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在英国实施数字心理健康评估工具的机遇:探索性调查研究

Opportunities for the Implementation of a Digital Mental Health Assessment Tool in the United Kingdom: Exploratory Survey Study.

作者信息

Spadaro Benedetta, Martin-Key Nayra A, Funnell Erin, Benáček Jiří, Bahn Sabine

机构信息

Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering, University of Cambridge, Cambridge, United Kingdom.

Psyomics Ltd, Cambridge, United Kingdom.

出版信息

JMIR Form Res. 2023 Aug 7;7:e43271. doi: 10.2196/43271.

Abstract

BACKGROUND

Every year, one-fourth of the people in the United Kingdom experience diagnosable mental health concerns, yet only a proportion receive a timely diagnosis and treatment. With novel developments in digital technologies, the potential to increase access to mental health assessments and triage is promising.

OBJECTIVE

This study aimed to investigate the current state of mental health provision in the United Kingdom and understand the utility of, and interest in, digital mental health technologies.

METHODS

A web-based survey was generated using Qualtrics XM. Participants were recruited via social media. Data were explored using descriptive statistics.

RESULTS

The majority of the respondents (555/618, 89.8%) had discussed their mental health with a general practitioner. More than three-fourths (503/618, 81.4%) of the respondents had been diagnosed with a mental health disorder, with the most common diagnoses being depression and generalized anxiety disorder. Diagnostic waiting times from first contact with a health care professional varied by diagnosis. Neurodevelopmental disorders (30/56, 54%), bipolar disorder (25/52, 48%), and personality disorders (48/101, 47.5%) had the longest waiting times, with almost half (103/209, 49.3%) of these diagnoses taking >6 months. Participants stated that waiting times resulted in symptoms worsening (262/353, 74.2%), lower quality of life (166/353, 47%), and the necessity to seek emergency care (109/353, 30.9%). Of the 618 participants, 386 (62.5%) stated that they felt that their mental health symptoms were not always taken seriously by their health care provider and 297 (48.1%) were not given any psychoeducational information. The majority of the respondents (416/595, 77.5%) did not have the chance to discuss mental health support and treatment options. Critically, 16.1% (96/595) did not find any treatment or support provided at all helpful, with 63% (48/76) having discontinued treatment with no effective alternatives. Furthermore, 88.3% (545/617) of the respondents) had sought help on the web regarding mental health symptoms, and 44.4% (272/612) had used a web application or smartphone app for their mental health. Psychoeducation (364/596, 61.1%), referral to a health care professional (332/596, 55.7%), and symptom monitoring (314/596, 52.7%) were the most desired app features. Only 6.8% (40/590) of the participants said that they would not be interested in using a mental health assessment app. Respondents were the most interested to receive an overall severity score of their mental health symptoms (441/546, 80.8%) and an indication of whether they should seek mental health support (454/546, 83.2%).

CONCLUSIONS

Key gaps in current UK mental health care provision are highlighted. Assessment and treatment waiting times together with a lack of information regarding symptoms and treatment options translated into poor care experiences. The participants' responses provide proof-of-concept support for the development of a digital mental health assessment app and valuable recommendations regarding desirable app features.

摘要

背景

在英国,每年有四分之一的人经历可诊断的心理健康问题,但只有一部分人能得到及时诊断和治疗。随着数字技术的新发展,增加心理健康评估和分诊机会的潜力很大。

目的

本研究旨在调查英国心理健康服务的现状,并了解数字心理健康技术的效用和人们对其的兴趣。

方法

使用Qualtrics XM生成基于网络的调查问卷。通过社交媒体招募参与者。使用描述性统计方法对数据进行探索。

结果

大多数受访者(555/618,89.8%)曾与全科医生讨论过他们的心理健康问题。超过四分之三(503/618,81.4%)的受访者被诊断患有心理健康障碍,最常见的诊断是抑郁症和广泛性焦虑症。从首次与医疗保健专业人员接触到确诊的等待时间因诊断而异。神经发育障碍(30/56,54%)、双相情感障碍(25/52,48%)和人格障碍(48/101,47.5%)的等待时间最长,这些诊断中近一半(103/209,49.3%)需要超过6个月。参与者表示,等待时间导致症状恶化(262/353,74.2%)、生活质量下降(166/353,47%)以及需要寻求紧急护理(109/353,30.9%)。在618名参与者中,386名(62.5%)表示他们觉得医疗保健提供者并非总是认真对待他们的心理健康症状,297名(48.1%)未得到任何心理教育信息。大多数受访者(416/595,77.5%)没有机会讨论心理健康支持和治疗选择。至关重要的是,16.1%(96/595)的人认为所提供的任何治疗或支持都毫无帮助,其中63%(48/76)在没有有效替代方案的情况下停止了治疗。此外,88.3%(545/617)的受访者曾在网上寻求有关心理健康症状的帮助,44.4%(272/612)曾使用网络应用程序或智能手机应用程序来管理他们的心理健康。心理教育(364/596,61.1%)、转介给医疗保健专业人员(332/596,55.7%)和症状监测(314/596,52.7%)是最期望的应用程序功能。只有6.8%(40/590)的参与者表示他们对使用心理健康评估应用程序不感兴趣。受访者最希望获得心理健康症状的总体严重程度评分(441/546,80.8%)以及是否应该寻求心理健康支持的指示(454/546,83.2%)。

结论

突出了当前英国心理健康服务中的关键差距。评估和治疗等待时间以及缺乏关于症状和治疗选择的信息导致护理体验不佳。参与者的回答为数字心理健康评估应用程序的开发提供了概念验证支持,并就理想的应用程序功能提出了有价值的建议。

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