Online Mental Health Services Research Articles

Digital Mental Health: Role of Artificial Intelligence in Psychotherapy

Background: It is estimated that 6%–7% of the population suffers from mental disorders. WHO reported that one in four families is likely to have at least one member with a behavioural or mental disorder. Post-pandemic, the world has experienced a huge surge in mental health issues. Unfortunately, not everyone is able to access the available mental health services due to constraints such as lack of financial assistance, living in remote areas, fear of being stigmatised and lack of awareness. The emergence of online mental health services could solve some of these problems, as these are easily accessible to people from anywhere, are cost effective and also reduce the fear of being judged or labelled. Lots of efforts are being made today to integrate artificial intelligence with the traditional form of psychotherapy. The role of chatbots for mental health services in the form of e-therapies has been found to be highly relevant and important. Summary: The present study aims to systematically review the evidence on the use of AI-based methods for treating mental health issues. Overall, 95 studies were extracted using some of the popular databases such as Mendeley, PubM, INFO and DOAJ. The terms used in the search included ‘psychotherapy’, ‘online therapies’, ‘artificial intelligence’ and ‘online counselling’. Finally, after screening, 13 studies were selected based on the eligibility criteria. Most of these studies had employed conversational agents as an intervention. The results obtained showed the significant positive consequences of using AI-based approaches in treating mental health issues. Key Message: The study strongly suggests integrating AI with the traditional form of counselling.

Digital disclosures: Exploring the role of online mental health services in supporting young people who disclose violence or maltreatment

BackgroundMental health practitioners can play a role in identifying and responding to young people at risk of harm and connecting them with appropriate supports. However, little is known about how clinicians providing mental health services through digital platforms support young people disclosing experiences of violence. ObjectiveThis study sought to understand the perspectives of clinicians working within digital mental health services on supporting young people disclosing violence. Participants and settingThis study recruited 19 practitioners who were currently or had recently worked within The Digital Mental Health Programs of an Australia-wide mental health service, which provides online chat, email, and phone support to young people aged 12–25. MethodsSixteen individual interviews and one focus group were recorded, transcribed, and analysed using a reflexive thematic analysis approach. FindingsThe analysis generated six themes relating to clinicians' experiences: balancing a client centered and empowering approach with clinicians’ duty of care; systemic or structural challenges; navigating a sense of dilemma and the impacts upon clinicians; tensions around anonymity; differing understandings of violence; and navigating the transparency continuum. ConclusionsMental health clinicians work to reconcile a client centered approach with their professional duty of care and at times legal mandate to report abuse concerns. Clinicians navigate structural challenges, the anonymous nature of an online service, and work to develop common ground with young people and communicate transparently. Despite challenges, online services may provide a space for young people experiencing violence to be heard, provided with information, and connected with supports.

Help-Seeking Preferences and Influencing Factors Among Chinese Nurses Exposed to COVID-19: A Person-Centered Approach

ABSTRACT Purpose This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach. Design A cross-sectional design including an online self-reported questionnaire survey was used. Methods A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS. Findings Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences. Conclusions Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses’ perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses’ help-seeking preferences and behaviors to reduce mental illness during public health emergencies. Clinical Evidence Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses.

Impact of COVID-19 on the use of online mental health services among adults in Riyadh: a cross-sectional study.

Online therapies are licensed online programs designed to aid the use of psychotherapy via the Internet or mobile phone applications by providing effective treatments through digital communication. The number of individuals seeking online therapy has increased during the COVID-19 pandemic. Thus, this study aimed to assess the impact of COVID-19 on the use of online mental health services among Saudi adults in Riyadh. The research design was a cross-sectional descriptive study. The data collection tool was an online survey distributed through social media and email. The survey consisted of two parts: a sociodemographic questionnaire and the e-Therapy Attitudes and Process (eTAP). A total of four hundred participants have completed the survey. Most of the respondents had used online therapy for the first time during the COVID-19 pandemic, and most of the users had a relatively positive experience with online interventions for mental health services. The findings showed that COVID-19 had an impact on the use of online therapy, as it caused an increase in the number of users of these services, and most of the users have found online therapy to be helpful.

Boots UK shuts online mental health service to new patients

Boots UK shuts online mental health service to new patients

Common stressors, coping processes, and professional help-seeking of medical professionals in Hong Kong: A qualitative study.

