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Evidence, Enactment, Engagement: The three 'nEEEds' of mental mHealth

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How can mobile tools change mental health research and practice? Blog post by psychology expert and researcher Andrea Gaggioli.

As a researcher in the field of mHealth & mental health, I welcome the "Green Paper on Mobile Health" recently published by the European Commission. I believe that this document can provide a useful platform for discussing key issues related to the deployment of mHealth, thereby contributing to bridge the gap between policy, research and practice.

Actually, according to my experience, citizens and public stakeholders are not well-informed or educated about mHealth. For example, to many people the idea of using phones to deliver mental health programs still sounds weird.

Yet the number of mental health apps is rapidly growing: a recent survey identified 200 unique mobile tools specifically associated with behavioral health.

These applications now cover a wide array of clinical areas including developmental disorders, cognitive disorders, substance-related disorders, as well as psychotic and mood disorders.

mHealth

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I think that the increasing "applification" of mental health is explained by three potential benefits of this approach:

  • First, mobile apps can be integrated in different stages of treatment: from promoting awareness of disease, to increasing treatment compliance, to preventing relapse.
  • Furthermore, mobile tools can be used to monitor behavioural and psychological symptoms in everyday life: self-reported data can be complemented with readings from inbuilt or wearable sensors to fine-tune treatment according to the individual patient’s needs.
  • Last - but not least - mobile applications can help patients to stay on top of current research, facilitating access to evidence-based care. For example, in the EC-funded INTERSTRESS project, we investigated these potentials in the assessment and management of psychological stress, by developing different mobile applications (including the award-winning Positive Technology app) for helping people to monitor stress levels “on the go” and learn new relaxation skills.

In short, I believe that mental mHealth has the potential to provide the right care, at the right time, at the right place. However, from my personal experience I have identified three key challenges that must be faced in order to realize the potential of this approach.

I call them the three "nEEEds" of mental mHealth: evidence, engagement, enactment.

  • Evidence refers to the need of clinical proof of efficacy or effectiveness to be provided using randomised trials.
  • Engagement is related to the need of ensuring usability and accessibility for mobile interfaces: this goes beyond reducing use errors that may generate risks of psychological discomfort for the patient, to include the creation of a compelling and engaging user experience.
  • Finally, enactment concerns the need that appropriate regulations enacted by competent authorities catch up with mHealth technology development.

Being myself a beneficiary of EC-funded grants, I can recognize that R&D investments on mHealth made by EC across FP6 and FP7 have contributed to position Europe at the forefront of this revolution. And the return of this investment could be strong: it has been predicted that full exploitation of mHealth solutions could lead to nearly 100 billion EUR savings in total annual EU healthcare spend in 2017.

I believe that a progressively larger portion of these savings may be generated by the adoption of mobile solutions in the mental health sector: actually, in the WHO European Region, mental ill health accounts for almost 20% of the burden of disease.

For this prediction to be fulfilled, however, many barriers must be overcome: the three "nEEEds" of mental mHealth are probably only the start of the list. Hopefully, the Green Paper consultation will help to identify further opportunities and concerns that may be facing mental mHealth, in order to ensure a successful implementation of this approach.

Andrea Gaggioli

Department of Psychology, Catholic University of Sacred Heart, Milan, Italy

Personal website: www.positivetechnology.it

Comments

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mHealth is definitly a new & innovative concept in the Healthcare industry. Making the overall process that includes health check-ups, diagnoses & treatment to be more flexible that might reduce a lot of overhead.Use of smart devices are also being discussed here that will increase the sales for more Healthcare prodcuts that have been present in the e-commerce market from a lot of time.