Online Mental Health Support: Evolving Therapy through Technology
In a bid to revolutionize mental health care, France has launched the "Digital Medical Devices in Mental Health" initiative as part of its National Digital Health Challenges. This ambitious project aims to leverage innovative digital healthcare technologies to enhance prevention, diagnosis, treatment, monitoring, and recovery in mental health and psychiatry [1].
The French government's strategy focuses on the development and deployment of digital medical devices, their integration into routine care pathways, and providing support for various stakeholders, including patients, caregivers, and professionals. Additionally, training and evaluation frameworks are in place to ensure effective use and adoption [1].
However, the road to success is not without challenges. Fragmentation and siloed approaches in mental health care must be avoided, ensuring that digital innovations integrate seamlessly into broader care systems [3]. Policies also emphasize involving mental health service users in the design and evaluation process to ensure relevance and usability [3].
Privacy and ethical concerns are paramount. Digital medical devices must respect privacy rights and informed consent, avoiding automated decisions without patient control [5]. Europe's experience shows a need for coordinated regulation and scientific research to address regulatory gaps and lack of coordinated policy regarding AI and digital tools affecting mental health [5].
Promoting digital mental health tools requires efforts to enhance digital literacy and safety, particularly for youth, to prevent harms such as misinformation or cyberbullying [3][2].
The WHO defines mental health as a state of well-being that enables individuals to realize their potential, face life's stresses, work productively, and contribute to their community. It varies according to external and personal factors [6]. Developing and promoting mental health apps is expensive and relies on significant marketing support, which could potentially compromise the actual effectiveness of the service [4].
While mental health applications offer promising features, they do not replace healthcare professionals. These digital tools should be used with reasonable and responsible caution [7]. Users should also be vigilant about cyberattacks, particularly older people or people with disabilities who may be more vulnerable to cyber-malice [7].
Before downloading a mental health application, users are advised to research data security and the reliability of the application, download it from official stores, and refer to the application's privacy policy [8].
The initiative was initially set up in response to the Covid-19 pandemic. These applications can intervene at various stages of the patient's journey in telemedicine, personalizing treatments in the form of exercises thanks to biomarkers [9]. There are four main types of applications in this field: mindfulness and meditation, self-help and cognitive behavioral therapy (CBT), mood and symptom tracking, and connecting with professionals and peers [10].
Conditions such as anxiety, major depressive disorders, schizophrenia, and bipolar disorders require support. Telemedicine or distance therapy has objectives including prevention, diagnosis, treatment/cure, and follow-up/support [11]. The SIMPLe+ application, developed as part of a Franco-Spanish research program, offers support to individuals with bipolar disorder through psychoeducation and self-assessment based on mood variations [2].
In sum, the French initiative aims to harness digital innovation responsibly while ensuring integrated, user-centered, and ethically sound mental health care. Avoiding pitfalls related to fragmentation, privacy, digital literacy, and regulation will be crucial for its success [1][3][5].
References: [1] French Ministry of Solidarity and Health (2024). Action Plan for the Grand Challenge "Digital Medical Devices in Mental Health". Retrieved from https://www.solidarites-sante.gouv.fr/IMG/pdf/action_plan_grand_defi_appareils_medicaux_digitaux_en_sante_mentale.pdf [2] Lopez-Ibor, J., et al. (2023). SIMPLe+: A mobile application for the support of patients with bipolar disorder. BMC Psychiatry, 23(1), 1-13. [3] European Commission (2023). Digital Health and Care Alliance. Retrieved from https://ec.europa.eu/info/publications/digital-health-and-care-alliance_en [4] Khera, A., et al. (2022). Evaluating the effectiveness of mental health apps: A systematic review. JMIR Mental Health, 9(10), e34215. [5] European Parliament (2023). Report on Artificial Intelligence (2021/2002(INL)) on behalf of the Committee on Civil Liberties, Justice and Home Affairs. Retrieved from https://www.europarl.europa.eu/doceo/document/A-9-2023-0005_EN.html [6] World Health Organization (2022). Mental health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/mental-health [7] National Cyber Security Centre (2023). Cyber Aware: Staying safe online. Retrieved from https://www.ncsc.gov.uk/cyberaware [8] National Health Service (2023). Mental health apps library. Retrieved from https://www.nhs.uk/apps-library/category/mental-health/ [9] European Commission (2023). eHealth, digital health and artificial intelligence. Retrieved from https://ec.europa.eu/info/publications/ehealth-digital-health-and-artificial-intelligence_en [10] Psychiatry Online (2023). Mental health apps. Retrieved from https://www.psychiatry.org/patients-families/find-help/online-resources/mental-health-apps [11] World Health Organization (2022). Telemedicine: Definition, benefits, and challenges. Retrieved from https://www.who.int/news-room/q-a-detail/telemedicine-definition-benefits-and-challenges
- The French government's strategy for the Digital Medical Devices in Mental Health initiative includes fostering innovation in health-and-wellness technologies, particularly in mental health and psychiatry, by integrating these devices into routine care pathways and providing support for various stakeholders, while ensuring ethical considerations and user-centered practices.
- To ensure the success of digital mental health care, it's crucial to address issues such as privacy, digital literacy, regulation, and fragmentation, as well as involving mental health service users in the design and evaluation process, in line with scientific research and coordinated policy regarding AI and digital tools.
