Digital Psychiatry: The Year Ahead

TECHNOLOGY AND PSYCHIATRY

With the rising interest in mobile and connected technologies, this is an exciting time to serve as the 2016 Digital Psychiatry Section Editor for Psychiatric Times. This promises to be a busy year as the roles of new digital tools converge to offer novel opportunities for clinical care. The focus will be on trust and data security, as well as efficacy and clinical outcomes data, as digital psychiatry matures from theoretical potential toward clinical reality. A foundation of trust and an evidence base with real data will be key areas for the field going forward.

Privacy and transparency

We already know how much information we can collect from smartphone apps and sensor technologies as well as how much of it can be stored. But will patients trust technology enough to share their mental health concerns?

The power of the patient-doctor relationship is in part due to strong confidentiality laws that protect health care discussions and data. Given how sensitive psychiatric patient information can be, perhaps it is not surprising that a study in 2015 found that while 86% of the general public was willing to share health data with a clinician, only 8% was willing to do so with a technology company.¹ Considering that another study found only 31% of the 600 most popular health apps had a privacy policy, this reluctance to share health data appears grounded in tangible concerns.²

To begin to address this problem, we can expect to see efforts on 2 fronts. First, connected technologies are beginning to better encrypt data and increase data security measures. But a focus on data security alone is not enough. A parallel theme will emerge toward greater transparency in how health data are collected, stored, and used. In fact, a failure to focus on trust can undermine an entire technology platform. In October 2015, the entire UK National Health Service App Library was taken offline after it was discovered that many of the featured apps were not secure and leaked patient data.³

Practical matters >

Practical matters

Last year we saw numerous examples of technology companies that claimed endless possibilities for technologies-such as apps and sensors-for patient care. Recent literature reviews of the evidence base of apps for depression, bipolar disorder, and schizophrenia demonstrate how scarce high-quality clinical data currently are.^4,5

Evidence for efficacy is largely lacking across the board. However, we will begin to see more clinical studies and evidence as patients and clinicians look beyond marketing and ask the simple question: where are the data?

The future

As Editor in Chief of JMIR Mental Health, a journal at the intersection of technology and psychiatry, I am fortunate to see much of the newest research on digital psychiatry and look forward to keeping the readers of Psychiatric Times up to date with the latest breakthroughs and clinical outcomes data. With the right steps, this may be the year that technology begins to fulfill its potential to bring affordable, accessible, scalable, and high-quality tools directly into the hands, hearts, and minds of millions of patients and psychiatrists.

Editor’s note: The staff at Psychiatric Times would like to thank Holly Peek, MD, MPH, for her role as 2015 Digital Psychiatry Editor.

Disclosures:

Dr Torous is a Clinical Fellow in Psychiatry at Harvard Medical School and Senior Resident at the Harvard Longwood Psychiatry Residency Training Program in Boston. Twitter: @JohnTorousMD. The author reports no conflicts of interest concerning the subject matter of this article.

References:

1. Ghandi M, Wang T. Digital Health Consumer Adoption: 2015. RockHealth. http://rockhealth.com/reports/digital-health-consumer-adoption-2015. Accessed January 22, 2016.

2. Sunyaev A, Dehling T, Taylor PL, Mandl KD. Availability and quality of mobile health app privacy policies. J Am Med Inform Assoc. 2015;22:e28-e33.

3. Marley J, Farooq S. Mobile telephone apps in mental health practice: uses, opportunities and challenges. B J Psych Bull. 2015;39:288-290. http://pb.rcpsych.org/content/39/6/288.e-letters. Accessed January 22, 2016.

4. Firth J, Torous J. Smartphone apps for schizophrenia: a systematic review. JMIR mHealth uHealth. 2015;3:e102. http://mhealth.jmir.org/2015/4/e102/. Accessed January 22, 2016.

5. Torous J, Powell AC. Current research and trends in the use of smartphone applications for mood disorders. Internet Interv. 2015;2:169-173.