Review of Mobile Health Technologies in Mental Health Promotion

This report examines the role of mobile health (mHealth) technologies in promoting mental health, particularly among individuals with serious mental illnesses. It begins by highlighting the increasing use of mobile and wireless technologies in healthcare and their potential to improve patient engagement and understanding of mental wellbeing. The report reviews existing literature, identifying barriers to traditional mental health treatments, such as limited resources and social stigma, and emphasizes the need for innovative solutions like mHealth. Various mHealth interventions, including text messaging and internet-based programs, are discussed, along with their benefits such as convenience, anonymity, and cost-effectiveness. The report also addresses the research question of how different mobile health technologies can promote mental health, and outlines a research plan involving a systematic review to investigate the effects of mental disorders on health, the significance of research, issues encountered while developing mobile health tools, and the resources that should be expanded. The methodology includes background search, study selection, data collection, and thematic analysis to link findings with research aims and objectives. The report concludes by acknowledging limitations and suggesting future recommendations for leveraging mHealth in mental health promotion. Desklib provides access to similar reports and study resources for students.

Promoting mental
health through
mobile technology
Name of the Student
Name of the University

Introduction
• Mobile and wireless technologies have
the potential of providing support to
various health objectives.
• Technology has become an unavoidable
fact of the daily lives
• Wireless technology have attractive
advantages that have accelerated the
fast development and use of mobile
applications (McNaughton and Light
2013)
• Mobile devices are considered as the
gateway to improve engagement of the
patients with their healthcare providers

Background information
• The current healthcare system is replete with
uncertainties for healthcare providers and the
patients, in addition to the key stakeholders
• Recently conducted research studies state
that patients show an increased desire of
remaining connected to their physicians (Free
et al. 2013)
• This facilitates the process of quality
interactions about health at the bed side.

Mobile usage
• Rates of mobile usage are found to
be approximately 89 per 100
inhabitants, across developing
nations (Itu.int 2018)
• Mobile technologies are also used for
accomplishing a range of daily tasks
such as, socializing, banking and
shopping
• There are a range of factors that
have driven the change in the use of
mobile technology in healthcare

Mobile health technologies
• Mobile health technologies have opened a
new frontier for supporting mental health
among people
• Mobile and wireless devices such as,
smartphones and tablets are providing the
opportunity to monitor patient progress
• They are also increasing the understanding of
mental wellbeing

• Mobile health technologies are
integrated into healthcare through
text messaging, teleconferencing, and
internet based interventions
• Such technology based applications
often use the built in sensor of the
device to collect patient information
on behavioural patterns
• These technologies take into
consideration the fact that more than
40% of the global population can
access the internet

Literature review
• Patient diagnosis, case formulation, and
monitoring the outcomes are integral to
delivery of evidence-based mental health
treatments (Salinas et al. 2016)
• Unlike domains of healthcare, mental health
treatment do not require any blood tests or
other diagnostic assays for determining the
symptoms of a client
• Mental health clinicians had to earlier
depend on their clinical judgment skills and
the self-reported symptoms of a client

 Solely relying on clinical judgment and self-
reported problems have been identified
problematic (Glenn and Monteith 2014)
 These traditional methods were dependent on
a retrospective recollection by the patients
during clinical interviews
 Mental health problems have recently been
recognised as a major reason that attributes
to global disability burden and account for
more than 14%

 Most mental disorders encompass
depression, post-traumatic stress
reactions, substance abuse and
anxiety
 According to the WHO World Mental
Health Survey Consortium, 76–85%
patients with mental health disorders
get no treatment facilities in low and
middle income countries (Benjet et al.
2016)
 A minute proportion of the health
budget gets allocated for treatment of
these disorders

Barriers
 Major barriers to these treatments
include limited infrastructure and
funding, lack of human resource, social
stigma, inequitable distribution of care
services, and centralisation
 WHO has taken efforts to support the
process of task-sharing, while increasing
the access to quality care
 Low-intensity and cross-diagnostic
psychological/mental interventions have
been developed and tested

