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By David Gratzer, Psychiatrist, Center for Addictions and Mental Health, Assistant Professor, Department of Psychiatry, University of Toronto
Ella, who is about 20 years old, suffers from depression. When, after stress at school, her sleep began to fall off, her smartphone was programmed to record night texts and telephone conversations indicating her insomnia. He made suggestions for improving her sleep.
When her messages on social networks became more and more negative, and she rarely called friends, her phone forced her to do a scale of depression, recorded her appointment with her psychiatrist, and then downloaded the results of the scale and the journal of her latest sleep patterns.
She communicated with her psychiatrist through video conferencing, and this doctor made some adjustments to the medication. Ella also started targeted psychotherapy through the app.
Ella is not real, but hundreds of thousands of Canadians have a serious depressive disorder. Today, smart phones do not respond to insomnia and do not schedule meetings with psychiatrists. But once they could.
We may soon use smartphones and wearable devices to help treat depression. As a psychiatrist, I think this is a good thing, allowing more people to get access to quality medical care.
Health apps track your mood
Psychiatric care is an area in need of transformation. One in five Canadians will have mental health problems this year, but many of them are trying to gain access to medical care. According to one study, only half of people with depression receive adequate care.
Evidence-based psychotherapy is especially difficult for people; A recent Canadian study found that only 13 percent of people with depression had any kind of psychotherapy. Yet cognitive-behavioral therapy — a type of therapy that focuses on how a person’s thoughts can affect his or her behavior and mood — is as effective as medication.
Just as technology has changed other aspects of our lives, people are increasingly using it for healthcare. There are, for example, more than 315,000 mobile medical applications.
Many of my patients use apps to get information about their illnesses; Some include applications in their care, helping them remember when to take medicine or track their mood over time. And more and more people are now searching online for therapy.
Studies show that if the therapy is carried out correctly (with the help of a therapist who directs the process), people can do the same thing as with personal help, but at lower cost.
Smartphones identify symptoms
The benefits are more than economic. For a single mother with three children or an elderly person who does not dare to visit the clinic in the middle of winter, online therapy is not the best care, but the only one.
Not surprisingly, this idea has proven popular in the private sector, as well as in the governments of Norway and Sweden.
And there is a lot of potential for technology to help in all aspects of care. Most North Americans have smartphones that are everywhere.
Looking at speech patterns and our movements, smartphones may notice minor changes indicating the onset or worsening of symptoms, while wearable devices may notice minor physical changes – long before the patients themselves even notice the problems. These devices can provide real-time, objective data for care.
Needless to say, research is active; For example, some of my colleagues at the Center for Addictions and Mental Health in Toronto are studying data on depression and Fitbit to find patterns that could signal the onset of depression earlier.
We must also be careful. There are hundreds of applications for depression, but quantity does not mean quality. In one study, when a basic quality control standard was applied (such as disclosing a source of information), only 25 percent of the applications studied were tested.
Digital mental health should also include digital privacy and confidentiality. Just as banking information should not be made foolishly, medical information transmitted on a smartphone or wearable device must be user-friendly.
And the conflict of interest should be clear. For example, a smartphone application should not be a hidden advertisement for a private company.
People often ask me if I think that technology will soon replace psychiatrists. This is unlikely to happen. But one day a patient like Ella can use technology to get the best care. And this is good news – if we have government policies and practices of suppliers to ensure that technology is used deliberately.
David Gratzer maintains a blog on psychiatry and research at http://www.davidgratzer.com.
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