Abstract

Scientific literature from the last two decades indicates that, when it comes to mental health, technology is presented either as panacea or anathema. This is partly because researchers, too frequently, have planted themselves either in the field of digital mental health interventions (variably called “telepsychiatry”, “digital therapeutics”, “computerized therapy”, etc.), or in that of the problems arising from technology, with little cross-fertilization between the two. Yet, a closer look at the two fields reveals unifying themes that underpin both the advantages and dangers of technology in mental health. This article discusses five such themes. First, the breakneck pace of technology evolution keeps digital mental health interventions updated and creates more potentially problematic activities, leaving researchers perennially behind, so new technologies become outdated by the time they are studied. Second, the freedom of creating and using technologies in a regulatory vacuum has led to proliferation and choice, but also to a Wild-West online environment. Third, technology is an open window to access information, but also to compromise privacy, with serious implications for online psychology and digital mental health interventions. Fourth, weak bonds characterize online interactions, including those between therapists and patients, contributing to high attrition from digital interventions. Finally, economic analyses of technology-enabled care may show good value for money, but often fail to capture the true costs of technology, a fact that is mirrored in other online activities. The article ends with a call for collaborations between two interrelated fields that have been—till now—mutually insular.

Highlights

  • In Aesop's ancient fable “Man and Satyr1”, the satyr saw the man blow on his hands on a cold winter's day and asked why

  • Rather than review the benefits and harms of technology when it comes to mental health as revealed in research—a very different, much more ambitious endeavor— we instead will focus on how research into both fields has revealed common issues and challenges

  • Will fully automated Artificial Intelligence (AI) platforms that simulate human decision-making and adaptability be able to sustain patients' engagement beyond an initial curiosity-driven stage? Until we find out, we need to invest in human support that strengthens ties and engagement—and improves outcomes—with digital interventions

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Summary

Introduction

In Aesop's ancient fable “Man and Satyr1”, the satyr saw the man blow on his hands on a cold winter's day and asked why. The man responded: “so that it cools down; can't you see how hot it is?” The. Technology Benefits and Risks in Mental Health satyr, indignantly, walked away. The allegory helps illustrate how digital technology in mental health can be therapeutic and problematic at the same time. This dissonance can cause confusion and mistrust, which leads clinicians, patients and the general public to either disengage from digital mental health interventions, or to underestimate the problems and risks associated with extensive technology use

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