Aboujaoude Elias, Gega Lina
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
Mental Health and Addiction Research Group, Department of Health Sciences & Hull York Medical School, University of York, York, United Kingdom.
Front Psychiatry. 2020 Jan 21;10:1017. doi: 10.3389/fpsyt.2019.01017. eCollection 2019.
Scientific literature from the last two decades indicates that, when it comes to mental health, technology is presented either as panacea or anathema. This is partly because researchers, too frequently, have planted themselves either in the field of digital mental health interventions (variably called "telepsychiatry", "digital therapeutics", "computerized therapy", etc.), or in that of the problems arising from technology, with little cross-fertilization between the two. Yet, a closer look at the two fields reveals unifying themes that underpin both the advantages and dangers of technology in mental health. This article discusses five such themes. First, the breakneck pace of technology evolution keeps digital mental health interventions updated and creates more potentially problematic activities, leaving researchers perennially behind, so new technologies become outdated by the time they are studied. Second, the freedom of creating and using technologies in a regulatory vacuum has led to proliferation and choice, but also to a Wild-West online environment. Third, technology is an open window to access information, but also to compromise privacy, with serious implications for online psychology and digital mental health interventions. Fourth, weak bonds characterize online interactions, including those between therapists and patients, contributing to high attrition from digital interventions. Finally, economic analyses of technology-enabled care may show good value for money, but often fail to capture the true costs of technology, a fact that is mirrored in other online activities. The article ends with a call for collaborations between two interrelated fields that have been-till now-mutually insular.
过去二十年的科学文献表明，在心理健康方面，技术要么被视为万灵药，要么被视为祸根。部分原因在于，研究人员常常要么投身于数字心理健康干预领域（有各种不同的叫法，如“远程精神病学”“数字疗法”“计算机化疗法”等），要么专注于技术引发的问题领域，这两个领域之间几乎没有交叉融合。然而，仔细审视这两个领域会发现一些统一的主题，这些主题支撑着技术在心理健康领域的优势和风险。本文讨论了五个这样的主题。首先，技术的飞速发展使数字心理健康干预不断更新，同时也催生了更多潜在问题活动，让研究人员始终难以跟上步伐，以至于新技术在被研究时就已过时。其次，在监管缺失的情况下创造和使用技术的自由导致了技术的泛滥和选择的增多，但也造就了一个类似西部荒野的网络环境。第三，技术是一扇获取信息的开放窗口，但同时也会危及隐私，这对在线心理学和数字心理健康干预有着严重影响。第四，在线互动，包括治疗师与患者之间的互动，其纽带较为薄弱，导致数字干预的脱落率很高。最后，对技术支持的护理进行的经济分析可能显示出良好的性价比，但往往未能涵盖技术的真实成本，这一事实在其他在线活动中也有所体现。文章最后呼吁两个至今相互隔绝的相关领域开展合作。
