From Digital Mental Health Interventions to Digital “Addiction”: Where the Two Fields Converge

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 crossfertilization 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and creates more potentially problematic activities, leaving researchers perennially behind, so new technologies become outdated by the time they are studied.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.

Mobile Internet Technologies, Ecological Momentary Assessment, and Intervention—Poison and Remedy for New Online Problematic Behaviors in ICD-11

“…A significant gap between the number of people that need or could benefit from treatment and the number of people actually receiving it is one of the most urgent problems in therapy ( 43 ). Due to its high cost-effectiveness, EMI offers the possibility to improve access to evidence-based treatment for various populations, democratizing it ( 1 , 5 ). EMI seems to be promising owning the possibility of identifying contextual (social interaction, location) and intra-individual (craving, mood, physiological responses) precipitating factors of lapses through the employment of machine learning algorithms and data mining ( 44 , 45 ).…”

“…Technological advancements often present new challenges to mental health and well-being while, at the same time, creating the possibility for new, effective interventions for its preservation, improvement, and recovery ( 1 ). In the current commentary, on one hand, we discuss the category of problematic behaviors for which mobile internet technologies have created an outlet.…”

The retention challenge in remote therapy and learning seen through the lens of the COVID‐19 pandemic

“…Although this challenge has been borne out in studies of both online therapy 1 and online education 2 , these fields have been mutually insular and have not benefited from each other's experience in addressing this common foe. This issue has been recently highlighted in the specialized education literature 3 . Here, we explore it for a mental health audience, since, besides learners and educators, countless online patients and therapists also stand to gain from retention-enhancing design.…”

“…The COVID-19 pandemic is profoundly impacting mental health worldwide [1][2][3] . Wuhan, China has been the first city to experience the emergency of COVID-19 and its high hospitalization and casualty rates, as well as the mandatory curfews that were strictly enforced for infection control, with their significant mental health implications 4 .…”

“…Retention, of course, is not the only metric by which to measure the success of online therapy and education; even if retention is poor, a massively popular intervention or course still means that many users can benefit 3 . Also, today's pandemic-dictated platforms are typically much smaller, less impersonal, more interactive and better coached than the typical self-paced online therapy or MOOC of yore, suggesting that retention may be a less relevant problem with current offerings.…”