By the Numbers - Aug. 17, 2015

By the Numbers - Aug. 17, 2015

6%

The percentage of current mobile health applications that are devoted to mental health, according to a recent article in World Psychiatry -- Telemental health: A status update.

The article provides a current look at the state of telemental health, including computerized CBT (cCBT), Internet-based CBT (iCBT), virtual reality exposure therapy (VRET), and mobile therapy (mTherapy). The researchers trolled four scientific databases -- PubMed, PsycINFO, ScienceDirect, and Wiley Online Library -- looking especially for "well-designed meta-analyses and larger, controlled trials with clearly defined outcome measures and inclusion and exclusion criteria." The authors point out that, according to current estimates, "up to 50% of all health care services will be conducted electronically by 2020." Due to the largely "hands-off" nature of mental health services -- involving relatively low use of physical exams, lab tests, imaging diagnostics, etc. -- this is an an area "that may be poised to grow even faster than other medical fields."

Taken together, published studies support an expanded role for telepsychiatry tools, with advantages that include increased care access, enhanced efficiency, reduced stigma associated with visiting mental health clinics, and the ability to bypass diagnosis-specific obstacles to treatment, such as when social anxiety prevents a patient from leaving the house. Of technology-mediated therapies, cCBT and iCBT possess the most efficacy evidence, with VRET and mTherapy representing promising but less researched options that have grown in parallel with virtual reality and mobile technology advances. Nonetheless, telepsychiatry remains challenging because of the need for specific computer skills, the difficulty in providing patients with a deep understanding or support, concerns about the “therapeutic alliance”, privacy fears, and the well documented problem of patient attrition.