Computer incursion in psychiatry via e-mental health: Innovation and implications to keep in mind

Titolo Rivista RIVISTA SPERIMENTALE DI FRENIATRIA
Autori/Curatori Sally Hardy, Fabian Van Essen, Luca Pingani
Anno di pubblicazione 2020 Fascicolo 2020/2
Lingua Inglese Numero pagine 12 P. 33-44 Dimensione file 176 KB
DOI 10.3280/RSF2020-002003
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The digital health technologies have gained dramatic levels of interest and offer potential for self-managed, at scale, cost effective e-mental health. In this discussion paper, we aim to outline some of the contemporary issues arising from the computer’s incursion in the field of psychiatry, as the global demand for improved mental wellbeing advances. The authors bring their personal reflections and areas of interest on the subject of e-mental health, taking into consideration both potential pitfalls and therapeutic possibilities. The paper outlines as an introduction what is meant by e-mental health and explores how it is being utilized in areas such as depression, anxiety management, alongside emergent outcome data on, for example, rates of admissions to hospital, as an initial measure of e-mental health’s success. Having undertaken a review of the published evidence from the past five years, it can be seen how the subject is gaining attention, yet results are as yet limited to small numbers, and thus there is a limited evidence base. However, we also consider the implications for inclusion, through the application of e-health strategies for people living with additional neurological aspects such as intellectual disabilities, which as a population tends to limit uptake and exposure to online digital activity to date. We conclude with consideration of two critical questions on how to monitor, evaluate and regulate e-mental health activities, plus the ethical implications of e-exposure.

Le tecnologie digitali a servizio della salute hanno raggiunto notevoli livelli di interesse e di possibilità d’intervento che hanno portato ad una e-mental health (salute mentale digitale) autogestita, su larga scala ed operativa. In questo articolo-discussione, ci si propone di evidenziare alcuni problemi attuali derivanti dall’invasione della tecnologia digitale nel contesto della psichiatria considerando, in particolare, che la domanda globale di miglioramento della salute mentale è in continuo aumento. Gli autori portano le loro riflessioni personali nei rispettivi settori di competenza in merito al tema della salute mentale digitale, prendendone in considerazione sia le potenziali insidie sia le opportunità terapeutiche. Nell’introduzione viene definito il concetto di salute mentale digitale e vengono descritti i suoi principali utilizzi in contesti come la depressione e la gestione dell'ansia. Sono inoltre presentati i dati recenti riguardanti, ad esempio, i tassi dei ricoveri ospedalieri che vengono utilizzati come misura iniziale di successo della salute mentale digitale. Attraverso una revisione non sistematica delle evidenze pubblicate negli ultimi cinque anni si evince come il tema della salute mentale digitale stia raccogliendo molta attenzione: i risultati sono però ancora limitati a contesti numericamente ridotti e quindi c'è un fondamento di evidenze limitato. Vengono inoltre prese in considerazione le implicazioni riguardanti il coinvolgimento, attraverso le tecnologie della salute mentale digitale, di persone che presentano anche comorbilità neurologiche: ad esempio le persone con disabilità intellettiva che a tutt’oggi non possono ancora beneficiare di una significativa inclusione sociale e dell’accesso ad attività digitali. La conclusione dell’articolo pone al lettore una domanda circa due ambiti ritenuti critici: come monitorare, valutare e regolamentare le attività legate alla salute mentale digitale e le implicazioni etiche ad essa connesse?

Keywords:Tecnologie digitali per la salute, Salute mentale digitale, Disabilità intellettiva, Esiti della salute mentale digitale.

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Sally Hardy, Fabian Van Essen, Luca Pingani, Computer incursion in psychiatry via e-mental health: Innovation and implications to keep in mind in "RIVISTA SPERIMENTALE DI FRENIATRIA" 2/2020, pp 33-44, DOI: 10.3280/RSF2020-002003