Abstract
Background: Web and Internet-based resources are remarkably popular with the public, patients and others as a way to access mental health information, tools for self-care, advice/consultation from a professional, and providerdirected treatments. Objective: This paper provides a framework of a spectrum that includes person-centered health education options (conceptual endpoint), patient and caregiver-centered mental health care interventions (evidence-based literature review), and more formal provider-directed treatments (conceptual endpoint). Methods: The evidence-based literature review was focused on treatment studies, using a minimum of three key words and the 1996-2015 period, resulting in 13,612 articles. This was reduced to 388 (title words used), to 125 (abstracts for methods, design, and outcomes) and 40 (evidence-based criteria of guidelines). Results: Technology is frequently used, is readily accessible and satisfies persons, patients, and caregivers. Its impact on openness to engage with others and begin self-care appears very positive; its ability to help people change behaviors and engage additional clinical services appears modest, though this is inadequately evaluated. Formal treatments over the Internet, asynchronous care models, or traditional video-based synchronous services are as good as or better than in-person services, though an incomplete range of services has been evaluated. Relatively few treatment studies assess outcomes, compare in-person and e-Mental Health care, and or compare technology-based care options to one another; hybrid models of care have emerged, but have rarely been studied. Conclusions: For persons or patients not in care, use of the internet for common, non-acute problems appears to work, though a one-time clinical evaluation may help them place options in context. Clinicians and patients should specifically plan how to use technology and exercise sound judgment, based on guidelines when available. More research is needed on the application of new technologies to clinical care, with randomized trials and health services studies for effectiveness suggested.
Highlights
Africa, the Middle East, and Latin America are the fastest growing populations in terms of Internet usage; in the United States, Internet use has grown dramatically over the past decade, with a jump from 44% of the population [1,2]
More research is needed on the application of new technologies to clinical care, with randomized trials and health services studies for effectiveness suggested
The terms telemental health (TMH) and telepsychiatry have typically been used for traditional MH care services provided synchronously by videoconferencing [17], or asynchronously
Summary
Africa, the Middle East, and Latin America are the fastest growing populations in terms of Internet usage; in the United States, Internet use has grown dramatically over the past decade, with a jump from 44% of the population [1,2]. The terms telemental health (TMH) and telepsychiatry have typically been used for traditional MH care services provided synchronously by videoconferencing [17], or asynchronously Guidelines are on a temporal, non-linear spectrum, starting with synopsis of guidelines on eMH/TMH, texting/e-mail, social media, professionalism, and Internet-based care; person/patientcentered health information and experimental treatments are less well-developed, but have been put out due to concerns, cautions and critical incidents (Table 3). Web and Internet-based resources are remarkably popular with the public, patients and others as a way to access mental health information, tools for self-care, advice/consultation from a professional, and providerdirected treatments
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