Disclosure of suicidal thoughts during an e-mental health intervention: relational ethics meets actor-network theory

Heinsch, Milena; Geddes, Jenny; Sampson, Dara; Brosnan, Caragh; Hunt, Sally; Wells, Hannah; Kay‐Lambkin, Frances

doi:10.1080/10508422.2019.1691003

Cited by 14 publications

(33 citation statements)

References 64 publications

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“…This potential benefit is of ethical significance because increased access to healthcare is a critical to promote health equality and justice. Furthermore, digital mental health solutions were expected to provide more continuous, around-the-clock availability of help or support ( 18 , 23 – 26 , 29 , 31 , 32 ). By increasing accessibility, digital mental health technologies were also seen to hold potential for increasing equality between different population groups ( 21 , 24 – 26 , 33 , 34 ), as well as within the patient-therapist relationship ( 32 ).…”

Section: Resultsmentioning

confidence: 99%

“…The usage of digital mental health therapeutics is also seen to facilitate the therapy, prediction and prevention of mental illness of the patient ( 24 , 26 , 29 , 31 ) The beneficial potential of digital mental health technology for continuous and accessible care delivery is of particular relevance to low-to-moderate cases that are not being evaluated and treated, especially in areas where mental health care resources are under high levels of pressure due to severe mental illness cases. At the same time, however, our findings underscore that digital mental health, albeit already useful for monitoring purposes, has yet to become effective for predictive purposes.…”

Section: Resultsmentioning

confidence: 99%

“…Another important theme was the potential of digital mental health technologies to increase the autonomy and sense of empowerment of young adults ( 24 , 29 , 32 ). The use of digital mental health tools gives youngsters, on the one hand, the chance to play a more active role in their own treatment as they can actively seek support or control difficult situations ( 18 , 20 , 25 , 26 , 29 , 31 , 32 ), as well as the pace of answering/responding ( 26 ). Additionally it gives the patient the opportunity to implement the learned coping strategies outside the therapy setting and thereby increases patient autonomy and sense of empowerment ( 33 , 34 ).…”

Section: Resultsmentioning

confidence: 99%

“…In addition, our analysis suggests that the acceptability of using digital mental health technologies may also be positively influenced by their potential for enabling more anonymous interactions compared to face-to-face meetings with health professionals (24,25,38). The flexibility and anonymity of the digital space allows young adults to avoid social stigma or exclusion and increases their feeling of comfort to share personal data as you can quickly access the therapy tool through your smartphone (22,(24)(25)(26)(27)38).…”

Section: High Acceptability Among Young Peoplementioning

confidence: 98%

“…The most recurrent expected benefit associated with the use of digital mental health is the prospect of increased accessibility to health care (18)(19)(20)(21). This assessment was based on the increased affordability of mental health apps or internet-based platforms in comparison to face-to-face consultations (22)(23)(24)(25)(26)(27) and the easy access given the liberation of geographical restraints (22)(23)(24)(25)(28)(29)(30). This potential benefit is of ethical significance because increased access to healthcare is a critical to promote health equality and justice.…”

Section: Accessibilitymentioning

confidence: 99%

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Digital Mental Health for Young People: A Scoping Review of Ethical Promises and Challenges