 Extended workforce represents an essential
component in addressing mental health
disorders in low resource settings
 There are limits in the sustainability and
scalability of human resources
 Meta-analytic reviews suggest that task sharing
cannot be considered as the sole solution for
addressing the treatment gap (Padmanathan
and De Silva 2013)
 Incentives, competence, worker distress and
lack of acceptance are major barriers

Need of mobile health technologies
 This called for the need of going beyond
mobilisation of human resources
 Non-consumable technology resources
were thus identified crucial in this
respect
 Mobile and wireless technologies were
thought to help in reducing the scarcity,
inefficiency and inequity of existing
mental health services
 The brevity and relative simplicity of
these interventions support their
adaptation

 Mobile health technologies have also been used
with the aim of improving the lives of people
suffering from schizophrenia and bipolar
disorders
 Results have shown that most e-mental health
programs encompassed emergency toll-free
telephone services (55%), health call centres
(59%), mobile telemedicine (49%), and
managing emergencies and disasters (54%)
(Hurling et al. 2007)
 Most countries that reported the aforementioned
programs belong to the higher income group

Use of m-Health technologies
 Service users most often keep their
phones in hand that provides them
support for emergency information
and management of immediate
distress
 Mobile and wireless technologies
can also extend the geographic
boundaries of mental care services
in low and middle income countries
 These technologies have the
potential of developing interventions
that will be able to accommodate an
increased number of patients

Basic attributes
 Mobile and wireless mental health
capabilities include basic functions of text
messaging such as, short messaging
services or SMS
 Such messaging services are essential owing
to the limitations in access of sophisticated
healthcare devices in the low and middle
income countries
 Furthermore, text based messaging
interventions have also been found effective
for diabetes management, smoking
cessation, and medical adherence

Text messaging services
 Text messaging have been used for
information provision, reminders, self-
monitoring, and supportive messages
 They act extensions of traditional care,
in place of treatments in themselves
 Research evidences have also
established their effectiveness in
managing anxiety among students
(Hall, Cole-Lewis and Bernhardt 2015)
 Use of text messaging has been
effective in management of post-
traumatic stress disorder and
associated problems, during and after
exposure to triggers

Internet interventions
 The internet allows delivery of interactive
content that helps in providing relevant
health information, mobilising social
support, facilitating assessment,
providing skills training, and
strengthening self-management
 Internet interventions have also been
found effective in eliminating or lowering
rates of anxiety, depression, and alcohol
consumption (Koehler, Vujovic and
McMenamin 2013)
 They also have the capability of
addressing a plethora of consequences
that arise due to mental trauma

 Web-based interventions have
also been formulated in the form
of a response to mass traumas,
such as, disasters
 There are approximately 112
states that have completed their
medical modules, which contain
m-Health initiatives (Tomlinson et
al. 2013)
 Internet interventions for
managing PTSD have been found
to be significantly more effective,

PTSD Coach
 One of the most commonly used
mobile technology for PTSD is PTSD
Coach
 Studies have indicated that patients
using the application have reported
reduced symptoms over a period of
three months (Kuhn et al. 2014)
 Smartphone applications can also
increase the adherence and
engagement to particular treatment
regimen by enhancing the interaction
with the care providers

Benefits
 Convenience- Treatment can occur at anytime and
anywhere
 Anonymity- Clients will be able to seek treatment without
involving other people
 Lower costs of care
 Services to more number of people
 Round-the clock monitoring of patients (Ventola 2014)
 Consistent treatment to all service users
 Complement traditional therapy by reinforcement of new
skills

Examples of m-health technologies
 Self-management applications- Sets up
medication reminder, manages stress, sleep
problems and anxiety
 Application for improving thinking skill- These
help the service users with appropriate
cognitive remediation
 Skill training applications- These help
patients learn new thinking and coping skills
 Supported care, illness management- They
create provisions for interaction with
physicians or peer support

Research question
 What are the different mobile health
technologies and their available benefits in
promoting mental health, among individuals
with serious mental illnesses?
The effects of mental disorders on health,
significance of the research, issues encountered
while developing mobile health tools and the
resources that should be expanded on will be
investigated in the research

Sub-research questions
 What are the various effects of mental health
issues which they could have on people and
the significance of research in driving
innovation in mental health care and in
bringing trust later on?
 Are there any issues in developing these
models related to -Health tools and what are
they meant for?
 What are the resources to expand and
maximize on the potential of m health tools
and facilities?

