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Efe Z, Baldofski S, Eckert M, Guenthner L, Saee S, Thomas J, Wundrack R, Kohls E, Rummel-Kluge C. Who are frequent chatters? Characterization of frequent users in a 24/7 messenger-based psychological chat counseling service for children and adolescents. Internet Interv 2023; 33:100638. [PMID: 37361028 PMCID: PMC10285518 DOI: 10.1016/j.invent.2023.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023] Open
Abstract
Background Online helplines have shown a high acceptance, feasibility, and usability, especially with young people. Helplines usually aim to provide one-time crisis intervention; however, there are users who frequently use such services, tying a disproportionately large proportion of service capacities. To date, there is no research on the characterization of frequent users of online helplines. Therefore, the aim of the present study is to characterize frequent chatters in a chat-based counseling context. Methods This cross-sectional study retrospectively analyzed anonymous data of users who approached the German messenger-based psychological chat counseling service krisenchat between May 2020 and July 2021 (N = 6657), with a focus on frequent users - the "frequent chatters". Frequent chatters were defined as those who received an above average (M + 2 ∗ SD) amount of messages from counselors over a period of one week and had at least 7 days of contact with the service over the entire data collection period. Chi-square-tests and Mann-Whitney-U tests were conducted to identify differences between frequent users and the population of all users. Results In total, n = 99 (1.5 %) users met the definition for frequent chatters and accounted for roughly a tenth (9.85 %) of all chats of the service. The mean frequent chatter was 17 years old (M = 17.29, SD = 3.56), female (n = 78, 82.1 %), and approached the service in the late afternoon (M = 5:00 pm, SD = 5:25 h). Compared to the general user population, frequent chatters reported significantly more severe concerns to counselors, of which 81.8 % included psychiatric symptoms, such as suicidality (43.4 %) and non-suicidal self-injury (41.4 %). In addition, frequent chatters were significantly more likely to contact krisenchat alongside the use of other professional help services. Further, frequent chatters wrote significantly longer and more messages during the counseling process and within a session than the general user population of krisenchat. Compared to the general user population, frequent chatters did not differ in their satisfaction with the service. Conclusion Frequent users are known from telephone helplines and are also represented in a chat-based context. Compared to the general user population, they are more likely to report serious mental health conditions and half of them currently receive professional help, suggesting a high need for social support. In light of the increasing development of chat-based helplines, there is a need for further research on frequent chatters to develop tailored counseling strategies for their needs and to analyze options for an optimized service provision. Study registration DRKS00026671.
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Affiliation(s)
- Zeki Efe
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | - Lukas Guenthner
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | | | - Richard Wundrack
- krisenchat gGmbH, Berlin, Germany
- Department of Psychology, Chair of Personality Psychology, Humboldt Universität zu Berlin, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Leipzig Medical Center, Leipzig University, Leipzig, Germany
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Chan EC, Wallace K, Yang EH, Roper L, Aryal G, Lodhi RJ, Isenberg R, Carnes P, Baskys A, Green B, Aitchison KJ. The feasibility and acceptability of mobile application-based assessment of suicidality using self-report components of a novel tool, the Suicide Ideation and Behavior Assessment Tool (SIBAT). Psychiatry Res 2022; 307:114316. [PMID: 34896843 DOI: 10.1016/j.psychres.2021.114316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess the validity of a mobile application-based self-report questionnaire in the assessment of suicidality. We developed a program for the administration of self-report components of the Suicide Ideation and Behavior Assessment Tool (SIBAT). We invited university students and trainees enrolled in a study of addictions to complete this component of the SIBAT using the program on their mobile devices or personal computer. 196 participants completed all required modules of the SIBAT, with 97 using their mobile device and 99 using their personal computer. Rates of completed questionnaires between the two groups were compared, as were the responses to the items and the total scores. There was a significant difference between proportions of scale completion in both groups, with a greater number of participants who used a personal computer to complete the scale not responding to all questions compared to participants who used a mobile device to complete the scale. Data collected via mobile device showed good concurrent validity with data collected via personal computer. A trend toward greater disclosure of suicidality was observed in the mobile device group however, replication of these findings using larger sample sizes is needed.
