How can we close the gaps in mental healthcare with technology? Part 1
We have an abundance of technologies available to help people manage their physical health outside the four walls of a clinic or hospital—tools like health apps, wearable fitness devices, blood pressure monitors, and more. We have far fewer consumer digital tools available to help people manage their mental health. This is a crucial area with tremendous gaps in care that directly affects millions of Americans every year. Nearly a quarter of Americans have mental illness, and technology is an important avenue to reach those struggling with a mental health problem.
Unlike physical health problems where people often appear at a healthcare provider’s doorstep at the first sign of trouble, most people with mental health problems delay getting help or don’t get linked into the right type of care–sometimes for years. For those in care, drop-out is high. There are several reasons for this. Patients sometimes must wait a long time to see a provider and have difficulty navigating the mental health system. Another reason is the time they must wait, after the start of treatment, to see meaningful improvements in symptoms. Treatments for mental health frequently take weeks to months to sufficiently work. And, it’s not an exact science. Many patients must try different types of treatments before they find the one that works for them. During this time, patients describe feelings of frustration or hopelessness; they worry they won’t ever get to feeling better. So they disengage. Others are worried about stigma. Only one in five patients will stay in care past their fourth or fifth visit.
There’s a real need (and opportunity for nurses) to find ways to close the gaps in care. Today’s technologies offer an unprecedented opportunity to do this!
By 2018, 3.4 billion people worldwide will be using a mobile device, according to the Robert Wood Johnson Foundation. Technology use extends to nearly all cross-sections of the population. I have found that many people have more access to technology and the Internet than they do the basic needs of survival, like food or shelter. For example, in one of my recent studies that looked at depressed mood in young adults, I encountered a woman who was homeless but had a cellphone. She used her phone to answer email and communicate with us during the study. She could stand outside of Starbucks to access the free Wi-Fi, but couldn’t buy a cup of coffee. She completed our research study that lasted several months.
The ubiquitous use of technology means we have the opportunity to reach people with potentially new leading-edge treatments. Digital therapeutics is one way. Digital therapeutics are treatments or tools that engage patients over time. They’re grounded in sound scientific evidence and produce clinically significant outcomes. I believe that digital therapeutics for mental health are the next frontier of health and wellness! This idea was the focus of a conference at the White House with SAMHSA in 2013, in which I was involved.
Through technology, we can connect with communities worldwide that may be far from healthcare facilities, or with people who can’t get to a therapist’s office, for example. We can bring healthcare to people, placing it literally in the palms of their hands. This is essential to building a Culture of Health for everyone.
Understanding how digital tools could help people in the real world stay engaged in improving their mental health is essential to building the necessary evidence base. By real world, I mean outside of traditional clinical settings. And who better to lead in this area than nurses?
Unlike physicians, who may only see patients during office visits or hospital stays and have limited time with patients, nurses are typically more involved in the continuity of care for patients. They coordinate care across providers and follow up with patients. And they’re out in the field—in people’s homes and communities—so they have firsthand knowledge of the challenges and opportunities for patients in their day-to-day lives.
Forging partnerships between nurses and our multidisciplinary colleagues who have technical expertise (like engineers and computer scientists) and those skilled in big data science is key to the development of new solutions. These partnerships are vital to advancing the field of digital therapeutics for mental health. I have much more to share on this topic and am excited to do so in my upcoming blogs. So please check back here in about a week’s time for my next blog in this series.
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