Wies Blanche, Landers Constantin, Ienca Marcello
Department of Health Sciences and Technology, ETH Zurich (Swiss Federal Institut of Technology), Zurich, Switzerland.
Front Digit Health. 2021 Sep 6;3:697072. doi: 10.3389/fdgth.2021.697072. eCollection 2021.
Mental health disorders are complex disorders of the nervous system characterized by a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Mental illness is of particular concern for younger people. The WHO estimates that around 20% of the world's children and adolescents have a mental health condition, a rate that is almost double compared to the general population. One approach toward mitigating the medical and socio-economic effects of mental health disorders is leveraging the power of digital health technology to deploy assistive, preventative, and therapeutic solutions for people in need. We define "digital mental health" as any application of digital health technology for mental health assessment, support, prevention, and treatment. However, there is only limited evidence that digital mental health tools can be successfully implemented in clinical settings. Authors have pointed to a lack of technical and medical standards for digital mental health apps, personalized neurotechnology, and assistive cognitive technology as a possible cause of suboptimal adoption and implementation in the clinical setting. Further, ethical concerns have been raised related to insufficient effectiveness, lack of adequate clinical validation, and user-centered design as well as data privacy vulnerabilities of current digital mental health products. The aim of this paper is to report on a scoping review we conducted to capture and synthesize the growing literature on the promises and ethical challenges of digital mental health for young people aged 0-25. This review seeks to survey the scope and focus of the relevant literature, identify major benefits and opportunities of ethical significance (e.g., reducing suffering and improving well-being), and provide a comprehensive mapping of the emerging ethical challenges. Our findings provide a comprehensive synthesis of the current literature and offer a detailed informative basis for any stakeholder involved in the development, deployment, and management of ethically-aligned digital mental health solutions for young people.
心理健康障碍是复杂的神经系统疾病，其特征是行为或心理模式导致严重痛苦或个人功能受损。精神疾病对年轻人尤为令人担忧。世界卫生组织估计，全球约20%的儿童和青少年患有心理健康问题，这一比例几乎是普通人群的两倍。减轻心理健康障碍的医学和社会经济影响的一种方法是利用数字健康技术的力量，为有需要的人部署辅助、预防和治疗解决方案。我们将“数字心理健康”定义为数字健康技术在心理健康评估、支持、预防和治疗方面的任何应用。然而，只有有限的证据表明数字心理健康工具能够在临床环境中成功实施。作者指出，数字心理健康应用程序、个性化神经技术和辅助认知技术缺乏技术和医学标准，可能是其在临床环境中采用和实施不理想的原因。此外，人们还对当前数字心理健康产品的有效性不足、缺乏充分的临床验证、以用户为中心的设计以及数据隐私漏洞等问题提出了伦理担忧。本文的目的是报告我们进行的一项范围审查，以收集和综合关于数字心理健康对0至25岁年轻人的前景和伦理挑战的不断增长的文献。这项审查旨在调查相关文献的范围和重点，确定具有伦理意义的主要益处和机会（例如，减轻痛苦和改善幸福感），并全面梳理新出现的伦理挑战。我们的研究结果对当前文献进行了全面综合，为参与为年轻人开发、部署和管理符合伦理的数字心理健康解决方案的任何利益相关者提供了详细的信息基础。