Despite the high prevalence of perceived stress and mental health problems among medical professionals (MPs), their professional help-seeking is extremely low. This qualitative study explored MPs' stressors, stress-coping, barriers and facilitators of professional help-seeking. 10 MPs (30% male, Mage = 34.8 years) were recruited by purposive-sampling for views from different roles/settings. Thematic analyses revealed five central stressors: emerging novel diseases, challenges from technology-advancement, patient-communication difficulties, lack of workplace mental health care culture, excessive workload/manpower shortage. Participants predominantly used peer support/supervision and de-stress activities for stress-coping. Five factors affecting professional help-seeking were time constraint versus flexibility, mental health stigma versus de-stigmatization, concern over confidentiality/anonymity versus sense of privacy, worry about damage on professional role versus least work disruption, doubts of service providers versus perceived efficacy. All participants indicated a preference for online mental health service delivery. Results reflected unmet needs and service gaps from MPs' perspectives for the development of future interventions.

'I probably wouldn't want to talk about anything too personal': A qualitative exploration of how issues of privacy, confidentiality and surveillance in the home impact on access and engagement with online services and spaces for care-experienced young people.

This paper draws on a qualitative interview-based study that explored online mental health and wellbeing interventions and services for care-experienced young people. The study involved young people (n = 4), foster carers (n = 8), kinship carers (n = 2) and social care professionals (n = 9) in Wales, UK. The paper reflects on the complexities of online communication in the space of 'the home'. It documents the ways in which care-experienced young people's living arrangements can restrict access to services and complicate confidentiality within portals to the virtual world, creating an environment where young people and their carers 'wouldn't want to talk about anything too personal'. Drawing on data generated in a study focused on services and interventions to support the mental health and wellbeing of care-experienced children and young people, the paper considers privacy, confidentiality and surveillance in the home and reflects on how associated relational practices impact on care-experienced young people. While the data discussed in this paper was generated during the Covid-19 pandemic, its findings have implications for how care-experienced young people and their carers can be supported to engage with the digital world in the future.

Developing Marketing Strategy Initiatives to Enhance Customer Acquisition and Customer Retention for MedTech Startup (Case Study: Riliv)

In response to increased consumption, the MedTech market in Indonesia, which includes applications for mental health services, has experienced phenomenal growth. However, customer acquisition and retention have emerged as significant obstacles for businesses such as Riliv, a prominent mental health service application. This study seeks to identify the factors that influence and improve Riliv user acquisition and retention among non-users, current users, and former users. A quantitative research strategy employing descriptive statistics and a non-probability sample of 200 respondents were utilized. To capture data, the Likert scale questionnaire was distributed online. The research included both internal and external analyses (STP, 7Ps of the marketing mix, and VRIO) as well as PESTEL, Porter’s Five Forces, competitor, and customer analyses. The SWOT and TOWS analyses were then conducted. The findings highlight the importance of effective promotional activities, competitive pricing, and superior product quality and service in attracting and retaining Riliv users. Increasing brand recognition, enhancing product attributes, and ensuring service quality have been identified as crucial factors positively influencing consumer acquisition and retention. Riliv can implement strategic marketing initiatives such as targeted advertising, influencer collaborations, refined messaging, content marketing, personalized experiences, trial periods, referral programs, and continuous engagement in order to overcome these obstacles. By adopting these strategies, Riliv can position itself as a dependable online mental health services provider and accomplish sustainable growth in the highly competitive MedTech industry.

Online mental health services during COVID-19 pandemic in Indonesia: Challenges from psychologist perspective.

COVID-19 are causing many psychological impacts and change many aspects of human life. Mental health services also experiencing changes because of COVID-19 outbreak. In Indonesia, COVID-19 outbreak prompted the rapid development of online mental health services. These online mental health services which will help people to connect with professional mental healthcare providers using technology were created in response to this pandemic. Therefore, converting mental health services into online services in a state of urgency is challenging. This qualitative case study aims to provide a map of the service challenges that professional healthcare providers face while providing online services at present time by interviewing eight Indonesian psychologists as one of the mental health professionals who provided the online mental health services. Semi-structured interviews were done using interview guidelines with open-ended questions, and any other complementary data was collected using questionnaire. The data gathered from interviews was first performed through triangulation and then analyzed using thematic network analysis, which resulted in the following challenges: (1) building engagement; (2) risk of getting distracted during the sessions; (3) maintaining professional boundaries during the sessions; (4) keeping the personal information and confidentiality of the sessions; (5) perceived efficacy; and (6) attitudes towards online sessions. According to the results, the relevant organization can use this finding to contribute and develop the online mental health services both in this COVID-19 situation and in the future.

Parenting amidst COVID-19: Pandemic-related stressors, inequities, and treatment utilization and perceptions.

