The Role of Social Media in Shaping Adolescent Mental Well-being: A Comprehensive Review on Its Pros and Cons

The widespread popularity of digital technology has brought about significant changes in the treatment of mental health problems. Traditional mental health services can no longer meet the needs of society for mental health, and digital mental health services are developing vigorously. Digital mental health services have shown significant advantages in rapid diagnosis, improving mental health, and improving mental service efficiency. This article outlines the development and application of mental health services so far. On the basis of describing the various uses of digital psychological intervention measures, it focuses on the ethical issues faced by the current application of digital mental health services, such as privacy and data security caused by Big data, potential ethical risks caused by digital technology, insufficient clinical verification, imperfect market regulations and professional threats to psychological workers. To ensure the rational and compliant use of digital technology in the field of mental health, this article discusses the ethical problem- solving directions of current digital mental health services from three levels: technical policies, ethical norms and systems, and social individuals, in order to promote the integration of digital technology and mental health services and improve the quality and efficiency of digital mental health services.

Digital mental health interventions are effective and can greatly enhance access to mental health care. They can reach people in remote and low-income areas and reduce the stigma of seeking mental health help by offering anonymity. Despite these benefits, they have not been fully integrated into mental health service delivery. The aim of this study was to understand consumers’ experiences and perceptions of accessing care through digital mental health services. Consumers of three key Australian Digital Mental Health Services completed an online survey about their experience receiving mental health care through digital mental health services. Some consumers were also invited to elaborate on their responses by taking part in a phone interview. A total of 351 participants completed an online survey (overall response rate of 11% of all those invited to take part), and 23 participants of whom also completed a phone interview. Most consumers were female and under the age of 50 years. Overall, consumers were very positive about their experience of using digital mental health services. They appreciated the accessibility, convenience, self-paced nature, therapeutic support, and guidance. Most found the services user-friendly, easy to use and navigate and were satisfied with their experience. A small number of consumers experienced difficulties with technology and internet connections. Most consumers would recommend services to their peers and recommend that digital mental health services be better promoted to improve awareness. Digital mental health services have a vital role in mental health care provision. Further research is needed to examine how digital mental health services can cater to the specific needs of disadvantaged sub-populations and diverse cultural populations and be seamlessly implemented in mental health care systems.

Ethics and governance in digital mental health research – a joint academic and provider perspective

The recent COVID-19 pandemic significantly exacerbated mental health issues worldwide, with South African university staff facing unique stressors that led to the adoption of e-health tools for digital mental health services. This study explores the university staff experiences gained during COVID-19 pandemic in the provision of digital mental health services through e-health tools. We conducted a case study at a public university in Cape Town, South Africa complemented by a survey using quantitative methods. Data from 348 respondents were collected via voluntary response sampling and analysed with Statistical Software Package for Social Sciences (SPSS) version 28, employing exploratory factor analysis. High factor loadings above 0.4 confirmed significant contributions from seven items: perceived usefulness of e-health tools, perceived usefulness of social media, user experience and satisfaction, university commitment, variety of digital mental health services, post-COVID-19 delivery mode preference and ethical considerations. These seven items revealed that during COVID-19, e-health tools provided significant benefits to university staff including increased access to digital mental services. However, the study findings revealed that university staff were concerned about the lack of a legal framework during COVID-19, and the role of AI-powered mental health applications did not significantly influence their experiences during the pandemic. Our study provides theoretical insights into the effectiveness and perceived usefulness of e-health tools for digital mental health services during COVID-19, reinforcing their significance in reducing anxiety, stress, and depression while enhancing emotional resilience. Practically, our study findings suggest that universities should integrate e-health tools into the provision of digital mental health services given that these tools proved effective during COVID-19.

