states there is a “huge potential” for digital technologies to improve mental health care access.
But Professor Wykes adds, “There are still barriers to overcome such as how we increase adherence to e-therapies and how we can overcome the digital divide.” The field is still in its infancy, says the expert, but the different ways in which the technology could be used for patient benefit are “hugely exciting.” For example, Wykes’s colleague Dr. Paul Wicks, also of King’s College London, says, “Any smartphone today is more powerful than the best home computer of a decade ago.”
But while we have greater access to mental health tools, apps, and games than ever before, there is wide variation in quality, so the experts looked at the best e-mental health interventions available. A German online system for people with eating disorders, using email and moderated forums to provide counseling, was found to have high user satisfaction (82 percent of 238 individuals) and frequently led users to seek professional support.
Over half of the users (57 percent) said this was the first time they accessed professional help, and 50 percent of these went on to seek other forms of support after registering for the online program. Most of those individuals stated that they would have not done so without the online service.
Early findings on a therapeutic video game called Playmancer, which “takes elements of personal therapy and supplements them with game-like elements and biofeedback,” suggest that it may benefit impulse control disorders such as gambling, by helping users develop more appropriate coping strategies for negative emotions and in response to stress.
The games’ developers believe that the nature of video games (i.e., they are intensive, promote concentration, are immersive and are engaging) combined with biofeedback can create “novel therapeutic opportunities.” For instance, it can identify areas of the game that a user finds difficult or stressful, and offer coping styles in a low-pressure environment.
A very recent study of the self-help intervention Psyfit (“mental fitness online”) found that it can “effectively enhance well-being,” at least in the short term. The service, based on positive psychology, was examined in a two-month trial of 284 mildly to moderately depressed adults seeking self-help. Although the dropout rate was nearly 40 percent, well-being scores were significantly raised and small improvements were seen in users’ general health, vitality, anxiety, and depression symptoms.
The internet also has a great potential for reaching groups of individuals to take part in research. A team of self-harm researchers quickly recruited 243 international respondents by posting in online forums. Online research studies can aid long-term studies, or even allow service users to design and execute research themselves.
Observing online drug forum communities can provide insight into compounds consumed and methods of administration in order to better inform clinical knowledge, treatment and approaches to prevention. This is especially important as new recreational drugs are constantly emerging, often rendering professional literature out of date.
Professor Wykes concludes that the opportunities offered by digital technologies and the internet “could help address some of the most difficult problems faced by mental health services including delivery costs, limited clinical workforce, access to services and continuity of care.”
The article is one of a series in the Journal of Mental Health on e-mental health interventions, that is, the use of the Internet and new media to support and improve mental health conditions and care.
In Dr. Wicks’s article, he points out, “It does not seem to have taken that long for the Internet to have gone from a hobby on the fringes of society in the early 1990s to today’s ubiquitous system that affects many elements of people’s lives, including their mental health.”
But users now have a unique chance to connect with each another and share information and experiences, as well as benefit from computer-guided therapies that are recognized as providing significant clinical benefit.
Nevertheless, the real potential of internet-based mental health support in the future is unclear. “One thing seems certain though,” writes Dr. Wicks. “In order to understand mental health problems in the context that service users (particularly young adults and adolescents) experience them, we must pay closer attention to developments online and make time to participate and engage in the connected world.
“If we do that,” he concludes, “we are bound to have another interesting decade ahead of us.”
Schmidt, U., Wykes, T. E-mental health: a land of unlimited possibilities. The Journal of Mental Health, 3 August 2012, doi:10.3109/09638237.2012.705930
Wicks, P. E-mental health: a medium reaches maturity. The Journal of Mental Health, August 2012, doi:10.3109/09638237.2012.682268
Bolier, L. et al. An internet-based intervention to promote mental fitness for mildly depressed adults: randomized controlled trial. The Journal of Medical Internet Research, 16 September 2013, doi: 10.2196/jmir.2603.