Death to Stock

Any conversation focused on what’s great about America usually includes a mention of optimism, hopefulness or some variation on the theme.

Americans generally still believe in a brighter future, and especially the ways in which technology can enable that future. But that sense of optimism contains a kernel of potential disappointment when we ask technology to do too much.

Consider the case of mental health care, a profession that faces massive budget shortfalls.

According to Robert Glover, executive director of the National Association of State Mental Health Program, from 2009 to 2012 states cut roughly $5 billion in mental health services and eliminated about 4,500 public psychiatric beds. As with all of healthcare, mental health is using technology to try and fill economic gaps.

Of the roughly 40,000 health apps available for smartphone, there are about 800 apps oriented around mental health. So, if the key to effective therapy, as most professionals argue, is human interaction, can apps provide any benefit at all? According to David Mohr, professor of preventive and behavioral medicine at Northwestern University, the answer is yes.

“A large body of clinical research shows that web-based and phone applications can treat depression and anxiety,” writes Mohr in the New York Times’ Room for Debate opinion page. “To be effective, behavioral intervention technologies (B.I.T.s) require repeated use over a number of weeks — an obstacle because many people with depression or anxiety have trouble staying engaged long enough to make substantial improvements.”

That last part seems relevant and important. If technology shortens attention spans and perhaps makes us less patient, then mental illness would seem to exacerbate that scenario.

“Immersing myself in a book or a lengthy article used to be easy,” writes Guy Billout in his landmark 2008Atlantic essay “Is Google Making Us Stupid?” “That’s rarely the case anymore. Now my concentration often starts to drift after two or three pages. I get fidgety, lose the thread, begin looking for something else to do. I feel as if I’m always dragging my wayward brain back to the text. The deep reading that used to come naturally has become a struggle.”

Studies focused on the use of health apps, the overwhelming majority of which deal with diet and exercise, suggest guarded optimism and unmet potential. In the popular technology vernacular, there is no ‘killer app.’

“These findings suggest that while many individuals use health apps, a substantial proportion of the population does not,” write the authors of a recent study on health app use in their abstract conclusion, “and that even among those who use health apps, many stop using them.”

The idea of staying engaged–of coming back again and again to ideas and ways of thinking that alter perspectives and patterns–seems essential to improved mental health. (Mohr says as much when he references “repeated use over a number of weeks.”) But technology seems to create the exact opposite–detachment instead of engagement.

“One of the most significant problems with apps is the high attrition rate: People begin using them but often tire of the required dedication quickly,” writes Matthew Hertenstein, an associate professor of psychology at Depauw University, in the same New York Times Room for Debate op-ed. “More important, using an app doesn’t allow individuals to deeply connect to other humans – be they therapist or friend.”


– Irv Lichtenwald

Source: Can technology transform mental health care? | Healthcare IT News