Adolescence is a vulnerable developmental period, characterized by high rates of mental health concerns, yet few adolescents receive treatment. Public libraries support adolescents by providing them with access to teen programming, technological resources, and have recently been providing mental health services. Digital mental health (DMH) services may help libraries provide scalable mental health solutions for their adolescent patrons and could be well positioned to address the mental health needs of historically underrepresented racial and ethnic (HURE) adolescents; however, little research has been conducted on the compatibility of DMH services with adolescent patron mental health needs or resource needs of library workers supporting them. The research team formed a partnership with a public library, which serves a large HURE adolescent population. We conducted needs assessment and implementation readiness interviews with 17 library workers, including leadership, librarians, and workers with specialized areas of practice. Interview questions focused on library infrastructure, as well as library needs and preferences around the design and implementation of DMH services for adolescents. We used the Consolidated Framework for Implementation Research as guiding implementation determinant framework to code and analyze the interview transcripts. Our findings revealed library workers play an important role in guiding patrons to desired resources and share a goal of implementing adolescent DMH resources into the library and elevating marginalized adolescents' voices. Existing library resources, such as the library's role as a safe space for adolescents in the community, close relationships with external and community organizations, and availability of no-cost technological resources, could help facilitate the implementation of DMH services. Barriers related to community buy-in, mental health stigma, and library worker confidence in supporting adolescent mental health could affect service implementation. Our findings suggest public libraries are highly promising settings to deploy DMH services for adolescents. We identified important determinants that may impact the implementation of DMH services in public library settings. Special considerations are needed to design services to meet the mental health needs of HURE adolescent populations and those adolescents' most experiencing health inequities.

Objectives: Digital interventions can offer accessible and scalable treatment for chronic conditions, though often focus separately on physical or mental health. People accessing digital health services may live with multiple conditions or experience overlapping symptoms. This study aimed to describe the breadth and characteristics of chronic health conditions and self-reported disability among routine users of a digital mental health service, and to examine related motivations to engage with digital mental health interventions. Methods: A cross-sectional survey of adults registered with a digital mental health service in the Australian community (THIS WAY UP) was conducted. Participant demography, chronic health conditions, self-reported disability and motivations for accessing digital treatment were collected and analyzed descriptively. Results: 366 participants responded (77% female, mean age 50 ± 15 years). 71.6% of participants (242/338) reported ≥1 chronic health condition and one-third reported multimorbidity (112/338, 33.1%). Chronic pain, musculoskeletal and connective tissue disorders were most common. 26.9% of respondents (90/334) reported a disability, most commonly physical disabilities. 95% of those with chronic conditions reported negative mental health effects and 46% reported heightened interest in digital mental health treatments because of their condition. Primary motivations for digital service use were receiving a recommendation from a health professional and service accessibility. Discussion: People who access digital mental health services in routine care report high rates of heterogenous chronic illness and related disability. There is interest in accessible digital treatments to support mental health at scale among people who live with varied chronic conditions and disabilities.

Presentations to the emergency department with self-harm or suicidal behaviours: A role for digital mental health services?

After the rapid spread of the novel SARS-CoV-2, the short-term and long-term mental health impacts of the pandemic on the public, in particular on susceptible individuals, have been reported worldwide. Although digital mental health services expand accessibility while removing many barriers to in-person therapy, their usability, feasibility, acceptability, and efficacy require continued monitoring during the initial phase of the pandemic and its aftermath. In this study, we aimed to understand what mental health services are offered, whether they are practical or acceptable, and to what extent digital mental health services are effective in response to the COVID-19 pandemic across high-income and low- and middle-income countries. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guideline. We implemented searches in PubMed (MEDLINE), Embase, PsycINFO, and Cochrane databases for studies that were published between December 2019 and November 2021 and that involved the use of digital mental health services. Two review authors screened, assessed, and extracted studies independently. The protocol was registered on the International Prospective Register of Systematic Reviews. This review identified 7506 articles through database searching. In total, 65 (0.9%) studies from 18 countries with 67,884 participants were eligible for the scoping review. Of the 65 studies, 16 (24.6%) were included in the meta-analysis. A total of 15 (23.1%) studies measured the usability; 31 (47.7%) studies evaluated the feasibility; 29 (44.6%) studies assessed the acceptability; and 51 (78.5%) studies assessed the efficacy. Web-based programs (21/65, 32.3%), videoconferencing platforms (16/65, 24.6%), smartphone apps (14/65, 21.5%), and SMS text messaging (5/65, 7.7%) were the main techniques. Psychotherapy (44/65, 67.7%) followed by psychoeducation (6/65, 9.2%) and psychological support (5/65, 7.7%) were commonly used. The results of the meta-analysis showed that digital mental health interventions were associated with a small reduction in depressive symptoms (standardized mean difference=-0.49; 95% CI -0.74 to -0.24; P<.001) and a moderate reduction in anxiety symptoms (standardized mean difference=-0.66; 95% CI -1.23 to -1.0; P=.02) significantly. The findings suggest that digital mental health interventions may be practical and helpful for the general population, at-risk individuals, and patients with preexisting mental disorders across high-income and middle-income countries. An expanded research agenda is needed to apply different strategies for addressing diverse psychological needs and develop integrated mental health services in the post-COVID-19 era. PROSPERO CRD42022307695; https://tinyurl.com/2jcuwjym.

