Kaiser Permanente Center for Health Research, Portland, OR, USA.
Gen Hosp Psychiatry. 2013 Jul-Aug;35(4):339-44. doi: 10.1016/j.genhosppsych.2013.03.013. Epub 2013 May 20.
A growing number of health information technologies (HIT) are being developed and tested to address mental health conditions. HIT includes Internet and smartphone programs or apps, text messaging protocols and telepsychiatry. We reviewed the promise and evidence that HIT can expand access to mental health care and reduce disparities in use of services across groups in need.
Limited reach of mental health services is a pervasive problem in the United States, and solving it will require innovations that enable us to extend our clinical reach into underserved populations without significantly expanding our workforce. In theory, HIT can extend access to mental health care in several ways: by enhancing the reach to priority populations, addressing system capacity issues, supporting training, improving clinical decision making, lowering the "consumer's threshold" for treatment, delivering preventive mental health services, speeding innovation and adoption and reducing cost barriers to treatment. At present, evidence is limited, and research is needed, focusing on consumer engagement strategies, the benefits and harms of HIT for the therapeutic relationship and the comparative effectiveness of various HIT alternatives.
越来越多的健康信息技术(HIT)正在被开发和测试,以解决心理健康问题。HIT 包括互联网和智能手机程序或应用程序、短信协议和远程精神病学。我们审查了 HIT 可以扩大获得心理健康护理的机会并减少服务使用方面的差距的前景和证据。
心理健康服务的有限覆盖范围是美国普遍存在的问题,要解决这个问题,需要创新,使我们能够在不显著扩大劳动力的情况下,将临床服务范围扩大到服务不足的人群。从理论上讲,HIT 可以通过以下几种方式扩大获得心理健康护理的机会:通过增强对重点人群的覆盖范围,解决系统容量问题,支持培训,改善临床决策,降低治疗的“消费者门槛”,提供预防性心理健康服务,加快创新和采用,降低治疗的成本障碍。目前,证据有限,需要进行研究,重点关注消费者参与策略、HIT 对治疗关系的益处和危害以及各种 HIT 替代方案的比较效果。