Research plan
 Identifying the title- Promoting Mental
Health Through Mobile Technology
 Considering conducting a systematic review
without any meta-analysis
 Enlisting the aims and objectives of the
study
 Attempting to identify the beginning and
ending dates for the completion of the
study

Methodology
 Conducting the background search to
describe the issue in sufficient details
 Reporting the search strategy
 Study selection to eliminate potential bias
 Data collection
 Conducting an assessment of the risk of
bias in the included studies

Final steps
 Synthesis of results
 Thematic analysis to link the study findings with the
research aim and objectives
 Assessment of the quality of each study included in the
review
 Assessing heterogeneity of the results
 Discussion
 Limitations of the research
 Future recommendations
 Conclusion

References
Benjet, C., Bromet, E., Karam, E.G., Kessler, R.C., McLaughlin, K.A., Ruscio, A.M., Shahly, V., Stein, D.J., Petukhova, M., Hill, E. and Alonso, J., 2016. The
epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychological medicine, 46(2), pp.327-
343.
Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., Patel, V. and Haines, A., 2013. The effectiveness of mobile-health technology-based
health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS medicine, 10(1), p.e1001362.
Glenn, T. and Monteith, S., 2014. New measures of mental state and behavior based on data collected from sensors, smartphones, and the
Internet. Current psychiatry reports, 16(12), p.523.
Hall, A.K., Cole-Lewis, H. and Bernhardt, J.M., 2015. Mobile text messaging for health: a systematic review of reviews. Annual review of public
health, 36, pp.393-415.
Hurling, R., Catt, M., De Boni, M., Fairley, B.W., Hurst, T., Murray, P., Richardson, A. and Sodhi, J.S., 2007. Using internet and mobile phone technology to
deliver an automated physical activity program: randomized controlled trial. Journal of medical Internet research, 9(2).
Itu.int., 2018. Statistics. [online] Available at: https://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx [Accessed 6 Jun. 2018].
Koehler, N., Vujovic, O. and McMenamin, C., 2013. Healthcare professionals’ use of mobile phones and the internet in clinical practice. Journal of mobile
technology in medicine, 2(1S), pp.3-13.
Kuhn, E., Greene, C., Hoffman, J., Nguyen, T., Wald, L., Schmidt, J., Ramsey, K.M. and Ruzek, J., 2014. Preliminary evaluation of PTSD Coach, a
smartphone app for post-traumatic stress symptoms. Military medicine, 179(1), pp.12-18.
McNaughton, D. and Light, J., 2013. The iPad and mobile technology revolution: Benefits and challenges for individuals who require augmentative and
alternative communication. Augmentative and Alternative Communication. 29(2), pp.107-116.
Padmanathan, P. and De Silva, M.J., 2013. The acceptability and feasibility of task-sharing for mental healthcare in low and middle income countries: a
systematic review. Social science & medicine, 97, pp.82-86.
Salinas, J., Sprinkhuizen, S.M., Ackerson, T., Bernhardt, J., Davie, C., George, M.G., Gething, S., Kelly, A.G., Lindsay, P., Liu, L. and Martins, S.C., 2016. An
international standard set of patient-centered outcome measures after stroke. Stroke, 47(1), pp.180-186.
Tomlinson, M., Rotheram-Borus, M.J., Swartz, L. and Tsai, A.C., 2013. Scaling up mHealth: where is the evidence?. PLoS medicine, 10(2), p.e1001382.
Ventola, C.L., 2014. Mobile devices and apps for health care professionals: uses and benefits. Pharmacy and Therapeutics, 39(5), p.356.

Thank you!