Many parents of children under age 18 are faced with additional COVID-19 parenting-related stressors and may be experiencing increases in psychological difficulties;however, we have yet to investigate parent's levels of posttraumatic stress symptoms (PTSS) and adjustment disorder. Further, COVID-19 has served as a sobering reminder of the significant public health disparities in our society and it is critical to identify risk factors for poorer clinical outcomes. The primary objectives of the present study were to: (a) determine whether parents are reporting higher levels of pandemic-related stress, PTSS, and adjustment disorder than controls, (b) identify specific individual-level factors (e.g., age, gender, race, number of children, age of children) that may be related to higher levels of stress and symptoms among parents, and (c) report parents' utilization of, and perceived efficacy of, psychological interventions during COVID-19. A U.S. nationally representative sample (N = 2,019) from Qualtrics Data panels was recruited in July-August 2020. Parents endorsed higher levels of stress, PTSS, and adjustment disorder, particularly younger parents. Further, 38.3% of parents reported PTSS above clinical cutoff. Younger participants and persons of color reported higher levels of pandemic-related stress. One-third of parents (33.1%) reported using online mental health services. Taken together, parents may be at greater risk for pandemic stress, PTSS, and adjustment disorder symptoms. Individual-level risk factors, such as age and minority status, are important to consider when understanding COVID-19 stress. Clinical intervention efforts should prioritize trauma-focused treatments for parents, especially those who are younger and identify as a person of color. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

The Effectiveness of Online vs Face-to-Face Psychotherapy During the COVID-19 Pandemic in the United Arab Emirates

The COVID-19 pandemic caused an abrupt and immediate change to the way in which mental health services are delivered. To mitigate against lockdown protocols imposed on a global scale, many individuals seeking mental health services were obliged to use online mental health services in place of face-to-face services. The study reported here investigated the differences in individuals’ experiences of online psychotherapy sessions compared to in-person psychotherapy services using a cross-sectional, within groups design. Forty-nine clients from a mental health clinic in the UAE, who received psychotherapy in both modalities, completed self-report questionnaires measuring satisfaction with therapy and working alliance. Results indicate that clients’ satisfaction levels did not significantly differ between online and in-person therapy sessions. However, clients rated their perceived working alliance with their therapist for in-person therapy sessions significantly higher than for online therapy sessions. Implications for future research are discussed.

Increasing Access to Mental Health Services: Videogame Players’ Perspectives

Young men's mental health is at the forefront of global public health concerns. Young males, who have a high incidence of mental health disorders, are a population that accesses services at lower rates than females and makes up the majority of videogame players. By considering the unique perspectives of digitally connected individuals on mental health service delivery, interventions may be designed to address their needs with a higher likelihood of success. This study investigated international male videogamers' perspectives on how their access to mental health services could be improved via an open-ended survey question. From a total of 2515 completed surveys, 761 responded to the qualitative question. Of these, the 71 responses that discussed access to and provision of mental healthcare services are reported in this article. Results suggest that digital mental health services were a promising way to reach this group. Anonymity and confidentiality were found to be important factors when considering online mental health services. Male videogame players identified a preference for both online and in-person services that are delivered synchronously, one-on-one with an expert practitioner, and readily available in settings that individuals find comfortable.

Text4Hope Effectiveness in Reducing Psychological Symptoms among Young Adults in Canada: Longitudinal and Naturalistic Controlled Program Evaluation