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Affiliation(s)
- Eric C Chan
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
| | - Keanna Wallace
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - Esther H Yang
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - Leslie Roper
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - Garima Aryal
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - Rohit J Lodhi
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Richard Isenberg
- American Foundation for Addiction Research, Psychological Counseling Services, Scottsdale, Arizona, USA
| | - Patrick Carnes
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Andrius Baskys
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Graduate College of Biomedical Sciences and University Medical Center, Western University of Health Sciences, Pomona, California, USA; Memory Disorders and Genomic Medicine Clinic, Riverside, California, USA
| | - Bradley Green
- Department of Psychology, University of Texas at Tyler, Tyler, USA
| | - Katherine J Aitchison
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
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Mucic D, Shore JH, Hilty DM, Krysta K, Krzystanek M. Lessons Learned or Forgotten? Impacts of COVID-19 on the Future Direction of Global (e-)Mental Health Care. Curr Psychiatry Rep 2021; 23:86. [PMID: 34842979 PMCID: PMC8628486 DOI: 10.1007/s11920-021-01300-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has impacted lives globally, posing unique challenges to mental health services exposing vulnerability and limitations within these systems. During the course of the pandemic, telecommunications technologies (e-mental health care) have served a critical role in psychiatric care. It is important to understand current lessons learned in e-mental health care and implications for global mental health systems for both emerging from the pandemic and after the pandemic has ended. RECENT FINDINGS There are significant regulatory, policy, and evaluation challenges for global e-mental health impacting patients, clinicians, health systems, and decision-makers. These include complex regulatory issues, difficulties of providing care across boundaries, and keeping pace with the implementation of new technologies in behavioral health. The collaborative development of global standards along with policies, appropriate regulations, and developing new models of research and development opens the possibility of improved access to care across national boundaries.
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Affiliation(s)
- D Mucic
- Little Prince Treatment Centre, Havneholmen 82, 5th, 1561, Copenhagen V, Denmark.
| | - J H Shore
- Office of Telehealth and Technology Implementation for Behavioral Health Practice and Science (TIPS), Department of Psychiatry, Aurora, USA
- Department of Psychiatry and Family Medicine, School of Medicine And Centers for American Indian and Alaska Native Health, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D M Hilty
- VA Northern California Health Care, System & UC Davis School of Medicine, 2230 Stockton Boulevard, Sacramento, CA, 95817, USA
| | - K Krysta
- Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Clinic of Psychiatric Rehabilitation, Medical University of Silesia, Ziołowa 45/47, 40-635, Katowice, Poland
| | - M Krzystanek
- Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Clinic of Psychiatric Rehabilitation, Medical University of Silesia, Ziołowa 45/47, 40-635, Katowice, Poland
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Gaebel W, Lukies R, Kerst A, Stricker J, Zielasek J, Diekmann S, Trost N, Gouzoulis-Mayfrank E, Bonroy B, Cullen K, Desie K, Ewalds Mulliez AP, Gerlinger G, Günther K, Hiemstra HJ, McDaid S, Murphy C, Sander J, Sebbane D, Roelandt JL, Thorpe L, Topolska D, Van Assche E, Van Daele T, Van den Broeck L, Versluis C, Vlijter O. Upscaling e-mental health in Europe: a six-country qualitative analysis and policy recommendations from the eMEN project. Eur Arch Psychiatry Clin Neurosci 2021; 271:1005-1016. [PMID: 32393997 DOI: 10.1007/s00406-020-01133-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/27/2020] [Indexed: 11/30/2022]
Abstract
E-mental health (eMH) encompasses the use of digital technologies to deliver, support, or enhance mental health services. Despite the growing evidence for the effectiveness of eMH interventions, the process of implementation of eMH solutions in healthcare remains slow throughout Europe. To address this issue, the e-Mental Health Innovation and Transnational Implementation Platform North-West Europe (eMEN) project was initiated to increase the dissemination and quality of eMH services in Europe. In this project, status analyses regarding eMH in the six participating countries (i.e., Belgium, France, Germany, Ireland, The Netherlands, and the UK) were conducted and eight recommendations for eMH were developed. Expert teams from the six participating countries conducted status analyses regarding the uptake of eMH based on a narrative literature review and stakeholder interviews. Based on these status analyses, the eMEN consortium developed eight policy recommendations to further support the implementation of eMH in Europe. The status analyses showed that the participating countries are in different stages of implementing eMH into mental healthcare. Some barriers to implementing eMH were common among countries (e.g., a limited legal and regulatory framework), while others were country-specific (e.g., fragmented, federal policies). The policy recommendations included fostering awareness, creating strong political commitment, and setting reliable standards related to ethics and data security. The eMEN project has provided the initial recommendations to guide political and regulatory processes regarding eMH. Further research is needed to establish well-tailored implementation strategies and to assess the generalizability of the recommendations beyond the countries involved in the eMEN project.
