This article was originally published in the Interview, an independent and nonprofit source of reports, analyzes, and comments from academic experts. Information on disclosure is available on the original site.
Author: David Gratzer, Psychiatrist, Center for Addiction and Mental Health, Psychiatric Assistant, University of Toronto
Ella, who is in the early 1920s, has depression. When her sleep began to drop after a stressful date at school, her smartphone was programmed to record the texts late at night and telephone conversations that suggested her insomnia. Suggest suggestions for improving sleep.
When her contributions to social media grew more negative and called friends more frequently, her phone was depressed, booked her to look at her psychiatrist, then recorded the results of the scale, and recorded her recent sleep.
She contacted the psychiatrist via videoconferencing, and this doctor made some medication adjustments. Ella also began some concentrated psychotherapy through the application.
Ella is not real, but hundreds of thousands of Canadians have a major depressive disorder. Today smart phones do not increase insomnia and do not start meetings with psychiatrists. But one day they could.
Often we can use smartphones and carriers to treat depression. As a psychiatrist I see it as a good thing that allows more people access to quality care.
Healthy applications follow the mood
Mental health care is an area that needs transformation. One in five Canadians this year will have problems with mental illness, but many people are trying to access care. According to one study, only half of people with depression receive adequate care.
Proven psychotherapy is especially difficult for people; a recent Canadian study found that only 13% of depressed people have some psychotherapy. However, cognitive behavioral therapy – a type of therapy that focuses on how human thoughts can influence behavior and mood – is just as effective as medication.
Just as technology has changed other aspects of our lives, people are increasingly using it for health needs. For example, there are over 315,000 mobile health applications.
Many of my patients have applications for information about their illnesses; some have integrated applications into their care, helping them remember when to take medication or monitor their mood over time. And other people are now looking for online therapy.
Studies show that if the therapy is done properly (with the process therapist), people can do just like personal care, but at a lower cost.
Smartphones identify flags
The benefits are more than economical. For a single mother with three children or an elderly person who hesitates to visit a clinic in the winter, online therapy is not a better care, it is the only care.
Not surprisingly, this idea has proven to be popular with the private sector as well as governments in Norway and Sweden.
And there is great potential to see help technology with all aspects of care. Most Americans of North America have smart phones that are all around.
When we look at speech patterns and our movements, smart phones could come up with gentle changes suggestive of the onset or worsening of symptoms, while wearers can experience fine physical changes – long before patients even notice problems. These devices could bring real-time objective data.
Needless to say that research is active; for example, my colleagues at the Center for Addiction and Mental Health in Toronto are dealing with depressions and Fitbit data to find patterns that could signal the onset of depression earlier.
The problem of privacy
We must be careful too. There are hundreds of depressing applications, but quantity does not mean quality. In one study, using a standard Quality Control standard (e.g., Revealing a source of information), only 25% of the studied applications passed the test.
Digital mental health must also include digital privacy and confidentiality. Just as banking information should not be shared indiscriminately, the medical information contained on the smartphone or wearing device must be safe for the user.
And conflicts of interest must be clear. For example, smart phone applications should not be hidden advertising for a private business.
People often ask me if I think technology will soon replace psychiatrists. That's unlikely. But one day, a patient like Ella can use technology to get better care. And that's good news – if we have government policies and practices in place to ensure that technology is thoughtful.
David Gratzer Blogs on Psychiatry and Research at http://www.davidgratzer.com.
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