Mobile Health for Mental Health: Barriers and Opportunities

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“When ‘I’ is replaced by ‘We’ even illness becomes wellness.” -unknown


According to the National Alliance on Mental Illness, about 60% of adults and 50% of youths ages 8-15 years old with a mental illness did not receive any mental health services in the previous year. WHO reports people with severe mental illness experience a 10-25 year decrease in life expectancy compared to the general population. Early deaths and excess spending could be prevented if people received adequate physical and mental health care.

Traditional healthcare involves barriers that mobile health (mHealth) hopes to turn into opportunities for mental healthcare.

Opportunity: Reduce Stigma. The stigma around mental illness often prevents people from seeking proper care. Technology is proving useful in overcoming stigma so people will seek help. Non-profit Give an Hour brings healthcare to military personnel and their families in the privacy of their own mobile phone screens. In addition, apps such as Doctor on Demand allow the public to reach out to licensed health care professionals and live chat. These mobile apps are not only made for individuals with a clinical diagnosis. They are also available to those who aren’t sure if they are depressed, for example, but would like to learn more.

 

Opportunity: Increase Access. Many people have difficulty accessing mental healthcare in a timely manner due to high costs, distance, and lack of transportation. Even if people overcome these obstacles, the inefficiencies of the health care system may inhibit prompt treatment. The National Institute of Mental Health is funding clinical trials for two mobile phone apps with the goal of overcoming these barriers: Mobilyze and CrossCheck. Both apps combine self reported information and data collected from “built-in sensors, such as GPS, ambient light, and recently made calls, in an attempt to predict the patient’s moods, emotions, and activities.” A baseline or healthy state is established. Deviations trigger advice or positive reinforcement text messages or a phone call from a healthcare provider. Heather Mansfield, author of Social Media for Social Good, reminds us that as price of smartphones, tablets, and data plans come down so will race and class barriers making mHealth more accessible to all.

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Image courtesy of jscreationzs at FreeDigitalPhotos.net

Opportunity: Integrate health systems. According to the 2011 WHO mHealth: New Horizons for Health through Mobile Technologies Global Observatory for eHealth Series, conflicting health system priorities is the top barrier to mHealth implementation across the globe. The current mental health system in the U.S. is dysfunctional. There are ten times more mentally ill Americans in jail than are receiving treatment in state hospitals. Additionally, countless lives are lost due to inadequate care. Despite inadequacies of traditional mental health care, progress is being made thanks to the growth of mHealth. Leaders in mHealth are investing in mental health campaigns and planning for the long run. People with mental illness may not have a regular doctor; instead they may visit the closest available doctor in times of need. In the traditional healthcare system this results in fragmented health records leading to insufficient care. mHealth allows records from various providers to be shared to provide more comprehensive health care. Mobile electronic medical records allow doctors to use telemedicine to provide prompt diagnosis and treatment in a convenient way for patients. Also, patients are more likely to use doctor-approved apps, so involving doctors early in development is invaluable in gaining patient participation and compliance. Finally, integrating telemedicine into the insurance system would complete the loop between patients, providers, and payers. Patients would be more likely to download and use apps if they received health insurance credits. Payers may be incentivized to give credits if apps prevented relapses, reduced larger treatment costs, and led to better health outcomes.

mHealth has the potential to raise the standard of mental healthcare in the U.S.

 

Featured image courtesy of Idea go at FreeDigitalPhotos.net.

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5 thoughts on “Mobile Health for Mental Health: Barriers and Opportunities

  1. I think you’ve made a really good point about how using mHealth for mental health care in the American penal system can lead to improved treatment of mental health issues for inmates. There has been a lot of discussion of mental health care in jails and prisons recently. The appointment of Nneka Jones Tapia as warden of the Cook County Jail (http://www.nytimes.com/2015/07/31/us/a-psychologist-as-warden-jail-and-mental-illness-intersect-in-chicago.html) has highlighted how, since the move to de-institutionalize in the 1980’s, the proportion of mentally ill inmates has risen dramatically.

    There has also been some discussion about suicide and mental health assessments in jails (as opposed to prisons). In a prison there exist some records on an inmate, about important medical and mental health information. For people who have just been arrested and are waiting in jail the guards might not have any way to know about existing medical or mental health issues, or any good tools for assessing people’s needs. An integrated mHealth system might allow for certain conditions (like diabetes) to be flagged so that an inmate doesn’t have to have a crisis before the problem is addressed. All of which would improve outcomes and reduce costs.

  2. Hi Jillian, I found this post really interesting. You’ve highlighted the potential for mHealth to improve access to psychiatric care broadly, and also specifically to a marginalized population. The idea that mHealth can provide “just-in-time” information to those looking (e.g. depressed, anxious) or feedback to patients (e.g. diabetes care) are all things that can improve clinical care of patients. Something that we have also been interested in at my work is looking at the the potential to gather patient reported outcomes (PRO) such as symptom tracking and intervention outcome through these tools (http://www.ajmc.com/journals/evidence-based-diabetes-management/2015/July-2015/Can-mHealth–Revolutionize–Evidence-Based–Practice-in–Diabetes-Care). There are many stakeholders in this space and seems to grow all the time. Thank you for this informative post.

  3. Hi Jillian, I think this post is really informative and very well structured.From a formatting standpoint, your images are just right, you have plenty of links to your sources, and the video is great. I especially like how you structured it in terms of “opportunities” which really helps the reader understand the idea behind the post – that mobile health applications can play an important role in helping reduce stigma, increase access, and integrate health systems. The only thing I can think of for improvement is linking to your prior blog post that also references using technology (social media) for mental health.
    From an information standpoint, you provided great information about the many ways that mobile health can improve the gaps in mental health services. For example, I think it’s so fascinating that the NIH is actually doing clinical trials on the mental health apps for increasing access. That makes so much sense! I love the idea of investigating technological advancements the same way we research drugs to find out what is really worth our while. Thanks for a great post!

  4. Jill, that is a great opening quote and your feature picture is fantastic. They both really helped to draw me in as a reader. Your mHealth examples focus primarily on the opportunities for healthcare professionals to obtain access to information about people with mental health problems, so they can provide better care and support to them. Some mobile apps help people to look after their own mental wellbeing, e.g. with mobile, online cognitive behaviour therapy for depression or anxiety – http://www.get.gg/mobile/step1.htm; tracking your mental state – http://apps.nhs.uk/app/moodscope/ (watch the embedded video for an engaging explanation: https://www.moodscope.com); or suicide prevention – http://www.prevent-suicide.org.uk/stay_alive_suicide_prevention_mobile_phone_application.html. Mental health is an area in which we need to increase access and reduce inequities, within limited resources. mHealth approaches could play an important part in that.

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