Lead author John A. Naslund, MPH, a doctoral candidate at The Dartmouth Institute for Health Policy and Clinical Practice, and an affiliate of Dartmouth's Center for Technology and Behavioral Health, wrote the paper along with colleagues at Dartmouth, the London School of Hygiene and Tropical Medicine, the Public Health Foundation of India, and the University of Washington. Though he believes technology has the potential to positively affect the treatment of mental disorders, he admits it is not a panacea, but rather a valuable tool whose use should be based on evidence.<\/p>\n Naslund identified 49 studies, mostly centered on preliminary evaluations of feasibility and acceptability. He and his colleagues then reviewed evidence cited by those studies on the use of digital technologies for treatment and prevention of mental disorders in low- and middle-income countries. Naslund says they found promising findings demonstrating the potential effectiveness of online, text messaging, and telephone support interventions.<\/p>\n \u201cOne of the major motivating factors for conducting this review is because the tremendous burden of mental disorders worldwide, which range from depression to serious mental illnesses such as schizophrenia to a broad range of trauma disorders, is greater in low-income countries,\u201d he says. \u201cOur goal was to summarize the state of the evidence on using digital technology, including mobile, online, and other remote technologies, for better understanding how we can make evidence-based mental health care available to the millions of people in need in low- and middle-income countries.\u201d<\/p>\n Naslund describes the work as, \u201cA call to action and something we should be seriously thinking about\u2014creating innovative approaches to treating mental health disorders.\u201d<\/p>\n Accessing the web through mobile technology has spread rapidly to significant portions of the global population\u2014nearly 40 percent of the world\u2019s web traffic stems from mobile devices\u2014and while there are many gaps in both mobile and online connectivity, this rapid growth in mobile telecommunications may offer new opportunities to reach, support, and treat individuals living with mental disorders.<\/p>\n \u201cIn some countries less than 10 percent of people with mental illness receive any treatment and even in high-income countries such as the US, fewer than half of people with mental illness ever receive treatment,\u201d Naslund explains. \u201cIn a country such as India or in many countries in sub-Saharan Africa, fewer than 10 percent of people receive treatment for mental health issues. The gap in treatment is huge. But what\u2019s most striking when thinking about mental disorders is that there are effective and inexpensive ways to treat them.<\/p>\n \u201cIt\u2019s quite amazing how many people have access to mobile devices. For example, we\u2019ve seen mobile phone subscriptions reach more than 80 percent of the population in low-income countries in Africa and South Asia\u2014a large portion of the world\u2019s web traffic is actually coming off of mobile devices,\u201d he says. \u201cIn a country like Nigeria, it\u2019s over 80 percent. This tells us that people are accessing the Internet over their phone\u2014and we can reach them.\u201d<\/p>\n Yet in the face of this access, treatment gaps remain. Globally, women have much lower access to mobile devices compared to men, and social and structural barriers make it difficult for them to access online mental health support. And when rural poverty is added to that equation access becomes more limited.<\/p>\n For Naslund and his colleagues this is an exciting opportunity, \u201cbecause we know there are meaningful ways to help treat people with mental illness and substance use.\u201d What\u2019s critical, they say, is getting the right treatment to the right people and getting it early on, \u201cIt can have a big impact, but the question is how do you get the right tools to the right people and we don\u2019t have a good answer for that yet.\u201d<\/p>\n Reaching vulnerable populations requires creative thinking.<\/p>\n \u201cWe need to think about the challenges that exist within different societies and the structural barriers that may make it difficult to access digital technologies and think of new ways to support people in need of mental health care,\u201d he says. \u201cAnd along with that, we also need to think carefully about risks, such as confidentiality or safety, when people access mental health care through a mobile device\u2014right now a lot remains largely unknown.\u201d<\/p>\n Because the number of mental health care providers is limited, Naslund says part of any discussion around treating mental disorders must include methods on how to scale up care by facilitating the supervision and mentoring of non-medical health workers while supporting professional development opportunities that promote workforce retention and satisfaction to bridge the treatment gap, \u201cThere will never be enough providers\u2014psychiatrists, psychiatric nurses, and others\u2014to meet the treatment demand.<\/p>\n \u201cShoring up this disparity is closely aligned with exploring how we can use a variety of digital technologies, such as online social networks, Facebook or Twitter, mobile devices, smartphone applications, or wearable devices to improve the quality and effectiveness of mental health care and to make these services more widely accessible to those in need,\u201d Naslund says.<\/p>\n Though preliminary findings are positive, it is still early in using technology for helping those with mental health disorders in low-income countries and rural areas, and there is a caveat\u2014the lack of strong data showing digital technology\u2019s effectiveness.<\/p>\n \u201cI think we need to try to move ahead and build off this preliminary work,\u201d Naslund says. \u201cBut there haven\u2019t been a large number of rigorous studies evaluating it, and that\u2019s the other thing highlighted in this paper\u2014the need for strong data showing its effectiveness.<\/p>\n \u201cSo yes, we need to understand this better, but what is remarkable is that digital devices, particularly the mobile phone is part of every culture in many parts of the world,\u201d he explains. \u201cIt\u2019s become second nature\u2014it has changed the way we communicate and access information and it has the potential to change the way we access mental health care.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" An advocate for evidence-based interventions, John Naslund and colleagues reviewed preliminary studies on the effectiveness of using digital technologies to treat mental disorders and summarized their finding in Lancet Psychiatry<\/em>.<\/p>\n","protected":false},"author":12,"featured_media":8172,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"aside","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1,8],"tags":[67,23,37,320,60,45],"class_list":["post-8171","post","type-post","status-publish","format-aside","has-post-thumbnail","hentry","category-news","category-research","tag-center-for-technology-and-behavioral-health","tag-global-health","tag-mental-health","tag-research-2","tag-technology","tag-tdi","post_format-post-format-aside","author-12"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2017\/04\/smartphone-shutterstock_592647671.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4r3h1-27N","_links":{"self":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/8171","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/comments?post=8171"}],"version-history":[{"count":8,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/8171\/revisions"}],"predecessor-version":[{"id":8176,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/posts\/8171\/revisions\/8176"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media\/8172"}],"wp:attachment":[{"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/media?parent=8171"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/categories?post=8171"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/geiselmed.dartmouth.edu\/news\/wp-json\/wp\/v2\/tags?post=8171"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"http:\/\/geiselmed.dartmouth.edu\/news\/wp-content\/uploads\/sites\/2\/2017\/04\/Naslund_Photo_2017-sqr-360x360.jpg\")