Abstract
BackgroundFor the World Health Organization, electronic health (eHealth) is seen as an effective way to improve therapeutic practices and disease prevention in health. Digital tools lead to major changes in the field of mental medicine, but specific analyses are required to understand and accompany these changes.ObjectiveOur objective was to highlight the positions of the different stakeholders of the mental health care system on eHealth services and tools, as well as to establish professional and user group profiles of these positions and the uses of these services.MethodsIn order to acquire the opinions and expectations of different categories of people, we carried out a qualitative study based on 10 focus groups (n=70, from 3-12 people per group) composed of: general practitioners, psychiatrists, psychologists, social workers, occupational therapists, nurses, caregivers, mental health services users, user representatives, and the general public. The analyses of focus group discussions were performed independently by four investigators through a common analysis grid. The constant comparative method was adopted within this framework.ResultsThe interviewees expressed different problems that new technologies engender in the field of mental health. What was previously strictly under the jurisdiction of physicians now tends to be fragmented and distributed over different groups and locations. New technologies reposition care in the field of domestic, rather than therapeutic, activities, and thus the conception of care as an autonomous activity in the subject’s life is questioned. The ideal of social autonomy through technology is part of the new logic of health democracy and empowerment, which is linked to a strong, contemporary aspiration to perform. Participants emphasized that there was the potential risk of a decrease in autonomy for the digitally engaged patient, while personal empowerment could become a set of obligations.ConclusionsThis qualitative research highlights the heterogeneity of opinions among the groups and within each group. It suggests that opinions on electronic mental health devices are still far from being stabilized, and that a change management process should be set up to both regulate the development and facilitate the use of these tools.
Highlights
The field of electronic mental health (e-mental health) is active and produces new tools at an extremely rapid pace [1,2,3], forcing people to position themselves in relation to these unavoidable innovations that lead to major recompositions of thought [4]
We set up the EQUME qualitative study to collect information from the main groups of actors involved in the field of e-mental health: general practitioners (GPs), psychiatrists, mental health services users, users’ representatives, the public, caregivers, social workers, psychologists, occupational therapists and nurses
The third main theme was associated with the “Impact of Electronic Health on the Caregiver and Patient Relationship,” and had three themes: (1) technology as an agent of change and improving connections; (2) electronic mental health is a barrier to the health care relationship; and (3) electronic mental health only brings about changes without a paradigm shift
Summary
The field of electronic mental health (e-mental health) is active and produces new tools at an extremely rapid pace [1,2,3], forcing people to position themselves in relation to these unavoidable innovations that lead to major recompositions of thought [4]. Far from being a side effect or a passing fad, the development of connected objects in the mental health field is epistemologically like new approaches in psychiatry, which are based on contextually situated networks In our opinion, this represents a fundamental trend that will nourish, and be nourished by, the already observed changes in nosographic and therapeutic categories in the field [5]. Many references in the scientific literature are interested in the important potential of electronic health (eHealth) technologies for transforming and improving therapeutic and preventative health practices [6] Are they likely to improve the effectiveness of care, they could change its very nature [7]. Digital tools lead to major changes in the field of mental medicine, but specific analyses are required to understand and accompany these changes
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