Many individuals experiencing mental health complications face barriers when attempting to access services. To bridge this care gap, digital mental health innovations (DMHI) have proven to be ...valuable additions to in-person care by enhancing access to care. An important aspect to consider when evaluating the utility of DMHI is perceived acceptability. However, it is unclear whether diverse sociodemographic groups differ in their degree of perceived acceptability of DMHI.
This scoping review aims to synthesize evidence on the role of sociodemographic factors (e.g., age, gender) in the perceived acceptability of DMHI among individuals seeking mental health care.
Guided by the JBI Manual of Evidence Synthesis, chapter on Scoping Review, a search strategy developed according to the PCC framework will be implemented in MEDLINE and then adapted to four electronic databases (i.e., CINAHL, MEDLINE, PsycINFO, and EMBASE). The study selection strategy will be piloted by two reviewers on subsets of 30 articles until agreement among reviewers reaches 90%, after which one reviewer will complete the remaining screening of titles and abstracts. The full-text screening, data extraction strategy, and charting tool will be completed by one reviewer and then validated by a second member of the team. Main findings will be presented using tables and figures.
This scoping review will examine the extent to which sociodemographic factors have been considered in the digital mental health literature. Also, the proposed review may help determine whether certain populations have been associated with a lower level of acceptability within the context of digital mental health care. This investigation aims to favor equitable access to DMHI among diverse populations.
In this article we have provided a perspective on the importance and value of youth mental health services for society and argued that advancing youth mental health services should be the number one ...priority of health services in Canada. Using the age period of 12–25 years for defining youth, we have provided justification for our position based on scientific evidence derived from clinical, epidemiological and neurodevelopmental studies. We have highlighted the early onset of most mental disorders and substance abuse as well as their persistence into later adulthood, the long delays experienced by most help seekers and the consequence of such delays for young people and for society in general. We have also provided a brief review of the current gross inadequacies in access and quality of care available in Canada. We have argued for the need for a different conceptual framework of youth mental disorders as well as for a transformation of the way services are provided in order not only to reduce the unmet needs but also to allow a more meaningful exploration of the nature of such problems presenting in youth and the best way to treat them. We have offered some ideas based on previous work completed in this field as well as current initiatives in Canada and elsewhere. Any transformation of youth mental health services in Canada must take into consideration the significant geographic, cultural and political diversity across the provinces, territories and indigenous peoples across this country.
There is growing interest in using information and communication technologies (ICTs) to improve access to mental health services for youth experiencing homelessness (YEH); however, limited efforts ...have been made to synthesize this literature.
This study aimed to review the research on the use of ICTs to provide mental health services and interventions for YEH.
We used a scoping review methodology following the Arksey and O'Malley framework and guidelines from the Joanna Briggs Institute Manual for Evidence Synthesis. The results are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A systematic search was conducted from 2005 to 2021 in MEDLINE, Embase, CINAHL, PsycInfo, Cochrane, Web of Science, and Maestro and in ProQuest Thesis and Dissertations, Papyrus, Homeless Hub, and Google Scholar for gray literature. Studies were included if participants' mean age was between 13 and 29 years, youth with mental health issues were experiencing homelessness or living in a shelter, ICTs were used as a means of intervention, and the study provided a description of the technology. The exclusion criteria were technology that did not allow for interaction (eg, television) and languages other than French or English. The data were analyzed using descriptive statistics and qualitative approaches. Two reviewers were involved in the screening and data extraction process in consultation with a third reviewer. The data were summarized in tables and by narrative synthesis.
From the 2153 abstracts and titles screened, 12 were included in the analysis. The most common types of ICTs used were communication technologies (eg, phone, video, and SMS text messages) and mobile apps. The intervention goals varied widely across studies; the most common goal was reducing risky behaviors, followed by addressing cognitive functioning, providing emotional support, providing vital resources, and reducing anxiety. Most studies (9/11, 82%) focused on the feasibility of interventions. Almost all studies reported high levels of acceptability (8/9, 89%) and moderate to high frequency of use (5/6, 83%). The principal challenges were related to technical problems such as the need to replace phones, issues with data services, and phone charging.