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Affiliation(s)
- Wolfgang Gaebel
- Department of Psychiatry, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Bergische Landstr. 2, 40629, Düsseldorf, Germany. .,WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany. .,LVR-Institute for Healthcare Research, Cologne, Germany.
| | - R Lukies
- LVR-Institute for Healthcare Research, Cologne, Germany
| | - A Kerst
- Department of Psychiatry, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Bergische Landstr. 2, 40629, Düsseldorf, Germany.,WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
| | - J Stricker
- Department of Psychiatry, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Bergische Landstr. 2, 40629, Düsseldorf, Germany.,WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
| | - J Zielasek
- LVR-Institute for Healthcare Research, Cologne, Germany
| | - S Diekmann
- LVR-Institute for Healthcare Research, Cologne, Germany
| | - N Trost
- LVR-Institute for Healthcare Research, Cologne, Germany
| | | | - B Bonroy
- Thomas More University of Applied Sciences, Geel, Belgium
| | - K Cullen
- Mental Health Reform, Dublin, Ireland
| | - K Desie
- Pulso Europe, Leuven, Belgium
| | - A P Ewalds Mulliez
- WHO Collaborating Centre for Research and Training in Mental Health-EPSM Lille-Métropole, Lille, France
| | - G Gerlinger
- German Association for Psychiatry, Psychotherapy and Psychosomatics e.V. (DGPPN), Berlin, Germany
| | - K Günther
- German Association for Psychiatry, Psychotherapy and Psychosomatics e.V. (DGPPN), Berlin, Germany
| | - H J Hiemstra
- Inserm, Clinical Epidemiology and Economic Evaluation Applied to Vulnerable Populations (ECEVE), Paris Diderot University, Paris, France
| | - S McDaid
- Mental Health Reform, Dublin, Ireland
| | - C Murphy
- Mental Health Foundation, London, UK
| | - J Sander
- German Association for Psychiatry, Psychotherapy and Psychosomatics e.V. (DGPPN), Berlin, Germany
| | - D Sebbane
- WHO Collaborating Centre for Research and Training in Mental Health-EPSM Lille-Métropole, Lille, France.,Inserm, Clinical Epidemiology and Economic Evaluation Applied to Vulnerable Populations (ECEVE), Paris Diderot University, Paris, France
| | - J L Roelandt
- WHO Collaborating Centre for Research and Training in Mental Health-EPSM Lille-Métropole, Lille, France.,Inserm, Clinical Epidemiology and Economic Evaluation Applied to Vulnerable Populations (ECEVE), Paris Diderot University, Paris, France
| | - L Thorpe
- Mental Health Foundation, London, UK
| | | | - E Van Assche
- Thomas More University of Applied Sciences, Geel, Belgium
| | - T Van Daele
- Thomas More University of Applied Sciences, Geel, Belgium
| | | | | | - O Vlijter
- Stichting Arq, Diemen, The Netherlands
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5
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De Witte NAJ, Carlbring P, Etzelmueller A, Nordgreen T, Karekla M, Haddouk L, Belmont A, Øverland S, Abi-Habib R, Bernaerts S, Brugnera A, Compare A, Duque A, Ebert DD, Eimontas J, Kassianos AP, Salgado J, Schwerdtfeger A, Tohme P, Van Assche E, Van Daele T. Online consultations in mental healthcare during the COVID-19 outbreak: An international survey study on professionals' motivations and perceived barriers. Internet Interv 2021; 25:100405. [PMID: 34401365 DOI: 10.1016/j.invent.2021.100405] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION While the general uptake of e-mental health interventions remained low over the past years, physical distancing