Towards the evolution of the mHealth in mental health with youth: the cyber-space used in psychological rehabilitation is becoming wearable into a pocket

Understanding Mobile Health and Youth Mental Health: Scoping Review

BACKGROUND

A total of 75% of people with mental health disorders have an onset of illness between the ages of 12 and 24 years. Many in this age group report substantial obstacles to receiving quality youth-centered mental health care services. With the rapid development of technology and the recent COVID-19 pandemic, mobile health (mHealth) has presented new opportunities for youth mental health research, practice, and policy.

OBJECTIVE

The research objectives were to (1) synthesize the current evidence supporting mHealth interventions for youths who experience mental health challenges and (2) identify current gaps in the mHealth field related to youth's access to mental health services and health outcomes.

METHODS

Guided by the methods of Arksey and O'Malley, we conducted a scoping review of peer-reviewed studies that used mHealth tools to improve youth mental health (January 2016-February 2022). We searched MEDLINE, PubMed, PsycINFO, and Embase databases using the following key terms: (1) mHealth; (2) youth and young adults; and (3) mental health. The current gaps were analyzed using content analysis.

RESULTS

The search produced 4270 records, of which 151 met inclusion criteria. Included articles highlight the comprehensive aspects of youth mHealth intervention resource allocation for targeted conditions, mHealth delivery methods, measurement tools, evaluation of mHealth intervention, and youth engagement. The median age for participants in all studies is 17 (IQR 14-21) years. Only 3 (2%) studies involved participants who reported their sex or gender outside of the binary option. Many studies (68/151, 45%) were published after the onset of the COVID-19 outbreak. Study types and designs varied, with 60 (40%) identified as randomized controlled trials. Notably, 143 out of 151 (95%) studies came from developed countries, suggesting an evidence shortfall on the feasibility of implementing mHealth services in lower-resourced settings. Additionally, the results highlight concerns related to inadequate resources devoted to self-harm and substance uses, weak study design, expert engagement, and the variety of outcome measures selected to capture impact or changes over time. There is also a lack of standardized regulations and guidelines for researching mHealth technologies for youths and the use of non-youth-centered approaches to implementing results.

CONCLUSIONS

This study may be used to inform future work as well as the development of youth-centered mHealth tools that can be implemented and sustained over time for diverse types of youths. Implementation science research that prioritizes youths' engagement is needed to advance the current understanding of mHealth implementation. Moreover, core outcome sets may support a youth-centered measurement strategy to capture outcomes in a systematic way that prioritizes equity, diversity, inclusion, and robust measurement science. Finally, this study suggests that future practice and policy research are needed to ensure the risk of mHealth is minimized and that this innovative health care service is meeting the emerging needs of youths over time.

A Remote Assessment of Anxiety on Young People: Towards Their Views and Their Different Pet Interaction

The lockdown was imposed in Italy on 9 March 2020 due to the COVID-19 outbreak. Restrictions severely limiting individual freedom were indispensable to protect the population and reduce virus diffusion. Italian people had never before experienced similar restrictions that undoubtedly tested psychological health. After 1 week, we developed an electronic survey to collect demographic data and information on the presence of pets and the type of interaction with them and to administer a self-assessment anxiety test. A total of 3905 subjects, pet owners and non pet owners, filled in the electronic survey; 652 (16.7%, mean age 21.6) of them were young subjects, adolescents, and university students. The study first showed the feasibility and success of the technological solution used, capable of providing, at a distance, structured information on the participants and quantitative data on the psychological condition. Second, it reported that 23.1% of the youths showed anxiety above an attention level during the lockdown, in line with other studies. Third, it indicated, based on the outcome of the self-assessment test, that the pet presence could have a positive effect in mitigating the psychological impact and encourage to continue and deepen these investigations. Fourth, it reported positive feedback from the participants on the procedure, found useful during the pandemic and for the post-pandemic future. The study highlights the importance of investing in these solutions based on mobile technology and useful both for mental health and to deepen the investigation of the impact of the pet presence on the human psychology.

Pet Presence Can Reduce Anxiety in the Elderly: The Italian Experience during COVID-19 Lockdown Assessed by an Electronic Survey

The lockdown imposed in Italy due to the COVID-19 outbreak required restrictions that severely limited individual freedom to protect the population and reduce virus diffusion. This situation psychologically challenged the entire Italian population but mostly the elderly. The "Digital mental health approach" employs digital tools to evaluate and prevent increasing mental health problems. "Anonymous online electronic surveys" are digital tools that assess rates of mental health outcomes (using for example self-assessment/awareness tools). Immediately at the beginning of restrictions, we designed an electronic survey a) to remotely investigate the psychological impact of the lockdown and b) to compare the anxiety between pet owners and not-pet owners. A total of 3905 subjects filled out the survey; we focused our study on 781 (20%) elderly subjects. Dividing elderly patients between pet-owners (n = 405) and not-pet owners (n = 376), the pet owners showed a Zung scale score significantly lower in respect to the not-pet owners. We observed that, during the COVID-19 outbreak, the pet presence could have a positive effect on anxiety in the elderly subject. These results: (A) encourage the use of mobile technologies for the assessment of psychological disorders that can be promptly employed in emergencies such as the COVID-19 outbreak; (B) highlight the positive effect of pet interaction to mitigate the psychological distress in elderly people.

Lessons from the COVID-19 Pandemic on the Use of Artificial Intelligence in Digital Radiology: The Submission of a Survey to Investigate the Opinion of Insiders

The development of artificial intelligence (AI) during the COVID-19 pandemic is there for all to see, and has undoubtedly mainly concerned the activities of digital radiology. Nevertheless, the strong perception in the research and clinical application environment is that AI in radiology is like a hammer in search of a nail. Notable developments and opportunities do not seem to be combined, now, in the time of the COVID-19 pandemic, with a stable, effective, and concrete use in clinical routine; the use of AI often seems limited to use in research applications. This study considers the future perceived integration of AI with digital radiology after the COVID-19 pandemic and proposes a methodology that, by means of a wide interaction of the involved actors, allows a positioning exercise for acceptance evaluation using a general purpose electronic survey. The methodology was tested on a first category of professionals, the medical radiology technicians (MRT), and allowed to (i) collect their impressions on the issue in a structured way, and (ii) collect their suggestions and their comments in order to create a specific tool for this professional figure to be used in scientific societies. This study is useful for the stakeholders in the field, and yielded several noteworthy observations, among them (iii) the perception of great development in thoracic radiography and CT, but a loss of opportunity in integration with non-radiological technologies; (iv) the belief that it is appropriate to invest in training and infrastructure dedicated to AI; and (v) the widespread idea that AI can become a strong complementary tool to human activity. From a general point of view, the study is a clear invitation to face the last yard of AI in digital radiology, a last yard that depends a lot on the opinion and the ability to accept these technologies by the operators of digital radiology.

The Social Robot in Rehabilitation and Assistance: What Is the Future?

This commentary aims to address the field of social robots both in terms of the global situation and research perspectives. It has four polarities. First, it revisits the evolutions in robotics, which, starting from collaborative robotics, has led to the diffusion of social robots. Second, it illustrates the main fields in the employment of social robots in rehabilitation and assistance in the elderly and handicapped and in further emerging sectors. Third, it takes a look at the future directions of the research development both in terms of clinical and technological aspects. Fourth, it discusses the opportunities and limits, starting from the development and clinical use of social robots during the COVID-19 pandemic to the increase of ethical discussion on their use.