Mental Health Goes Digital

Mental Health Goes Digital

There are 10 million adults in the United States with a serious mental illness, according to the National Institute for Mental Health. It is no secret that the system we have in place to provide mental health care for these individuals — who account for almost 5 percent of the population — is falling short.

There are many reasons why this has happened: limited insurance coverage for psychological issues, social stigmatization, and an inadequate number of mental health professionals.

There are some encouraging signs that change may be coming, like the provisions in several major laws in recent years that have attempted to address mental health concerns. There, however, remains an immediate and fairly urgent need for better mental care now. A growing group of mental health professionals, researchers, and innovators are taking a completely different approach to this problem: taking mental health care digital.

One such organization is Prevail Health which runs VetsPrevail, an online mental health service for military veterans dealing with depression and post-traumatic stress disorder Given that an estimated 20 percent of veterans returning from conflicts in Iraq and Afghanistan have a significant mental health or substance abuse disorder, there is a large and pressing need for more effective, scalable, and practical mental health services for these individuals.

VetsPrevail was developed as part of a collaborative effort between the Veterans Affairs Administration and Prevail Health with support from the National Science Foundation.

This web-based platform delivers evidence-based, interactive content that is grounded in cognitive behavioral therapy (CBT). CBT is a strategy that is part of the standard of care for a variety of mental health conditions. VetsPrevail also connects veterans to colleagues who have struggled with similar issues.

Another technological approach to delivering effective mental health interventions is through smartphones. This approach limits your reach to people who own smartphones. Unfortunately, people in lower socioeconomic strata are less likely to be able to afford a smartphone, yet are burdened with a higher prevalence of mental illness and reduced access to care than those in higher strata. A 2013 survey by the Pew Foundation found that among individuals in households with less than $30,000 in annual income, 42 percent owned a smartphone.

Step Away, a mobile app to help manage substance abuse, is trying to take advantage of the growing ubiquity of smartphones. Developed with a team from the University of Alaska’s Department of Psychology and support from the National Institute on Alcohol Abuse and Alcoholism, Step Away helps users get more insight into their addiction by tracking triggers, drinking patterns and moods. The app then offers interventions likes craving management techniques, weekly feedback sessions and reminders about goals and aspirations. Step Away also lets users enter support contacts who can serve as a safety net during high risk moments. In an initial pilot study, Step Away showed promising results in improving alcohol abstinence.

While there are examples of useful digital health tools out there, the market is by and large crowded by ineffective applications. In one study looking at smartphone apps marketed for depression, researchers found that for every one app truly related to depression, they had to go through three that were irrelevant. There are also serious concerns about the quality of apps out there for mental health issues. Another study by a group of Australian researchers looked at apps for bipolar disorder. They found that the majority of apps evaluated failed to follow best clinical practices. Some of the apps even made dangerous suggestions.

For instance, one app indicated alcohol can help treat episodes of mania.

We are in need of better technology to provide effective mental health care to the millions of Americans currently being under-served by our existing system. Fortunately, it could turn out that with the right innovation there is going to be “an app for that.”

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