Our results indicate the emerging role of ICTs in the delivery of mental health services to YEH and that there is a high level of acceptability based on early feasibility studies. However, our results should be interpreted cautiously, considering the limited number of studies included in the analysis and the elevated levels of dropout. There is a need to advance efficacy and effectiveness research in this area with larger and longer studies.
RR2-10.1136/bmjopen-2022-061313.
IntroductionDespite the importance to address mental health issues as early as possible, youth experiencing homelessness (YEH) often lack prompt and easy access to health services. Recently, there ...has been a surge of studies focusing on leveraging technology to improve access to mental health services for YEH; however, limited efforts have been made to synthesise this literature, which can have important implications for the planning of mental health service delivery. Thus, this scoping review aims to map and synthesise research on the use of information and communication technologies (ICTs) to provide mental health services and interventions to YEH.Methods and analysisA scoping review of the literature will be conducted, following Arksey and O’Malley’s proposed methodology, the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews and recent guidelines from the Joanna Briggs Institute. All peer-reviewed papers using ICTs as a means of intervention will be considered, as well as grey literature. Only documents in English or French will be included in the analysis. First, 10 electronic databases will be consulted. Next, all data will be extracted into Covidence. Then, two reviewers will independently conduct the screening and data extraction process, in the case of discrepancies, a third reviewer will be included. Finally, data will be synthesised according to our objectives.Ethics and disseminationEthics approval is not required, as data will be collected from published literature. Findings will be disseminated through conference presentations and peer-reviewed journals.
Limited knowledge exists on telepsychiatry in specialized services for first-episode psychosis (FEP), despite its potential for improving service access and engagement.
To explore access and use of ...technology, obstacles to attending clinic appointments, and perspectives of young adults with FEP on using telepsychiatry as part of outpatient services.
A cross-sectional, descriptive survey study was conducted between July and October 2017 with young adults between the ages of 18 and 38 recruited from a specialized program for FEP in an urban Canadian setting. Data were analysed using descriptive statistics and content analysis.
Among 51 participants (mean age = 26.1, SD = 4.2; 59% male; 20% experiencing housing instability), more than half (59%, n = 30) rarely or never used mainstream video chat (e.g., Facetime). The majority (78%, n = 40) reported obstacles to attending appointments, with several (37%, n = 19) identifying two or more. Almost half (49%, n = 25) were very favorable towards telepsychiatry and a quarter (25%, n = 13) were somewhat favorable. Participants expressed several concerns about telepsychiatry, including loss of human contact and confidentiality.
To our knowledge, this is a first study on the perspectives of individuals with FEP about telepsychiatry. Despite experiencing obstacles to attending appointments and expressing receptivity towards telepsychiatry, participants did not have access to these services. It is important to provide education to clinicians on the potential of telepsychiatry to improve service access. Also, more research is needed on when, where, and how telepsychiatry can be integrated into existing care while addressing patient and clinician concerns.
Semiconducting single-walled carbon nanotubes (SWNTs) are potential active materials for fast-growing flexible/wearable applications with low-power dissipation, especially suitable for increasingly ...important radio-frequency (RF) wireless biosensor systems. However, the operation frequency of the existing flexible carbon nanotube field-effect transistors (CNT-FETs) is far below the current state-of-the-art GSM spectrum frequency band (typical 850 MHz) for near-field wireless communication applications. In this paper, we successfully conduct a 900 °C annealing process for the flexible CNT-FETs and hence significantly improve their operation frequency up to 2.1 gigahertz (GHz), making it possible to cover the current GSM spectra for integrated wireless sensor systems. The high-temperature annealing process significantly improves the electrical characteristic of the flexible CNT-FETs by removing the surfactant impurities of the SWNT materials. The obtained flexible CNT-FETs exhibit record transconductance (
) as high as 48 μS/μm. Despite an applied strain level of 2%, a characteristic frequency of over 1 GHz is observed. Further demonstration of GHz performance is also exhibited for flexible RF integrated circuits (ICs) such as frequency multipliers and mixers, which are the fundamental components for wireless applications. This work offers a new pathway for realizing SWNT-based wearable wireless GHz sensor systems with power efficiency.
