Kohl Simon H, Henn Alina T, Fendel Johannes C, Luttermann Alfred, van Noort Betteke Maria, Konrad Kerstin
Klinische Neuropsychologie des Kindes- und Jugendalters, Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universitätsklinik RWTH Aachen, Deutschland.
JARA Institute Molecular Neuroscience and Neuroimaging (INM-11), Forschungszentrum Jülich, Deutschland.
Z Kinder Jugendpsychiatr Psychother. 2024 Sep;52(5):291-313. doi: 10.1024/1422-4917/a000989. Epub 2024 Aug 23.
Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany With the Digital Healthcare Act, Germany has taken a decisive step toward promoting high-quality, evidence-based digital health applications (DiHAs). Presently, there is a significant gap in the provision of mental health services throughout Germany, particularly regarding children and adolescents and especially in the aftermath of the COVID-19 pandemic. DiHAs as low-threshold, location- and time-independent additional mental health services - may offer a way to address this situation. Particularly in the emerging generation of digital natives, there is a high demand for digital mental health services. However, despite the rapidly growing supply of DiHAs for adults, there is a lack of approved DiHAs for children and adolescents with mental disorders. Rather, the demand for care is left to the unregulated market of diverse internet- and mobile-based interventions; early studies have questioned the evidence base, safety, and quality. This discrepancy arises from various specific challenges and risks that reduce incentives to develop DiHAs for this particularly vulnerable target group, including (1) limited evidence, (2) high complexity in study execution, (3) high complexity in the development of applications, (4) poorly researched specific risks, and (5) high regulatory requirements. This article discusses these challenges and risks and outlines the perspectives for a high-quality, safe, and evidence-based digital mental healthcare for children and adolescents.
希望的数字灯塔?德国针对患有精神障碍的儿童和青少年的数字健康应用的挑战与潜力 通过《数字医疗法案》,德国朝着推广高质量、循证数字健康应用(DiHAs)迈出了决定性的一步。目前,德国全国心理健康服务的提供存在显著差距,尤其是针对儿童和青少年,在新冠疫情之后尤为明显。DiHAs作为低门槛、不受地点和时间限制的额外心理健康服务,可能为解决这一状况提供一条途径。特别是在新兴的数字原生代中,对数字心理健康服务有很高的需求。然而,尽管针对成年人的DiHAs供应迅速增长,但针对患有精神障碍的儿童和青少年却缺乏经批准的DiHAs。相反,护理需求被留给了不受监管的各种基于互联网和移动设备的干预措施的市场;早期研究对这些措施的证据基础、安全性和质量提出了质疑。这种差异源于各种特定的挑战和风险,这些挑战和风险降低了为这个特别脆弱的目标群体开发DiHAs的积极性,包括(1)证据有限,(2)研究执行的高度复杂性,(3)应用开发的高度复杂性,(4)研究不足的特定风险,以及(5)高监管要求。本文讨论了这些挑战和风险,并概述了为儿童和青少年提供高质量、安全且循证的数字心理护理的前景。