Opinion

Latimer: Therapy is as close as your smart phone

Today there are a growing number of apps and websites offering various forms of therapy for mental health issues.

Of course therapy apps have been coming ever since the invention of the smart phone.

Really, since the Internet age began, it’s been simply a matter of time before we figured out how to do some mental health care online.

In many ways this is in response to the way we tend to communicate now via social media or text message.

It makes sense for established mental health organizations to reach out in these media – especially for younger clients who tend to be very comfortable communicating over their phones or computers rather than in person.

The rise in online mental health services also has the potential to make this kind of care much more accessible both here and abroad where there is often a real shortage of trained healthcare professionals.

Most effective treatments for mental health conditions recommend an element of psychological therapy led by a highly qualified professional such as a clinical psychologist or psychiatrist.

Unfortunately, even here in North America, we have a shortage of these professionals and it is difficult for those who need health care to get it in a timely fashion.

In developing countries the situation is often much worse.

For example, in India there are roughly 5,000 mental health professionals to service a population of about 1.2 billion people.

Obviously, this is nowhere near sufficient.

Although we need to continue training more specialists, this will not be the only solution to the problem of access to mental health services. Creating a new clinical psychologist or psychiatrist takes years and a lot of resources and we simply can’t catch up to demand. Some countries are looking into task shifting – training less qualified people to take on a specific task in therapy.

This is interesting and may prove useful in certain settings, but there is a concern about compromising quality of care.

Moving mental health services online will perhaps prove to be the most effective way to dramatically improve access to these services and to stretch professional expertise through program-led treatments.

Therapist-free interventions have been around for a while in the form of self-help books and some have good evidence to show they can be effective.

Now with smartphones and high speed Internet, these resources can be enhanced to be more interactive and greatly expanded. The development and use of these therapy apps and other online mental health resources will need to be monitored and researched more fully, but studies to date do show promise – particularly in depression and anxiety disorders.

One consistent finding is that these programs are most effective when there is additional external support.

Ideally, this support would come from a call centre or non-specialist to ensure the intervention is still program-led.

I think online resources have the potential to be a very useful tool provided they are developed by professionals with a nuanced understanding of the complex issues involved in mental health conditions.

I would also caution that although online, program-led treatments may be useful for some issues, they will likely not replace the need for thoughtful professional care in many cases.

Another difficulty will likely be sifting out the good quality programs from cheap imitations, which may not be helpful and could be damaging.

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