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Highlight: A Therapist in One’s Pocket: mHealth to Improve Access to Mental Health Care

Intellicare, a smartphone app to serve users with anxiety or depression, holds promise for improving access to mental health care.

Intellicare, a smartphone app to serve users with anxiety or depression, holds promise for improving access to mental health care.

Source: David Mohr, Ph.D., Northwestern University

Less than half of individuals struggling with a mental illness receive services. The reasons for this disparity between need and service uptake include the cost of medication or therapy, regional scarcity of mental health professionals, inability to access mental health services due to distance and time, and, in some cases, resistance to seeing a mental health professional. So-called behavioral intervention technologies, or BITs—such as smartphones, wearable sensors, and video games—have the capacity to change this situation.

Many of the devices used by people every day— smartphones, tablets, and laptops—have sensors built in that are constantly capturing data on location, movement, and communication. We are beginning to explore the use of these devices to create real-time pictures of emotional state. How can technologies be further harnessed to address mental health care needs? We currently use mobile technologies for improving adherence to treatment or for collecting passive data about activity or sleep, but the additional possibilities of these technologies are just emerging.

Approaches on the cutting edge of mental health mobile technologies use patient-initiated dialogue (think Siri as a psychotherapist) or personalized messages keyed to environmental cues—such as proximity to an anxiety-inducing stimulus detected by a GPS system.41 Social prosthetics for autism are being developed for detecting facial expressions and translating them into words describing emotions. Other potential therapeutic opportunities include the use of social media and gaming to develop group support and increase resilience via cognitive training games.

Reports that online cognitive behavioral treatment can be as effective as in-person psychotherapy suggest that technology will expand access, extend the therapist impact, and expedite treatment.42 For those with the most disabling illnesses, these tools will extend rather than replace the therapist. A recent report noted that over 40,000 new mobile health applications are available for download.43 The promise of technology for improving diagnosis and treatment—and the need to establish an evidence base for efficacy—demands the attention of the research and technology communities, and the NIMH.

Highlight from Strategic Objective 4