Youth mental health service organizations continue to rapidly broaden their use of virtual care and digital mental health interventions as well as leverage artificial intelligence and other technologies to inform care decisions. However, many of these digital services have failed to alleviate persistent mental health disparities among equity-seeking populations and in some instances have exacerbated them. Transdisciplinary and intersectional knowledge exchange is greatly needed to address structural barriers to digital mental health engagement, develop and evaluate interventions with historically underserved communities, and ultimately promote more accessible, useful, and equitable care. To that end, the Digital, Inclusive, Virtual, and Equitable Research Training in Mental Health Platform (DIVERT), the Maritime Strategy for Patient Oriented Research (SPOR) SUPPORT (Support for People and Patient-Oriented Research and Trials) Unit and IWK Mental Health Program invited researchers, policymakers, interprofessional mental health practitioners, trainees, computer scientists, health system administrators, community leaders and youth advocates to participate in a knowledge exchange workshop. The workshop aimed to (a) highlight local research and innovation in youth-focused digital mental health services; (b) learn more about current policy and practice issues in inclusive digital mental health for youth in Canada, (c) participate in generating action recommendations to address challenges to inclusive, diverse and equitable digital mental health services, and (d) to synthesize cross-sector feedback to inform future training curriculum, policy, strategic planning and to stimulate new lines of patient-oriented research. Eleven challenge themes emerged related to white-colonial normativity, lack of cultural humility, inaccessibility and affordability of participating in the digital world, lack of youth and community involvement, risks of too much digital time in youth's lives, and lack of scientific evidence derived from equity-deserving communities. Nine action recommendations focused on diversifying research and development funding, policy and standards, youth and community led promotion, long-term trust-building and collaboration, and needing to callout and advocate against unsafe digital services and processes. Key policy, training and practice implications are discussed.

Digital mental health services (DMHSs) have great potential for mitigating the mental health burden related to COVID-19, but public accessibility (ease of acquiring services when needed) to DMHSs during the pandemic is largely unknown. Accessibility to DMHSs was tracked longitudinally among a nationwide sample of 18,804 adults in China from before to one year after COVID-19 outbreak. Unconditional and conditional latent growth curve models and latent growth mixture models were fitted to explore the overall growth trend, influencing factors, and latent trajectory classes of accessibility to DMHSs throughout COVID-19. Generalized estimating equation models and generalized linear mixed models were employed to explore the association between accessibility to DMHSs and long-term mental health symptoms. We found that people generally reported increased difficulty in accessing DMHSs from before to one year after COVID-19 outbreak. Males, youngsters, individuals with low socioeconomic status, and individuals greatly affected by COVID-19 reported greater difficulty in accessing DMHSs. Four DMHS accessibility trajectory classes were identified: “lowest–great increase” (6.3%), “moderate low–slight increase” (44.4%), “moderate high–slight decrease” (18.1%) and “highest–great decrease” (31.2%). Trajectory classes reporting greater difficulty in accessing DMHSs were at higher risk for long-term mental symptoms. In conclusion, an overall increase in difficulty in accessing DMHSs is observed throughout COVID-19, and heterogeneity exists in DMHS accessibility trajectories. Our results suggest that easy access to DMHSs should be consistently facilitated. Moreover, access gaps should be reduced across demographic groups, and target populations for service allocation should alter as the pandemic evolves.

There is a large body of research showing that psychological treatment can be effectively delivered via the internet, and Digital Mental Health Services (DMHS) are now delivering those interventions in routine care. However, not all attempts to translate these research outcomes into routine care have been successful. This paper draws on the experience of successful DMHS in Australia and Canada to describe ten lessons learned while establishing and delivering internet-delivered cognitive behavioural therapy (ICBT) and other mental health services as part of routine care. These lessons include learnings at four levels of analysis, including lessons learned working with (1) consumers, (2) therapists, (3) when operating DMHS, and (4) working within healthcare systems. Key themes include recognising that DMHS should provide not only treatment but also information and assessment services, that DMHS require robust systems for training and supervising therapists, that specialist skills are required to operate DMHS, and that the outcome data from DMHS can inform future mental health policy. We also confirm that operating such clinics is particularly challenging in the evolving funding, policy, and regulatory context, as well as increasing expectations from consumers about DMHS. Notwithstanding the difficulties of delivering DMHS, we conclude that the benefits of such services for the broader community significantly outweigh the challenges.