and lockdown measures relating to the COVID-19 pandemic created a need and demand for online consultations in only a matter of weeks. OBJECTIVE This study investigates the uptake of online consultations provided by mental health professionals during lockdown measures in the first wave of the COVID-19 pandemic in the participating countries, with a specific focus on professionals' motivations and perceived barriers regarding online consultations. METHODS An online survey on the use of online consultations was set up in March 2020. The Unified Theory of Acceptance and Use of Technology (UTAUT) guided the deductive qualitative analysis of the results. RESULTS In total, 2082 mental health professionals from Austria, Belgium, Cyprus, France, Germany, Italy, Lebanon, Lithuania, the Netherlands, Norway, Portugal, Spain, and Sweden were included. The results showed a high uptake of online consultations during the COVID-19 pandemic but limited previous training on this topic undergone by mental health professionals. Most professionals reported positive experiences with online consultations, but concerns about the performance of online consultations in a mental health context (e.g., in terms of relational aspects) and practical considerations (e.g., relating to privacy and security of software) appear to be major barriers that hinder implementation. CONCLUSIONS This study provides an overview of the mental health professionals' actual needs and concerns regarding the use of online consultations in order to highlight areas of possible intervention and allow the implementation of necessary governmental, educational, and instrumental support so that online consultations can become a feasible and stable option in mental healthcare.
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6
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Kopelovich SL, Monroe-DeVita M, Buck BE, Brenner C, Moser L, Jarskog LF, Harker S, Chwastiak LA. Community Mental Health Care Delivery During the COVID-19 Pandemic: Practical Strategies for Improving Care for People with Serious Mental Illness. Community Ment Health J 2021; 57:405-415. [PMID: 32562033 PMCID: PMC7304659 DOI: 10.1007/s10597-020-00662-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/13/2020] [Indexed: 11/24/2022]
Abstract
The COVID-19 pandemic has presented a formidable challenge to care continuity for community mental health clients with serious mental illness and for providers who have had to quickly pivot the modes of delivering critical services. Despite these challenges, many of the changes implemented during the pandemic can and should be maintained. These include offering a spectrum of options for remote and in-person care, greater integration of behavioral and physical healthcare, prevention of viral exposure, increased collaborative decision-making related to long-acting injectable and clozapine use, modifying safety plans and psychiatric advance directives to include new technologies and broader support systems, leveraging natural supports, and integration of digital health interventions. This paper represents the authors' collaborative attempt to both reflect the changes to clinical practice we have observed in CMHCs across the US during this pandemic and to suggest how these changes can align with best practices identified in the empirical literature.
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Affiliation(s)
- Sarah L Kopelovich
- Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359911, Seattle, WA, 98104, USA.
