This week I read an emotive article in the Guardian, about the demonstrated benefits of Electro Convulsive Therapy written by the brother of a patient suffering with severe depression.
In this article the author, Andrew Mayers, talked about the lack of response to prescribed pharmaceuticals and the four years of respite gained following a course of ECT. In this article he discussed the controversial nature of this treatment and himself made references to the medieval portrayal of it in the media.
This started me thinking about the treatment of mental health conditions and patients other options if the ‘traditional’ pharmaceutical methods simply do not work. There is a wide range of conditions and different levels of severity and as Andrew highlighted – one option does not suit all.
I began to research the digital approach and how they technology most of us already have in our homes and offices are being used.
Mobile phone applications seem to be making increased inroads into this arena as a way of measuring social interactions, improving communication between the doctor and patient but also as a tool to communicate changes in physiology that may indicate a change in emotional state. These include changes in brain activity, increased hormone presence in blood but also minor changes such as intonation and inflection in speech pattern and muscle tension. Monitoring these real time changes will allow interaction from the healthcare professional or even by the patient in the manner of employing coping strategies before the situation escalates.
Virtual reality has also been shown to have positive outcomes in the treatment of Post-Traumatic Stress Disorder (PTSD) and phobias. The sufferer is exposed to the ‘trigger’ in a safe environment and through ongoing treatment it stops the onset of anxiety.
Many studies have focused on the treatment of adolescents and perhaps unsurprisingly, digital interventions are showing a benefit and games are being used as a form of e-therapy. One game called SPARX (Smart Positive Active Realistic X-Factor thoughts), released in New Zealand, allows young people to resolve issues and problem solve as part of a 3D fantasy game and during a test in 2012 showed more positive outcomes than those offered counselling during the same time period. This approach offers adolescents to access therapy in a way which is fun but also allows anonymity from others in the game. The option of digital communication also proves beneficial to establishing better rapport between patient and doctor within the same age group.
Interestingly this approach has also lead to further diagnostic measures. One study, which was using wearable detectors to measure physiological changes, noted a common thread in the gait analysis results of those with schizophrenia. This highlighted the need for future research into gait analysis and biomechanics.
So with all these benefits why are these alternatives not offered so readily?
There is obviously a cost implication to taking this digital approach through clinical trials and the lack of clinical data is a precursor to money being spent. Other problems include the onus on the patient to continue to wear the devices so data can be collect and analysed. Also the transfer of data to the healthcare professional via electronic methods opens up concerns and problems with regards to the privacy and security of the patient’s data.
Mental health has been under an increased spotlight recently with the coverage of campaigns from the British Red Cross - #tacklingloneliness and Heads Together being championed by the Duke and Duchess of Cambridge and the Prince of Wales. Given that mental health care is the largest item on the NHS budget I am sure that the time will come were the ‘traditional’ diagnosis, treatment and monitoring of patients with mental health problems will be very much in the digital age.
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Julie has written numerous interesting and well researched blogs on a wide range of topics related to Medical Devices and Human Factors. Please click here to read more of Julie's blogs and here to find out more about Julie.