Lal Shalini, Siafa Lyna, Lee Hajin, Adair Carol E
School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.
Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, QC, Canada.
J Med Internet Res. 2021 May 5;23(5):e25547. doi: 10.2196/25547.
The use of information and communication technologies (ICTs) to deliver mental health and addictions (MHA) services is a global priority, especially considering the urgent shift towards virtual delivery of care in response to the COVID-19 pandemic. It is important to monitor the evolving role of technology in MHA services. Given that MHA policy documents represent the highest level of priorities for a government's vision and strategy for mental health care, one starting point is to measure the frequency with which technology is mentioned and the terms used to describe its use in MHA policy documents (before, during, and after COVID-19). Yet, to our knowledge, no such review of the extent to which ICTs are referred to in Canadian MHA policy documents exists to date.
The objective of this systematic policy review was to examine the extent to which technology is addressed in Canadian government-based MHA policy documents prior to the COVID-19 pandemic to establish a baseline for documenting change.
We reviewed 22 government-based MHA policy documents, published between 2011 and 2019 by 13 Canadian provinces and territories. We conducted content analysis to synthesize the policy priorities addressed in these documents into key themes, and then systematically searched for and tabulated the use of 39 technology-related keywords (in English and French) to describe and compare jurisdictions.
Technology was addressed in every document, however, to a varying degree. Of the 39 searched keywords, we identified 22 categories of keywords pertaining to the use of technology to deliver MHA services and information. The 6 most common categories were tele (n=16/22), phone (n=12/22), tech (n=11/22), online (n=10/22), line (n=10/22), and web (n=10/22), with n being the number of policy documents in which the category was mentioned out of 22 documents. The use of terms referring to advanced technologies, such as virtual (n=6/22) and app (n= 4/22), were less frequent. Additionally, policy documents from some provinces and territories (eg, Alberta and Newfoundland and Labrador) mentioned a diverse range of ICTs, whereas others described only 1 form of ICT.
This review indicates that technology has been given limited strategic attention in Canadian MHA policy. Policy makers may have limited knowledge on the evidence and potential of using technology in this field, highlighting the value for knowledge translation and collaborative initiatives among policy makers and researchers. The development of a pan-Canadian framework for action addressing the integration and coordination of technology in mental health services can also guide initiatives in this field. Our findings provide a prepandemic baseline and replicable methods to monitor how the use of technology-supported services and innovations emerge relative to other priorities in MHA policy during and after the COVID-19 pandemic.
利用信息通信技术（ICT）提供心理健康与成瘾（MHA）服务是一项全球优先事项，尤其是考虑到为应对新冠疫情而迫切转向虚拟护理服务。监测技术在MHA服务中不断演变的作用非常重要。鉴于MHA政策文件代表了政府心理健康护理愿景和战略的最高优先事项，一个出发点是衡量技术在MHA政策文件（新冠疫情之前、期间和之后）中被提及的频率以及用于描述其使用的术语。然而，据我们所知，迄今为止尚无对加拿大MHA政策文件中提及ICT程度的此类审查。
本系统政策审查的目的是研究在新冠疫情大流行之前，加拿大政府发布的MHA政策文件中涉及技术的程度，以建立记录变化的基线。
我们审查了加拿大13个省和地区在2011年至2019年期间发布的22份政府MHA政策文件。我们进行了内容分析，将这些文件中涉及的政策优先事项综合为关键主题，然后系统地搜索并列出39个与技术相关的关键词（英语和法语）的使用情况，以描述和比较不同司法管辖区。
每份文件都涉及了技术，但程度各不相同。在搜索的39个关键词中，我们确定了22类与使用技术提供MHA服务和信息相关的关键词。最常见的6类是远程（n = 16/22）、电话（n = 12/22）、技术（n = 11/22）、在线（n = 10/22）、线路（n = 10/22）和网络（n = 10/22），其中n是在22份文件中提及该类别的政策文件数量。提及先进技术的术语，如虚拟（n = 6/22）和应用程序（n = 4/22），使用频率较低。此外，一些省和地区（如艾伯塔省、纽芬兰和拉布拉多省）的政策文件提到了多种ICT，而其他一些文件只描述了一种ICT形式。
本审查表明，在加拿大MHA政策中，技术受到的战略关注有限。政策制定者在该领域使用技术的证据和潜力方面可能知识有限，这凸显了知识转化以及政策制定者与研究人员之间合作倡议的价值。制定一个泛加拿大行动框架，以解决技术在心理健康服务中的整合与协调问题，也可以指导该领域的倡议。我们的研究结果提供了一个疫情前的基线和可复制的方法，以监测在新冠疫情期间及之后，相对于MHA政策中的其他优先事项，技术支持服务和创新的使用情况如何出现。