| | - Maria Monroe-DeVita
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Benjamin E Buck
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Carolyn Brenner
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Lorna Moser
- Department of Psychiatry, Center of Excellence in Community Mental Health, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - L Fredrik Jarskog
- Department of Psychiatry, North Carolina Psychiatric Research Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Steve Harker
- Ramsey County ACT and Radias Forensic ACT Team, St. Paul, MN, USA
| | - Lydia A Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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7
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Kerst A, Zielasek J, Gaebel W. Smartphone applications for depression: a systematic literature review and a survey of health care professionals' attitudes towards their use in clinical practice. Eur Arch Psychiatry Clin Neurosci 2020; 270:139-152. [PMID: 30607530 DOI: 10.1007/s00406-018-0974-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/19/2018] [Indexed: 12/30/2022]
Abstract
Smartphone applications ("apps") may contribute to closing the treatment gap for depression by reaching large populations at relatively low costs. The general public seems open towards the use of apps for mental disorders but less is known about the attitudes of health care professionals. Therefore, the aim of this study was to examine the available evidence on the effectiveness of apps for depression and to explore the attitudes of health care professionals towards their use in practice. A systematic literature search was performed aimed at studies utilizing smartphone applications for depression. In addition, a survey was conducted to explore health care professionals' attitudes towards using these treatment apps in clinical practice. Twelve articles were identified in the systematic literature review. All included trials reported a decline in depressive symptoms after the intervention periods. In the survey, 72 health care professionals participated. Significant differences were found between the level of technology experience and how much the health care professional would consider the use of mobile applications in clinical practice. Survey participants reported openness towards therapeutic app use but very little knowledge and experience in the field. Apps appear to be a promising self-management tool for reducing depressive symptoms. Despite some concerns, health care professionals' attitudes towards the use of smartphone applications in clinical practice are quite positive. The provision of information on the potential benefits of e-health interventions as well as the training of professionals in the application of new technologies may increase health care professionals' awareness and knowledge about mobile apps for the treatment of mental disorders.
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Affiliation(s)
- Ariane Kerst
- Department of Psychiatry, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
- WHO Collaborating Center for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany.
| | | | - Wolfgang Gaebel
- Department of Psychiatry, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- WHO Collaborating Center for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
- LVR-Institute for Healthcare Research, Cologne, Germany
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Barnett S, Huckvale K, Christensen H, Venkatesh S, Mouzakis K, Vasa R. Intelligent Sensing to Inform and Learn (InSTIL): A Scalable and Governance-Aware Platform for Universal, Smartphone-Based Digital Phenotyping for Research and Clinical Applications. J Med Internet Res 2019; 21:e16399. [PMID: 31692450 PMCID: PMC6868504 DOI: 10.2196/16399] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 02/06/2023] Open
Abstract
In this viewpoint we describe the architecture of, and design rationale for, a new software platform designed to support the conduct of digital phenotyping research studies. These studies seek to collect passive and active sensor signals from participants' smartphones for the purposes of modelling and predicting health outcomes, with a specific focus on mental health. We also highlight features of the current research landscape that recommend the coordinated development of such platforms, including the significant technical and resource costs of development, and we identify specific considerations relevant to the design of platforms for digital phenotyping. In addition, we describe trade-offs relating to data quality and completeness versus the experience for patients and public users who consent to their devices being used to collect data. We summarize distinctive features of the resulting platform, InSTIL (Intelligent Sensing to Inform and Learn), which includes universal (ie, cross-platform) support for both iOS and Android devices and privacy-preserving mechanisms which, by default, collect only anonymized participant data. We conclude with a discussion of recommendations for future work arising from learning during the development of the platform. The development of the InSTIL platform is a key step towards our research vision of a population-scale, international, digital phenotyping bank. With suitable adoption, the platform will aggregate signals from large numbers of participants and large numbers of research studies to support modelling and machine learning analyses focused on the prediction of mental illness onset and disease trajectories.
