- Rapidly advancing consumer technology has unlocked the potential for digitised mental health services.
- Mindfully crafted apps and games can now connect with users in previously unforeseen ways: from providing tools for self-development to symptom-tracking or even to seek help when it’s needed.
- While ‘e-mental health’ could reach millions more at lower cost, significant care must be taken when designing and delivering these experiences.
There is no understating the issue of mental health in Australia and around the world. The Australian Bureau of Statistics’ 2014-15 National Health Survey found that up to four million Australians – 17.5% of the population – reported having an ongoing mental or behavioural condition. These are very high figures: only cancer and heart disease are more prevalent chronic diseases among the population.
With such a significant proportion of Australians living with a mental illness, and with many likely still undiagnosed and not managing their symptoms, the social and economic flow-on effects are significant. Afflictions such as drug and gambling addiction, homelessness and suicide can frequently be linked to poorly treated mental illness.
But mental health is also a global issue. A 2016 paper, Psychiatric Apps: Patient Self-Assessment, Communication, and Potential Treatment Interventions, reported that by 2030, mental health conditions throughout the world’s workers could cost the global economy up to US$16 trillion in labour productivity – that’s the GDP of the entire United States.
Back in Australia, the federal government has begun to recognise the seriousness of a poorly resourced mental health sector. In 2015, following a review by the National Mental Health Commission, the Prime Minister and the Minister for Health announced a reform of the nation’s mental health services. Among the initiatives announced was the development of a ‘digital gateway’ that seeks to ‘harness innovative digital mental health technologies’.
A digital approach
to mental health
Whether an online portal accessed via a web browser or a carefully designed smartphone app, digital mental health technology can overhaul a wide range of pre-existing services that were traditionally delivered face-to-face or over the phone. This is achieved by adapting aspects of the service for the digital realm. Once digitised, a much wider audience can be reached quickly and efficiently.
A successful example of this can be found in the general health and wellbeing category, with the mainstream adoption of mindfulness meditation apps such as beyondblue’s Mind the Bump or Headspace. Merging elements of an audio book, health tracking and social media, these apps work by providing a guided meditation experience in parallel with feedback tools, progress tracking, and social networking.
Other examples include the post-traumatic stress disorder management app PTSD Coach, the smoke-free app My QuitBuddy, and the anxiety management tool Talking Anxiety. More recently, a gamified digital mental health service was released in the form of ReachOut Orb. Targeting adolescent teens, the app combines positive psychology with gameplay, encouraging players to log real-world ‘positive thoughts’ to defeat a miserable monochromatic villain.
As well as the economies of scale and an ability to reach new population segments (such as those who live in remote locations), digital mental health services can offer other benefits. By placing elements of care into the hands of the patient, digitised services – depending on the category – can have an empowering effect, making users more autonomous and avoiding the need for extended out-of-home hospital stays.
Another advantage is the ability for digitised services to cut through many of the social taboos surrounding mental health. This encourages previously reluctant demographics such as young teens or middle-aged males – two very digitally savvy groups – to explore services on their own terms.
But the real benefit of digitisation may lie on the back end. By pairing mental health information with geographic and demographic data, organisations can receive invaluable survey statistics that could pave the way for the better targeting and deployment of mental health resources. This would be particularly advantageous for a geographically large nation such as Australia, where access to such resources in regional or rural areas is severely hampered.
Taking care with
digital mental health services
Although digitisation comes with a whole host of benefits, services must be designed and delivered with a great deal of care. A poorly designed user experience could dissuade potential users from interfacing with the service. There are also significant privacy and security considerations.
If these elements are not factored, the consequences could be disastrous. In 2014, a British mental health organisation had to pull its Twitter app in the wake of considerable backlash. Intended to algorithmically analyse the language of Twitter posts to identify individuals in distress, the app was instead lambasted for a perceived ability to harvest personal information from unsuspecting Twitter users.
Another issue, identified by the authors of Psychiatric Apps, was that individuals currently living with mental health issues often have limited education and socioeconomic status – restricting their access to technology and their means to use it. So while digital mental health apps may be good at assisting large swathes of the population, it won’t be a catch-all for everybody.
While there are still some issues to be ironed out in the digitisation of mental health services, the ongoing evolution of the sector remains highly exciting. Thanks to the development of apps and web portals, there are opportunities to tackle long-standing structural problems with new resources, reaching many more people in the process.