Mental health problems have become more widespread in modern society, with urbanization, economic difficulties, and the post-pandemic environment intensifying worldwide mental health crises (World Health Organization, 2022a). The increasing prevalence of mental health issues and the growing integration of digital technologies into daily life have opened up new opportunities for both social and enterprise sectors. Digital mental health services (DMHS) appear to be on the rise among the numerous medical care services currently provided online (Grech, 2018; Kraemer, 2017). Digital mental health interventions have emerged as a scalable and accessible solution to address the lack of resources, uneven access, and discomfort with traditional mental health care (World Health Organization, 2022b; Carolan et al., 2017; Fairburn &amp; Patel, 2017; Kanuri et al., 2020; Schueller et al., 2019). Nevertheless, the adoption rate of DMHS is inconsistent across populations, as a result of a multifaceted interplay of technological, social, and psychological factors. Understanding what factors drive consumer intention to purchase DMHS can provide very valuable insights for improving adoption rates. JEL Codes: I12, L86, D91 Keywords: Mental Health, Model of Goal-Directed Behavior, Perceived Severity, Perceived Susceptibility

The 11th Australian Rural and Remote Mental Health Symposium Communiqué.

BackgroundPrevious research suggests that the COVID-19 pandemic caused significant disruption to the lives and mental health of Australians. In response, health services adapted rapidly to digital modes of treatment, prevention and care. Although a large amount of research emerged in the first year of the pandemic, the longer-term mental health impacts, contributing factors, and population-level utilization of digital health services are unknown.MethodsA population-based online survey of 5,100 Australians adults was conducted in October 2021. Psychological distress was assessed with the Kessler 6-item Psychological Distress Scale. Additional survey questions included use and satisfaction with digital health services. Where available, data were compared with our previous survey conducted in 2018, permitting an examination of pre- and post-pandemic digital health service utilization.ResultsIn 2021, almost a quarter (n = 1203, 23.6%) of respondents reported serious levels of psychological distress; participants with pre-existing health related conditions, of younger age, lower educational attainment, those who lost their job or were paid fewer hours, or living in states with lockdown policies in place were at highest risk of serious psychological distress. Almost half of all respondents (n = 2177, 42.7%) reported using digital health technologies in 2021, in contrast to just 10.0% in 2018. In 2021, respondents with serious psychological distress were significantly more likely to consult with a healthcare professional via telephone/videoconferencing (P < 0.001), access healthcare via a telephone advice line (P < 0.001), or via an email or webchat advice service (P < 0.001) than those with no serious psychological distress. Those with and without psychological distress were highly satisfied with the care they received via digital health technologies in 2021.ConclusionRates of serious psychological distress during the second year of the pandemic remained high, providing further evidence for the serious impact of COVID-19 on the mental health of the general population. Those with psychological distress accessed digital mental health services and were satisfied with the care they received. The results highlight the continued need for mental health support and digital health services, particularly for people living with chronic conditions, younger adults and people most impacted by the COVID-19 pandemic, both in the short term and beyond.

The NHS has recently announced plans to kitemark the best health apps so they can be recommended to patients, and to accelerate the development of digital mental health services. There is considerable demand for mental health support delivered this way, in line with rising internet and smartphone use. We describe the types of services available, and consider when a GP might consider referring patients to them, in terms of the characteristics of the patient and the attributes of the service. When patients present at surgeries with mental health problems there is a good chance they will already have sought help and information online. NHS Choices recorded more than 2 million visits to its mental health pages in April 2014 alone (the last month for which figures are available)1 and Mind reported 5.8 million website hits in 2012–2013.2 Many of these patients will also be using, or would be interested in using, digital services to improve their mental health, ranging from apps to support mindfulness to therapy delivered online. Until recently, central NHS organisations have paid relatively scant attention to digital mental health, although clinical commissioning groups (CCGs) and mental health trusts often commission such services locally. The National Institute for Health and Care Excellence (NICE) has approved some digital services for mild-to-moderate mental health problems, but the length and complexity of the application process means that this is an option for only a few of the many providers in the field. The Medicines and Healthcare products Regulatory Authority (MHRA) has some powers over the sale of ‘medical software’, which includes some …