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Affiliation(s)
- Scott Barnett
- Applied Artificial Intelligence Institute (A2I2), Deakin University, Geelong, Australia
| | - Kit Huckvale
- Black Dog Institute, UNSW Sydney, Randwick, Australia
| | - Helen Christensen
- Black Dog Institute, UNSW Sydney, Randwick, Australia.,Mindgardens Neuroscience Network, Sydney, Australia
| | - Svetha Venkatesh
- Applied Artificial Intelligence Institute (A2I2), Deakin University, Geelong, Australia
| | - Kon Mouzakis
- Black Dog Institute, UNSW Sydney, Randwick, Australia
| | - Rajesh Vasa
- Applied Artificial Intelligence Institute (A2I2), Deakin University, Geelong, Australia
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Rodda SN, Merkouris S, Lavis T, Smith D, Lubman DI, Austin D, Harvey P, Battersby M, Dowling NA. The therapist experience of internet delivered CBT for problem gambling: Service integration considerations. Internet Interv 2019; 18:100264. [PMID: 31890617 DOI: 10.1016/j.invent.2019.100264] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Countries with legalized gambling offer a network of government funded face-to-face therapy, but usage of this expertise is on the decline. One way to address this issue is to recruit therapists from existing services whereby they provide guidance for the delivery of internet delivered CBT. OBJECTIVE To explore the experiences and perceptions of therapists supporting guided online cognitive-behavioural therapy. METHODS Interviewees were a sub-sample of therapists from a randomised trial that investigated the relative efficacy of online guided self-directed versus pure self-directed interventions in Australia. RESULTS In-person, semi-structured interviews with seven service providers were completed, and thematic content analysis identified five themes which related to: participant suitability and screening (e.g., motivation, computer literacy and access); program content and modality acceptability (e.g., amount of content, look and feel); participant information and management (e.g., program engagement and progression); email communication (e.g., use of templates, appointments, rapport building), and; ongoing service integration (e.g., infrastructure, confidence in product). Overall experiences and perceptions of therapists were positive, notwithstanding barriers concerning assessment of participant suitability, participant management systems and low participant engagement. CONCLUSIONS Key themes emphasized the benefits of Internet-based interventions for problem gambling, and suggested several areas for improvement. Results should inform the development of future treatments to enable flexible tailoring of interventions to individuals.
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Casey LM, Oei TPS, Raylu N, Horrigan K, Day J, Ireland M, Clough BA. Internet-Based Delivery of Cognitive Behaviour Therapy Compared to Monitoring, Feedback and Support for Problem Gambling: A Randomised Controlled Trial. J Gambl Stud 2017; 33:993-1010. [PMID: 28124288 DOI: 10.1007/s10899-016-9666-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment.
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Gunn J, Cameron J, Densley K, Davidson S, Fletcher S, Palmer V, Chondros P, Dowrick C, Pirkis J. Uptake of mental health websites in primary care: Insights from an Australian longitudinal cohort study of depression. Patient Educ Couns 2018; 101:105-112. [PMID: 28739180 DOI: 10.1016/j.pec.2017.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 06/25/2017] [Accepted: 07/08/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To describe the characteristics of primary care attendees with depressive symptoms who use mental health websites. METHODS 789 individuals with depressive symptoms recruited and followed up annually for nine years. Self-reported written surveys included mental health, professional and self-help use, e-mental health interventions or therapeutic websites. Marginal logistic regression examined association between mental health website (MHW) use and patient's mental health, health services use, anti-depressant use and self-help strategies. RESULTS 36% of participants used an MHW at least once. MHW users were more likely to be female, younger, highly educated and employed. MHW use increased with depressive symptom severity; reported in 16% of assessments when minimal symptoms were present and 28% when severe symptoms were present. MHW use was associated with: GP mental health visits, psychologist and psychiatrist visits and other self-help strategies including self-help books and telephone helplines. CONCLUSION(S) Mental health websites were more likely to be used by those with severe depressive symptoms rather than those with mild depression as recommended in current guidelines. PRACTICE IMPLICATION(S) Whilst mental health websites offer potential to support the high volume of people with mild depression new strategies may be required to ensure uptake.
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Affiliation(s)
- Jane Gunn
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Jacqui Cameron
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Konstancja Densley
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Sandra Davidson
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Susie Fletcher
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Victoria Palmer
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Patty Chondros
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia.
| | - Christopher Dowrick
- Institute of Psychology Health and Society, University of Liverpool, United Kingdom.
