Health and care services

Digital interventions: eMental health in Ireland

As Ireland continues to invest in the emerging field of eMental health, eolas magazine assesses the findings of the ‘eMental Health: State-of-the-art & Opportunities for Ireland’ report.

A report recently published following joint funding from Mental Health Reform and the Health Service Executive (HSE) offers itself as one of the country’s first resources on eMental health applications currently on offer to service users. The report employs a broad definition of eMental health, which describes the concept as ‘technology-supported provision of mental health services and supports’ and includes a variety of applications including telecommunications; online and computer-based programmes, mobile apps, virtual and augmented reality, gaming, social media and data analytics.

Fresh applications

Indeed, the applications for eMental health digital technology are broad, as outlined in the report: more enhanced provisions are envisaged in mobile technology, with instant messaging, live chat and telephone support highlighted as essential elements of the service. For those with the greatest need, much emphasis has been placed upon the provision of online counselling and tele-psychiatry. However, the report issues an imperative warning: “eMental Health is not a panacea”. The technology, whilst in its early stages, offers no replacement to talking and therapeutic treatments – a key limitation highlighted in the report.

The report recommends that traditional service models evolve and adapt to the “major societal trends associated with the pervasiveness of the internet, smart-phones and other technologies”. A core element of this includes telepsychiatry applications which allow for improved access to specialists in primary care settings and emergency departments, as well as telepsychology and counselling arrangements which would enable remote client-practitioner therapy sessions – an offering referred to in the report as “eTherapy”.

The employment of mobile and gaming applications has been emphasised in the report as a key factor in how the Irish State may adapt the direct provision of mental health services to an increasingly youthful and technologically-aware demographic. Beyond demographic suitability, the use of such applications has also been highlighted as particularly useful as proactive tools which support ongoing care management and self-management for patients suffering from multiple, and in some cases long-term and severe mental health conditions. Gaming applications and virtual reality technology are similarly highlighted as a support treatment provision for young people.

A new intervention

Notably, virtual and augmented technology are proposed as innovative treatments for phobias and other conditions.  Whilst online platforms offer no face-to-face treatment options, they are nonetheless outlined in the report as providing key repositories of mental health information and psycho-education modules, as well as support from similarly-affected peers on group-based applications.

Ensuring choice for the service-user has been highlighted as a key element behind the promotion of eMental health. Statements in the publication welcome further research into eMental health within a specifically Irish context, given the report’s general reliance on international research. Further statements recommend a measured perspective on the technology, with “circumspection about the hype that can surround technological innovations and about overly simplistic claims of dramatic cost efficiencies”.

Whilst addressing the applications and limitations of digital technology in mental health service provision, the report also suggests the “most useful next steps” in establishing eMental health in Ireland. These action lines include stakeholder engagement and consultation, quality assurance, guidance for users and practitioners, implementation pilots, innovation support and further research into eMental health.

The report concludes with a call to wider society to embrace mental health research in Ireland, including into the efficacy and effectiveness evaluation of eMental health offerings, translational and implementation research on putting useful innovations into practice, eMental health user experience research, and wider population research on utilisation patterns and their implications.

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