Online ethics: where will the interface of mental health and the internet lead us?

Cosgrove, Victoria E.; Gliddon, Emma; Berk, Lesley; Grimm, David; Lauder, Sue; Dodd, Seetal; Berk, Michael; Suppes, Trisha

doi:10.1186/s40345-017-0095-3

Cited by 18 publications

(26 citation statements)

References 22 publications

(19 reference statements)

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“…Electronic health (E-health) allows health resources and health care status to be communicated and transferred by electronic medium 19 . Smartphone applications allow global access, enabling assessment or intervention for adults with depression and other psychiatric disorders 20 , 21 . Patients report high levels of satisfaction with the E-mental health programme as a self-help tool because it overcomes multiple barriers, including cost, timeliness and concerns regarding confidentiality 22 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Depression in the Community from 30 Countries between 1994 and 2014

Lim

Tam

et al. 2018

Sci Rep

1,195

104

705

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The prevalence of depression may be affected by changes in psychiatric practices and the availability of online mental health information in the past two decades. This study aimed to evaluate the aggregate prevalence of depression in communities from different countries between 1994 and 2014 and to explore the variations in prevalence stratified by geographical, methodological and socio-economic factors. A total of 90 studies were identified and met the inclusion criteria (n = 1,112,573 adults) with 68 studies on single point prevalence, 9 studies on one-year prevalence, and 13 studies on lifetime prevalence of depression. A random-effects model meta-analysis that was performed to calculate the aggregate point, one-year and lifetime prevalence of depression calculated prevalences of 12.9%, 7.2% and 10.8% respectively. Point prevalence of depression was significantly higher in women (14.4%), countries with a medium human development index (HDI) (29.2%), studies published from 2004 to 2014 (15.4%) and when using self-reporting instruments (17.3%) to assess depression. Heterogeneity was identified by meta-regression and subgroup analysis, and response rate, percentage of women and year of publication, respectively, were determined contribute to depression prevalence. This meta-analysis allows benchmarking of the prevalence of depression during the era when online health information emerged, facilitating future comparisons.

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Section: Introductionmentioning

confidence: 99%

Prevalence of Depression in the Community from 30 Countries between 1994 and 2014

Lim

Tam

et al. 2018

Sci Rep

1,195

104

705

View full text Add to dashboard Cite

show abstract

“…Legalities surrounding Web-based delivery of mental health interventions across different jurisdictions require urgent attention. Currently, university ethical review boards are either unaware of, or not resourced to address, legal issues arising from geographic jurisdictions other than their own [ 37 ]. For review boards to undertake appropriate vetting of clinical trials of Web-based interventions, clear identification of protective factors (eg, participants’ privacy and safety, ethical considerations, and risk issues) across jurisdictions is necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Transparent models for multinational internet intervention research initiatives are now needed to navigate these legalities. One component of such a model may include clearly informing participants in consenting documents that while their participation has been ethically vetted by only one institution in a given geographic and legal jurisdiction, they remain bound by legal and ethical precedents in their own geographical jurisdiction [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Participants are directed back to their mental health professional as needed throughout their involvement in the ORBIT project. Third, a “red flag” protocol was developed to guide adverse event procedures, based on our experience with other Web-based interventions and websites for BD [ 32 - 37 ] and consultation with the CREST.BD CAG. This is detailed in the protocol paper [ 9 ].…”

Section: Key Learnings: Opportunities and Challengesmentioning

confidence: 99%

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Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project

2018

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BackgroundBipolar disorder (BD) is a complex, relapsing mood disorder characterized by considerable morbidity and mortality. Web-based self-management interventions provide marked opportunities for several chronic mental health conditions. However, Web-based self-management programs targeting BD are underrepresented compared with programs targeting other psychiatric conditions.ObjectiveThis paper aims at facilitating future research in the area of self-management of BD and draws insights from the development of one such intervention—the Online, Recovery-Oriented Bipolar Individualised Tool (ORBIT)—that is aimed at improving the quality of life of people with BD.MethodsWe have discussed the opportunities and challenges in developing an engaging, evidence-based, safe intervention within the context of the following three nested domains: (1) intervention development; (2) scientific testing of the intervention; and (3) ethical framework including risk management.ResultsWe gained the following insights across the three abovementioned overlapping domains: Web-based interventions can be optimized through (1) codesign with consumers with lived experience to ensure relevance and appropriateness to the target audience; (2) novel content development processes that iteratively combine evidence-based information with lived experience perspectives, capitalizing on multimedia (eg, videos) that the digital health space provides; and (3) incorporating Web-based communities to connect end users and promote constructive engagement by access to a Web-based coach.ConclusionsSelf-management is effective in BD, even for those on the more severe end of the spectrum. While there are challenges to be aware of, guided self-management programs, such as those offered by the ORBIT project, which are specifically developed for Web-based delivery provide highly accessible, engaging, and potentially provocative treatments for chronically ill populations who may otherwise have never engaged with treatment. Key questions about engagement, effectiveness, and cost-effectiveness will be answered by the ORBIT project over the next 18 months.

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“…The lack of regulation and validation of many commercially available remote monitoring methods is especially relevant in this regard [38]. Participants might be provided with poor information, or encouraged towards selfdiagnosis and self-treatment rather seeking appropriate support [39]. Equally concerning are suggestions that when used inappropriately, remote interventions may even increase symptoms of anxiety/mental distress [40].…”

Section: Ethicsmentioning

confidence: 99%

Remote Monitoring for Understanding Mechanisms and Prediction in Psychiatry

Gillett

Saunders

2019

Curr Behav Neurosci Rep

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Purpose of Review Technological advances offer the potential to better characterise the symptoms and mechanisms of psychiatric disorders. This review provides an overview of how remote monitoring might inform understanding of mood and anxiety disorders, and may be used by clinicians to predict clinical outcomes and treatment response. The review also discusses salient ethical issues and the field's future directions. Recent Findings A range of psychological and physiological remotely-collected data have been associated with clinical symptoms and outcomes, including momentary self-report, actigraphy, geolocation and heart-rate variability. Remote monitoring has shown promise in phenotyping, predicting symptoms and clinical severity, predicting treatment response and has informed psychological models of anxiety disorders. Summary Remote monitoring is a diverse field involving the collection of clinically relevant data in naturalistic settings. Although facing significant practical and ethical challenges, it has shown much potential in developing understanding in the context of mood and anxiety disorders.

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Online ethics: where will the interface of mental health and the internet lead us?

Cited by 18 publications

References 22 publications

Prevalence of Depression in the Community from 30 Countries between 1994 and 2014

Prevalence of Depression in the Community from 30 Countries between 1994 and 2014

Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project

Remote Monitoring for Understanding Mechanisms and Prediction in Psychiatry

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