| | - Jane Pirkis
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
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Clough BA, Zarean M, Ruane I, Mateo NJ, Aliyeva TA, Casey LM. Going global: do consumer preferences, attitudes, and barriers to using e-mental health services differ across countries? J Ment Health 2017; 28:17-25. [PMID: 28857650 DOI: 10.1080/09638237.2017.1370639] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND e-Mental health services have the capacity to overcome barriers to care and reduce the unmet need for psychological services, particularly in developing countries. However, it is unknown how acceptable e-mental health interventions may be to these populations. AIMS The purpose of the current study was to examine consumer attitudes and perceived barriers to e-mental health usage across four countries: Australia, Iran, the Philippines and South Africa. METHODS An online survey was completed by 524 adults living in these countries, assessing previous contact with e-mental health services, willingness to use e-mental health services, and perceived barriers and needs for accessing e-mental health services. RESULTS Although previous contact with e-mental health services was low, the majority of respondents in each sample reported a willingness to try e-mental health services if offered. Barriers toward e-mental health usage were higher among the developing countries than Australia. The most commonly endorsed barriers concerned needing information and assurances regarding the programmes. CONCLUSIONS Across countries, participants indicated a willingness to use e-mental health programmes if offered. With appropriate research and careful implementation, e-mental health has the potential to be a valuable part of mental healthcare in developing countries.
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Affiliation(s)
- Bonnie A Clough
- a Institute for Resilient Regions, University of Southern Queensland , Toowoomba , QLD , Australia.,b School of Applied Psychology, Behavioural Basis of Health, Menzies Health Institute Queensland, Griffith University , Mt Gravatt , QLD , Australia
| | - Mostafa Zarean
- c Department of Psychology, Faculty of Education and Psychology , Tabriz University , Tabriz , Iran
| | - Ilse Ruane
- d Private Practice , Pretoria , South Africa
| | - Niño Jose Mateo
- e Counseling and Educational Psychology Department , College of Education, De La Salle University , Manila , Philippines , and
| | - Turana A Aliyeva
- f Department of Social and Pedagogical Psychology , Baku State University , Baku , Azerbaijan
| | - Leanne M Casey
- b School of Applied Psychology, Behavioural Basis of Health, Menzies Health Institute Queensland, Griffith University , Mt Gravatt , QLD , Australia
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Van der Zanden R, Curie K, Van Londen M, Kramer J, Steen G, Cuijpers P. Web-based depression treatment: associations of clients' word use with adherence and outcome. J Affect Disord 2014; 160:10-3. [PMID: 24709016 DOI: 10.1016/j.jad.2014.01.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 01/12/2014] [Accepted: 01/13/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The growing number of web-based psychological treatments, based on textual communication, generates a wealth of data that can contribute to knowledge of online and face-to-face treatments. We investigated whether clients' language use predicted treatment outcomes and adherence in Master Your Mood (MYM), an online group course for young adults with depressive symptoms. METHODS Among 234 participants from a randomised controlled trial of MYM, we tested whether their word use on course application forms predicted baseline levels of depression, anxiety and mastery, or subsequent treatment adherence. We then analysed chat session transcripts of course completers (n=67) to investigate whether word use changes predicted changes in treatment outcomes. RESULTS Depression improvement was predicted by increasing use of 'discrepancy words' during treatment (e.g. should). At baseline, more discrepancy words predicted higher mastery level. Adherence was predicted by more words used at application, more social words and fewer discrepancy words. LIMITATIONS Many variables were included, increasing the chance of coincidental results. This risk was constrained by examining only those word categories that have been investigated in relation to depression or adherence. CONCLUSIONS This is the first study to link word use during treatment to outcomes of treatment that has proven to be effective in an RCT. The results suggest that paying attention to the length of problem articulation at application and to 'discrepancy words' may be wise, as these seem to be psychological markers. To expand knowledge of word use as psychological marker, research on web-based treatment should include text analysis.
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Affiliation(s)
- Rianne Van der Zanden
- Trimbos Institute, Knowledge Centre of Mental Health and Addiction, Da Costakade 45, Post Office Box 727, 3500 Utrecht, The Netherlands.
| | - Keshia Curie
- Trimbos Institute, Knowledge Centre of Mental Health and Addiction, Da Costakade 45, Post Office Box 727, 3500 Utrecht, The Netherlands.
| | | | - Jeannet Kramer
- Trimbos Institute, Knowledge Centre of Mental Health and Addiction, Da Costakade 45, Post Office Box 727, 3500 Utrecht, The Netherlands
| | - Gerard Steen
- Department of Language and Communication, Network Institute, VU University Amsterdam, The Netherlands.
| | - Pim Cuijpers
- Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands.
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