CyberSightings

In the Spotlight

With the rapid adoption of mobile technologies and the proliferation of smartphones, new opportunities are emerging for the delivery of mental health services. Indeed, psychologists are starting to realize this potential. A recent survey (Luxton et al. mHealth for mental health: integrating smartphone technology in behavioral healthcare. Professional Psychology: Research & Practice 2011; 42:505–12) identified more than 200 smartphone apps focused on behavioral health, covering a wide range of disorders, including developmental disorders, cognitive disorders, substance-related disorders, as well as psychotic and mood disorders. These applications are used in behavioral health for several purposes, the most common of which are health education, assessment, homework, and monitoring progress of treatment.

For example, T2 MoodTracker (http://t2health.org/apps/t2-mood-tracker/) is an application that allows users to self-monitor, track, and reference their emotional experience over a period of days, weeks, and months using a visual analog rating scale. Using this application, patients can self-monitor emotional experiences associated with common deployment-related behavioral health issues like posttraumatic stress, brain injury, life stress, depression, and anxiety. Self-monitoring results can be used as a self-help tool or they can be shared with a therapist or healthcare professional, providing a record of the patient's emotional experience over a selected time frame.

Measuring objective correlatives of subjectively reported emotional states is an important concern in research and clinical applications. Physiological and physical activity information provide mental health professionals with integrative measures, which can be used to improve understanding of patients' self-reported feelings and emotions. The combined use of wearable biosensors and smartphones offers the opportunity to collect, elaborate, and transmit real time body signals to the remote therapist. This approach is also useful for allowing patients to collect real time information related to their health conditions and to identify specific trends. Insights gained by means of this feedback can empower patients to self-engage and manage their own health status, minimizing any interaction with other healthcare actors. One such tool is MyExperience, an open source mobile platform that allows the combination of sensing and self-report to collect both quantitative and qualitative data on user experience and activity (http://myexperience.sourceforge.net/). Other applications are designed to empower users with information for making better decisions, preventing life-style-related conditions, and preserving/enhancing cognitive performance. For example, BeWell (www.bewellmobile.com/) monitors different user activities (sleep, physical activity, social interaction) and provides feedback to promote healthier life-style decisions.

Besides applications for mental health and well-being, smartphones are being increasingly used in psychological research. The potential of this approach has been recently discussed by Geoffrey Miller in a review entitled “The smartphone psychology manifesto” (Perspectives on Psychological Science 2012; 7:221–37). According to Miller, smartphones can be effectively used to collect large quantities of ecologically valid data in an easier and quicker way than other available research methodologies. Since the smartphone is becoming one of the most pervasive devices in our lives, it provides access to domains of behavioral data not previously available without either constant observation or reliance on self-reports only.

Although the use of smartphones could have a significant impact on both psychological research and practice, there is still limited evidence of their effectiveness. As for other mHealth applications, few controlled trials have tested the potential of mobile technology interventions in improving mental healthcare delivery processes. Therefore, further research is needed in order to determine the real cost-effectiveness of this approach.

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