Chronic stress, anxiety, and depression are psychological problems that can hurt young adults, interfering with their everyday function, academic achievement, and interpersonal relationships. This study aimed to assess the impact of Text4Hope, an online mental health service, on the psychological well-being of young adults. This study adopted both longitudinal and naturalistic controlled trial designs. It examined clinical outcomes in young adult (≤26 years old) subscribers of Text4Hope who completed surveys at baseline and six weeks and compared clinical parameters in two groups of subscribers. The first group comprised the intervention group (IG) (young adult subscribers who received once-daily supportive text messages for six weeks and completed sixth-week evaluation measures between 26 April and 12 July 2020), and the second group was the control group (CG) (young adult subscribers who joined Text4Hope in the same time frame and completed a baseline survey and were yet to receive any text messages). The prevalence of moderate to high stress, anxiety, and depression was measured at baseline and six weeks in the longitudinal study and between the two groups for the naturalistic controlled study using the Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Inferential statistics, including the t-test, McNemar test, chi-square, and binary logistic regression analyses, were used to evaluate the differences in the prevalence and severity of the psychological symptoms. In the longitudinal study, of the 9214 subscribers to Text4Hope who completed the baseline survey, 1047 (11.4%) were identified as youth. For the young adult subscribers who completed both the baseline and sixth-week surveys (n = 114), a significant reduction in the prevalence of moderate to high stress (8%) and likely GAD (20%) from baseline to six weeks was reported. Similarly, there was a significant reduction in the mean scores on the PSS-10, GAD-7, and Composite Mental Health score but not the PHQ-9 from baseline to six weeks. The largest reduction in mean scores was for the GAD-7 scale (18.4%), with a small effect size overall. For the naturalistic study, the IG included 173 young adult subscribers of Text4Hope who completed the sixth-week survey compared to 92 subscribers in the CG who completed the baseline survey during the designated period. There was a significantly lower prevalence for likely Moderate Depressive Disorder (MDD) (25.2%) and suicidal thoughts/thoughts of self-harm (48.4%), with a small effect size in the IG compared to the CG. Similarly, lower mean scores were reported for all outcome variables in the IG compared to the CG, with a small to medium effect size. The receipt of daily supportive text messages for six weeks resulted in significantly lower odds of both likely GAD and experiencing thoughts of self-harm or death wish while controlling for sociodemographic characteristics. The Text4Hope service is an effective tool for mental health support for young adult subscribers. Young adults receiving the service exhibited a reduction in psychological symptoms, including thoughts of self-harm or death wish. This population-level intervention program can be used to effectively support young adult mental health and in suicide prevention programs.

Artificial intelligence: An eye cast towards the mental health nursing horizon.

There has been an international surge towards online, digital, and telehealth mental health services, further amplified during COVID-19. Implementation and integration of technological innovations, including artificial intelligence (AI), have increased with the intention to improve clinical, governance, and administrative decision-making. Mental health nurses (MHN) should consider the ramifications of these changes and reflect on their engagement with AI. It is time for mental health nurses to demonstrate leadership in the AI mental health discourse and to meaningfully advocate that safety and inclusion of end users' of mental health service interests are prioritized. To date, very little literature exists about this topic, revealing limited engagement by MHNs overall. The aim of this article is to provide an overview of AI in the mental health context and to stimulate discussion about the rapidity and trustworthiness of AI related to the MHN profession. Despite the pace of progress, and personal life experiences with AI, a lack of MHN leadership about AI exists. MHNs have a professional obligation to advocate for access and equity in health service distribution and provision, and this applies to digital and physical domains. Trustworthiness of AI supports access and equity, and for this reason, it is of concern to MHNs. MHN advocacy and leadership are required to ensure that misogynist, racist, discriminatory biases are not favoured in the development of decisional support systems and training sets that strengthens AI algorithms. The absence of MHNs in designing technological innovation is a risk related to the adequacy of the generation of services that are beneficial for vulnerable people such as tailored, precise, and streamlined mental healthcare provision. AI developers are interested to focus on person-like solutions; however, collaborations with MHNs are required to ensure a person-centred approach for future mental healthcare is not overlooked.

Metaverse as a new place for online mental health services in the post-COVID-19 era: Is it a challenge or an opportunity?

In this article, the author describes the challenges and opportunities of metaverse's presence in the world for online mental health services. Aside from that, the author provides insight that metaverse can become a new place that is more comfortable and enjoyable for everyone who can relish the online mental health meetings with a new atmosphere and sensation, especially in the post-COVID-19 era.

3.129 The Effect of Mobile Digital Interventions on Mental Health Measures During the COVID-19 Pandemic: A Systematic Review of Controlled Studies

The COVID-19 pandemic has resulted in increased demands for online mental health (MH) services because social distancing measures have made access to MH care increasingly difficult. Before the pandemic, many mobile app-based interventions had shown their effectiveness on MH-related measures. However, effectiveness under pandemic conditions has not been systematically reviewed.

Child and youth mental health needs and service utilization during COVID-19.