Wies

Landers

Ienca

2021

Front. Digit. Health

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Mental health disorders are complex disorders of the nervous system characterized by a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Mental illness is of particular concern for younger people. The WHO estimates that around 20% of the world's children and adolescents have a mental health condition, a rate that is almost double compared to the general population. One approach toward mitigating the medical and socio-economic effects of mental health disorders is leveraging the power of digital health technology to deploy assistive, preventative, and therapeutic solutions for people in need. We define “digital mental health” as any application of digital health technology for mental health assessment, support, prevention, and treatment. However, there is only limited evidence that digital mental health tools can be successfully implemented in clinical settings. Authors have pointed to a lack of technical and medical standards for digital mental health apps, personalized neurotechnology, and assistive cognitive technology as a possible cause of suboptimal adoption and implementation in the clinical setting. Further, ethical concerns have been raised related to insufficient effectiveness, lack of adequate clinical validation, and user-centered design as well as data privacy vulnerabilities of current digital mental health products. The aim of this paper is to report on a scoping review we conducted to capture and synthesize the growing literature on the promises and ethical challenges of digital mental health for young people aged 0–25. This review seeks to survey the scope and focus of the relevant literature, identify major benefits and opportunities of ethical significance (e.g., reducing suffering and improving well-being), and provide a comprehensive mapping of the emerging ethical challenges. Our findings provide a comprehensive synthesis of the current literature and offer a detailed informative basis for any stakeholder involved in the development, deployment, and management of ethically-aligned digital mental health solutions for young people.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: High Acceptability Among Young Peoplementioning

confidence: 98%

Section: Accessibilitymentioning

confidence: 99%

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Digital Mental Health for Young People: A Scoping Review of Ethical Promises and Challenges

Wies

Landers

Ienca

2021

Front. Digit. Health

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The Role of Moderators in Facilitating and Encouraging Peer-to-Peer Support in an Online Mental Health Community: A Qualitative Exploratory Study

Deng

Rogers²,

Naslund

2023

J. technol. behav. sci.

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Online peer support platforms have gained popularity as a potential way for people struggling with mental health problems to share information and provide support to each other. While these platforms can offer an open space to discuss emotionally difficult issues, unsafe or unmoderated communities can allow potential harm to users by spreading triggering content, misinformation or hostile interactions. The purpose of this study was to explore the role of moderators in these online communities, and how moderators can facilitate peer-to-peer support, while minimizing harms to users and amplifying potential benefits. Moderators of the Togetherall peer support platform were recruited to participate in qualitative interviews. The moderators, referred to as 'Wall Guides', were asked about their day-to-day responsibilities, positive and negative experiences they have witnessed on the platform and the strategies they employ when encountering problems such as lack of engagement or posting of inappropriate content. The data were then analyzed qualitatively using thematic content analysis and consensus codes were deduced and reviewed to reach final results and representative themes. In total, 20 moderators participated in this study, and described their experiences and efforts to follow a consistent and shared protocol for responding to common scenarios in the online community. Many reported the deep connections formed by the online community, the helpful and thoughtful responses that members give each other and the satisfaction of seeing progress in members' recovery. They also reported occasional aggressive, sensitive or inconsiderate comments and posts on the platform. They respond by removing or revising the hurtful post or reaching out to the affected member to maintain the 'house rules'. Lastly, many discussed strategies they elicit to promote engagement from members within the community and ensure each member is supported through their use of the platform. This study sheds light on the critical role of moderators of online peer support communities, and their ability to contribute to the potential benefits of digital peer support while minimizing risks to users. The findings reported here accentuate the importance of having well-trained moderators on online peer support platforms and can guide future efforts to effectively train and supervise prospective peer support moderators. Moderators can become an active 'shaping force' and bring a cohesive culture of expressed empathy, sensitivity and care. The delivery of a healthy and safe community contrasts starkly with non-moderated online forums, which can become unhealthy and unsafe as a result.

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Potential pitfalls and lessons learned

Kay‐Lambkin

Heinsch²,

Sampson³

2023

Digital Therapeutics for Mental Health and Addiction

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Disclosure of suicidal thoughts during an e-mental health intervention: relational ethics meets actor-network theory

Cited by 14 publications

References 64 publications

Digital Mental Health for Young People: A Scoping Review of Ethical Promises and Challenges

Digital Mental Health for Young People: A Scoping Review of Ethical Promises and Challenges

The Role of Moderators in Facilitating and Encouraging Peer-to-Peer Support in an Online Mental Health Community: A Qualitative Exploratory Study

Potential pitfalls and lessons learned

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