Online psychiatry expansion is the only way to address the massive and growing mental health burden in all countries

News Hour:

Experts at this year’s European Congress on Psychiatry in Florence, Italy (1-4 April) say that the only way to address the massive and growing mental health burden in countries of all incomes is to expand online resources such as virtual clinics that could provide online assessments and web-based psychotherapies.

At a special symposium dedicated to the potential of social media and e-mental health, Michael Krausz, Professor of Psychiatry at the University of British Columbia, Vancouver, BC, Canada, and Chair of E-Mental Health at the World Psychiatric Association, will highlight that the global mental health system is only serving a small minority (approximately 10%) of patients in any way.

“Even in highly developed countries, there are long waiting times to see a specialist, of 6-12 months or more. Added to this, marginalized populations or individuals in remote and rural areas are not having any access to care, and even for those that have access, this may be unaffordable.”

Professor Krausz will say that the web is the only place that can provide significant additional capacity for mental health treatment. Web-based interventions are proven to be effective and are covering a broad range of conditions, although critical is the implementation and the integration with other services. He will give the example of interactive suicide assessments.

Cognitive behavioral therapy (CBT) for depression is the best developed and tested online intervention, and has found to be very effective. Professor Krausz says there is potential for online CBT to be modified for conditions such post-traumatic stress disorder and social anxiety.

Technologies like virtual reality and artificial intelligence can also support certain psychosocial interventions like the treatment of anxiety (exposition), and various online games and apps are being developed to support treatment – for example, SPARX, a game addressing depression in children in New Zealand.

Elsewhere, scientists at King’s College London have developed an Avitar animation system to help treat people with schizophrenia who hear distressing voices. Several high-income countries have begun implementing online treatment strategies for mental health.

“New Zealand and Australia are advanced in this area with national strategies and youth mental health initiatives,” explains Professor Krausz.

“Good solutions are also developed in Europe for online CBT, including in Switzerland, Sweden, and Germany.”

“These online services would use a web based framework of apps and systems making intense use of all new communicative tools for patient-centered care, and the online environment integrating different clinical systems clinical settings – face to face, online platforms, and virtual clinics,” says Professor Krausz.

“E-mail, chat and video calling can be used to help link patients who are far away from specialist help.”

He will also call for more utilization of peer support in online networks. He says: “Peers are an invaluable and most underutilized resource in health care. They can be involved in different ways like navigators and mentors, people with lived experiences or individual resources.”

He concludes: “Through a proactive approach we can create an additional virtual system of care which could build capacity, improve the quality of care and make mental health care more effective building a platform for early intervention, integration of different treatment settings and offering online resources. Online assessments, web-based psychotherapies, and other resources informed decision-making and online research strategies will significantly change the field.”

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