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By David Gracer, Psychiatrist, Center for Addiction and Mental Health, Associate Professor of Psychiatry, University of Toronto
Ella, who is in the early 20's, has depression. When her dream began to break through a stressful term at school, her smartphone was programmed to note the texts of late nights and phone conversations pointing to her insomnia. She made suggestions for improving her dream.
When her social media posts became negative, and rarely called her friends, her phone made her depressed, reserved her to see her psychiatrist, then set the scales and diary results from her recent sleep patterns.
She binds her psychiatrist though a video conference and this doctor has made some adjustments to the drugs. Ella also started a particular focused psychotherapy through an application.
Ella is not real, but hundreds of thousands of Canadians have a major depressive disorder. Today, smartphones do not rise to insomnia and do not set up psychiatric meetings. But one day they could.
Soon we can use smartphones and clothing to help treat depression. As a psychiatrist, I see this as a good thing, allowing more people to access quality care.
Health applications follow the mood
Mental health is an area that needs a transformation. One in five Canadians will have mental health problems this year, but many struggle for access to care. According to a study, only half of people with depression receive adequate care.
Evidence based psychotherapy is particularly difficult for people to have access; a recent Canadian study found that only 13 percent of people with depression had psychotherapy. However, cognitive behavioral therapy – a kind of therapy that focuses on how a person's thoughts can affect his or her behavior and mood – is as effective as drugs.
Just as technology transforms other aspects of our lives, people are more eavesdropping on health needs. For example, there are more than 315,000 mobile health applications.
Many of my patients use applications for information about their diseases; some incorporate applications into their care, helping them remember when to take medication or to follow the mood over time. And more people are now browsing the internet for therapy.
Studies show that if therapy is done correctly (with the therapist who is leading the process), people can do the same as with facial care, but at a lower cost.
Smartphones identify symptoms
The advantages are more than economic. For a single mother with three children or an elderly person who hesitates to attend the clinic in the winter dead, online therapy is not better care, it's the only concern.
Not surprisingly, the idea proved to be popular with the private sector, as well as with governments in Norway and Sweden.
And there is great potential to see technology to help with all aspects of protection. Most North Americans have smartphones that are worn everywhere.
By examining patterns of speech and our movements, smartphones can suppress subtle changes that indicate a start or worsening of symptoms, while clothing may notice subtle physical changes – long before patients notice problems. These devices can bring real-time real-time data to care.
Needless to say, the research is active; For example, several of my colleagues at the Center for Addiction and Mental Health in Toronto have reviewed depression and Fitbit data to detect patterns that could signal the onset of depression earlier.
A Privacy Challenge
We also need to be careful. There are hundreds of depression applications, but the quantity does not mean quality. In a study, when a basic quality control standard (such as disclosure of the source of information) was applied, only 25 percent of the studies they attended passed the test.
Digital mental health should also include digital privacy and confidentiality. Just as banking information should not be shared unconsciously, medical information transmitted to a smartphone or device that can be used should be safe for the user.
Conflicts of interest must be clear. A smartphone application, for example, should not be a hidden advertisement for a private company.
People often ask me if I think that technology will soon replace psychiatrists. It is unlikely to happen. But one day, a patient like Ella can touch the technology to get better care. And that's good news – if we have government policies and practices to ensure that technology is used deliberately.
David Graser blog about psychiatry and research at http://www.davidgratzer.com.
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