Rutvij Merchant1, John Torous2, Elena Rodriguez-Villa2, John A Naslund3. 1. Harvard T.H. Chan School of Public Health. 2. The Division of Digital Psychiatry at Beth Israel Deaconess Medical Center. 3. Department of Global Health & Social Medicine, Harvard Medicl School, Boston, Massachusetts, USA.
Abstract
PURPOSE OF REVIEW: Increasingly, digital technologies, especially mobile telecommunications and smartphone apps, are seen as a novel tool for managing severe mental disorders (SMDs) in low-income and middle-income countries (LMICs). However, there is a need to identify best practices in the use of digital technologies to effectively reach, support, and manage care for patients living with SMDs. In this review, we summarize recent studies using digital technology to manage symptoms and support clinical care for this patient population and discuss new opportunities to advance digital psychiatry research and practice in LMICs. RECENT FINDINGS: Studies evaluating digital interventions for clinical populations living with SMDs in LMICs are limited. Yet, across recent articles surveyed, digital technology appears to yield diverse benefits for this at-risk patient population. These benefits include improved medication adherence, appointment adherence, reduced instances of relapse, and fewer re-hospitalizations. SUMMARY: Continued rigorous research evaluating effectiveness and cost-effectiveness of digital technologies in reaching, treating, and managing symptoms and supporting clinical care for patients with SMDs in LMICs is vital. The urgency for remote approaches for delivering specialized psychiatric care is particularly pronounced because of the immediate and long-term impact of the coronavirus (COVID-19) pandemic on access to in-person services. Future research should emphasize participatory approaches rooted in a process of codesign with target users, in order to achieve clinically effective remotely delivered digital mental health interventions.
PURPOSE OF REVIEW: Increasingly, digital technologies, especially mobile telecommunications and smartphone apps, are seen as a novel tool for managing severe mental disorders (SMDs) in low-income and middle-income countries (LMICs). However, there is a need to identify best practices in the use of digital technologies to effectively reach, support, and manage care for patients living with SMDs. In this review, we summarize recent studies using digital technology to manage symptoms and support clinical care for this patient population and discuss new opportunities to advance digital psychiatry research and practice in LMICs. RECENT FINDINGS: Studies evaluating digital interventions for clinical populations living with SMDs in LMICs are limited. Yet, across recent articles surveyed, digital technology appears to yield diverse benefits for this at-risk patient population. These benefits include improved medication adherence, appointment adherence, reduced instances of relapse, and fewer re-hospitalizations. SUMMARY: Continued rigorous research evaluating effectiveness and cost-effectiveness of digital technologies in reaching, treating, and managing symptoms and supporting clinical care for patients with SMDs in LMICs is vital. The urgency for remote approaches for delivering specialized psychiatric care is particularly pronounced because of the immediate and long-term impact of the coronavirus (COVID-19) pandemic on access to in-person services. Future research should emphasize participatory approaches rooted in a process of codesign with target users, in order to achieve clinically effective remotely delivered digital mental health interventions.
Authors: John A Naslund; Pattie P Gonsalves; Oliver Gruebner; Sachin R Pendse; Stephanie L Smith; Amit Sharma; Giuseppe Raviola Journal: Curr Treat Options Psychiatry Date: 2019-09-07
Authors: Dong Roman Xu; Shuiyuan Xiao; Hua He; Eric D Caine; Stephen Gloyd; Jane Simoni; James P Hughes; Juan Nie; Meijuan Lin; Wenjun He; Yeqing Yuan; Wenjie Gong Journal: PLoS Med Date: 2019-04-23 Impact factor: 11.069
Authors: Diana Frasquilho; Margarida Gaspar Matos; Ferdinand Salonna; Diogo Guerreiro; Cláudia C Storti; Tânia Gaspar; José M Caldas-de-Almeida Journal: BMC Public Health Date: 2016-02-03 Impact factor: 3.295
Authors: John Torous; Sandra Bucci; Imogen H Bell; Lars V Kessing; Maria Faurholt-Jepsen; Pauline Whelan; Andre F Carvalho; Matcheri Keshavan; Jake Linardon; Joseph Firth Journal: World Psychiatry Date: 2021-10 Impact factor: 49.548
Authors: Elena Rodriguez-Villa; Abhijit R Rozatkar; Mohit Kumar; Vikram Patel; Ameya Bondre; Shalini S Naik; Siddharth Dutt; Urvakhsh M Mehta; Srilakshmi Nagendra; Deepak Tugnawat; Ritu Shrivastava; Harikeerthan Raghuram; Azaz Khan; John A Naslund; Snehil Gupta; Anant Bhan; Jagadisha Thirthall; Prabhat K Chand; Tanvi Lakhtakia; Matcheri Keshavan; John Torous Journal: Glob Ment Health (Camb) Date: 2021-08-24
Authors: Katie M Lavigne; Geneviève Sauvé; Delphine Raucher-Chéné; Synthia Guimond; Tania Lecomte; Christopher R Bowie; Mahesh Menon; Shalini Lal; Todd S Woodward; Michael D Bodnar; Martin Lepage Journal: Schizophrenia (Heidelb) Date: 2022-03-05
Authors: Milton L Wainberg; Maria Lídia Gouveia; Melissa Ann Stockton; Paulino Feliciano; Antonio Suleman; Jennifer J Mootz; Milena Mello; Andre Fiks Salem; M Claire Greene; Charl Bezuidenhout; Phuti Ngwepe; Kathryn L Lovero; Palmira Fortunato Dos Santos; Simone H Schriger; David S Mandell; Rogerio Mulumba; Anibal Neves Anube; Dirceu Mabunda; Flavio Mandlate; Francine Cournos; Jean-Marie Alves-Bradford; Terriann Nicholson; Bianca Kann; Wilza Fumo; Cristiane S Duarte; Jair de Jesus Mari; Marcelo F Mello; Ana O Mocumbi; Maria A Oquendo; Myrna M Weissman Journal: Evid Based Ment Health Date: 2020-11-11
Authors: Dror Ben-Zeev; Suzanne Meller; Jaime Snyder; Dzifa A Attah; Liam Albright; Hoa Le; Seth M Asafo; Pamela Y Collins; Angela Ofori-Atta Journal: JMIR Ment Health Date: 2021-07-02