Background:
The use of telepsychiatry (TP) for inpatient service delivery is still an emerging field and there is limited literature on its practice and evidence. This review was conducted with the ...objectives of (a) exploring the models of TP for inpatient service delivery, (b) qualitative synthesis of the efficacy of TP in inpatient settings, and (c) proposing a best-fit model of TP-based inpatient care for Indian settings.
Methods:
An electronic database search was conducted on July 22, 2020, in PubMed, Directory of Open Access Journals, and Google Scholar for relevant articles. Seventeen articles were included in the review.
Results:
The review revealed three models for TP-based inpatient care; direct care model, teleconsultation model, and the collaborative care model. Preliminary evidence suggests that TP is cost-effective and reliable, and that patients and service providers are highly satisfied with this approach. Evidence gaps were seen for some diagnostic categories such as psychosis and for extremes of age groups. Based on the existing models, we propose an Indian model for implementing TP in inpatient settings.
Conclusion:
Promising initial results and the evidence gaps highlight the need for further research in this area.
Objectives:
In low- and middle-income countries (LMIC), major mental disorders often remain untreated because of barriers related to access and resources. In rural areas and in conflict-ridden ...regions, the problem can be exacerbated by increased rates of mental illness and by reduced access to care. This paper describes a project designed to provide mental health services for major mental disorders among youth using a low-cost model in a rural district of the troubled Kashmir valley.
Methods:
We describe the geographic and political context, the guiding principles and adaptation of the service model (through partnership with a voluntary organization and use of technology), and the implementation of the model using Theory of Change framework. The core of the intervention was to train a pool of lay health workers (LHWs) to provide mental health services to young (aged 14-30 years) people with major mental disorders in their own communities, supported by clinical professionals.
Results:
Despite political turmoil and major floods, 40 (male and female) LHWs were trained. The LHWs efficiently engaged in case identification, basic interventions, and data collection on outcomes. Several different stakeholders were engaged in activities relevant to the objectives of the project; however, the use of technologies was moderated by several challenges, including access to internet services and patient preference for personal contact.
Conclusions:
This service model is applicable in an environment where protracted political and armed conflict, low resources, and geographical isolation make exclusive reliance on scarce professional services impractical.
The increasing need for mental health services in the population is posing significant challenges for the health system. It is therefore important to identify new approaches to delivering care that ...are sustainable and scalable in terms of reach and impact. E-mental health is one approach that shows promise in addressing the treatment gap in mental healthcare. E-mental health involves leveraging the Internet and related technologies such as smartphone apps, web sites, and social media to deliver mental health services. Over the past decade, this field has made significant advancements in Canada and internationally. In this article, the author introduces the e-mental health field and provides an overview of promising Canadian developments in relation to policy, research, and practice. In addition, the article discusses some of the challenges facing the wide-scale implementation of e-mental health and identifies priority areas of focus for health leaders to advance the field.
Youth are among the fastest growing subset of the homeless population. Youth experiencing homelessness (YEH) face multiple barriers in accessing health information and health care services. As such, ...they may best be reached through information and communication technologies (ICTs); however, limited efforts have been made to synthesize literature on this topic. In this paper, we review studies on access and use of ICTs among YEH. We also discuss the implications of the review for healthcare.
Using scoping review methodology, we searched four databases (Medline, Embase, PsycInfo, and CINAHL) for studies published between 2005 and 2019, screening 1,927 titles and abstracts.
We identified 19 articles reporting on studies with YEH between the ages of 12-30, the majority of which were published in the USA. On average, more than half of the samples owned smartphones, used social media, and accessed the internet weekly to search for housing, employment, health information, and to communicate with family, peers, and health workers; however, many youths faced barriers to sustaining their access to technology. Benefits of using ICTs were connecting with home-based peers, family, and case workers, which was associated with a reduction in substance use, risky sexual health behaviors, and severity of mental health symptoms. Connecting with negative, street-based social ties was identified as the most common risk factor to using ICTs due to its association with engaging in risky sex behaviors and substance abuse.
This review supports the advancement of research and practice on using ICTs to deliver public health information and health services to YEH, while also considering the health-related risks, benefits, and barriers that YEH face when accessing ICTs.
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