The COVID-19 pandemic has significantly impacted the lives of children, youth, and their families and their access to mental health services through new virus containment measures, such as social distancing guidelines, school and service closures, and the emergence of online mental health services. In this study, we utilized a total of 47,417 interRAI assessments to evaluate the impact of the current pandemic on the mental health service needs and referral trends of children and youth across 55 mental health service agencies in Ontario, Canada. Child and youth assessments that were conducted in the period of March 1 to October 31 in 2018 and 2019 were compared with the same period in 2020 to assess pandemic-related differences. Findings demonstrated that mental health assessments among children and youth decreased significantly during the pandemic period, with the greatest decline observed among children from low-income neighborhoods. Results also demonstrated a change in the proportion of mental health concerns previously seen in children and youth. Specifically, referrals for anxiety, depression, self-harm, problem videogaming, and Internet use increased, whereas referrals related hyperactivity/distractibility, risk of harm to others, aggressive, and disruptive behavior decreased. A decrease in bullying and increase in domestic violence exposure was also noted during the pandemic, with no reported differences in children and youth's experiences of physical abuse, sexual abuse, emotional abuse, and neglect. The clinical implications for children, youth, and their families, especially those within more vulnerable communities, are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Googling “mental health” after mental health legislation and during the COVID-19 pandemic: an infodemiological study of public interest in mental health in the Philippines

Background Public interest in mental health in the Philippines can change after the Mental Health (MH) act approval and during the COVID-19 pandemic. To determine these changes, online searches in Google can be analyzed as an alternative measure. Aims To determine the trends of public interest in mental health before and after the MH act approval and during the COVID-19 pandemic. Method Aggregated search volumes for mental health using the keyword, “Mental Health (Topic)” were gathered from Google Trends. Search volume indices (SVIs), and related queries were analyzed. SVIs from the different periods were compared using means, t test, ANOVA, and ARIMA. Results Public interest in mental health increased after the MH Act approval and during the COVID-19 pandemic. The top and rising related queries revolved around mental health definitions, translations, factors, services, policy, adverse mental state, and its context during the pandemic. Conclusions These increased public interests may stem from aspirations for mental health after legislation and higher mental health needs during the pandemic. Related queries may indicate that the public may be using online information to search for mental health services and concepts. Thus, there is a need to improve reliable and trustworthy online mental health information and services.

Text Messages in the Field of Mental Health: Rapid Review of the Reviews.

BackgroundWhile mental health problems constitute a worldwide concern contributing to the global rates of morbidity and mortality, conventional mental healthcare services do not meet the current needs. Text messages (TM) represent a live model that incorporates technology into health services, spanning a large number of health conditions and playing different roles that may support the current healthcare system.ObjectiveTo examine the TM services in the field of mental health, regarding their effectiveness, feasibility, acceptability, and economic evaluation in different contexts of mental health diagnoses and during critical times, when provided to individuals with mental health symptoms/disorders.MethodsThis rapid review was conducted through an online search in PubMed, Embase, PsycINFO, and Medline databases. The review targeted the review studies which examined online or mobile addiction and mental health services, utilizing TM services. The search was run from the inception up to September 30, 2021.ResultsSixty review articles met the inclusion criteria and were included in this review. All reviews were published over the last decade. The results showed that people of a young age were fairly represented, and most reviews were run over substance use disorders (SUD), including Alcohol. Most reviews examined the effectiveness outcomes of the texting service, while to a lesser extent the acceptability and feasibility, among others. Texting services were reported as effective in psychotic disorders and SUD. However, the results related to depression and anxiety were mixed. Most reviews reported a considerably high risk of bias among their included studies. High satisfaction and acceptability of the texting services were reported for patients with various mental health conditions, including those with severe mental illness.ConclusionsThis rapid review highlighted the applications, usability, benefits, and satisfaction with the TM in the field of mental health. For a higher quality of evidence, future studies should consider TM interventions in the contexts with mixed results or a dearth of literature, and during critical times, such as the COVID-19 pandemic. Policy- and decision-makers, therefore, need to further support text-based services with guided investments in interventions that were evidenced to be accepted, economic and feasible.

Internet Use among Patients with Schizophrenia and Depression

Background: The high and increasing prevalence of internet use in the general population and the significant burden of depression and schizophrenia urge us to investigate the patterns of internet use among patients with these illnesses. The aim of this study is to assess internet use and mental health-related internet use among patients suffering from schizophrenia and depression. Methods: A total of 104 patients with psychosis and 105 patients with depression were surveyed to assess their internet use and mental health-related internet use. Results: The majority of participants were internet users (87.6%), with 66.7% of internet users with psychosis and 71.4% of internet users with depression using it as a source of information on mental health. Participants with psychosis significantly more attributed the internet and mental health internet forums as helpful in coping with their mental illness and were more interested in the utilization of online mental health services than participants with depression. Conclusions: General internet use in patients with schizophrenia and depression corresponds with the internet use of the general population; however, they use it more often as a source of health information than the general population. Mental health service providers should offer more online interventions and treatment programs to patients with psychosis and depression, as our study suggests there is an unmet need for online mental health services for such patients.