Mobile Mental Health for Depression Assistance: Research Directions, Obstacles, Advantages, and Disadvantages of Implementing mHealth

Mobile Mental Health for Depression Assistance: Research Directions, Obstacles, Advantages, and Disadvantages of Implementing mHealth

Jorge Magalhães Rodrigues, Frédéric Oliveira, Carolina Porto Ribeiro, Regina Camargo Santos
Copyright: © 2022 |Pages: 20
DOI: 10.4018/978-1-7998-8634-1.ch002
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Depression is a prevalent and severe medical illness that negatively affects how people feel, think, and act, with estimates pointing towards more than 300 million suffering from depression worldwide. Although effective treatments exist, about 80% of people in low and middle-income countries do not receive therapy. Therefore, technology has become a promising tool to assist in reducing disparities. This study aims to identify and map the available evidence on mobile health applied to depression and clarify key concepts. The authors analyzed clinical trials developed over the last five years. EBSCO and PubMed were searched, and a total of 14 conducted RCTs were selected and reviewed. Despite some limitations regarding dropout rates and several ethical and safety concerns, the mobile mental health future seems promising.
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The adaptation of the human being to the frantic pace of society involves an enormous physical, mental, and social struggle. The strategies to overcome these challenges of modern society are usually insufficient. According to the World Health Organization (2008, 2017a), more than 50% of the population of middle and high-income countries will suffer from at least one mental disorder at some point in their lives. Since it does not target only a small group of individuals, but crosses every social boundary and degree, mental illness must be understood as a public health issue with dire consequences for society.

Mainly, depression is one of the most common results of everyday society's stress. It affects people in different ways and can cause a wide variety of symptoms. Generally, it can affect people's thoughts, behavior, motivation, feelings, and sense of well-being.

According to the National Institute of Mental Health (2021), depression is a common but serious mood disorder. The resulting symptoms usually affect one's behavior, mainly meddling with the people's thoughts, feelings, and the ability to handle basic daily activities such as working, eating, and sleeping. Some of these disruptive symptoms usually present themselves as a constant feeling of sadness, a sense of hopelessness, pessimistic thoughts, irritability, and several other feelings that usually translate to an overall loss of interest or pleasure in hobbies, activities, and life in general. It can even lead to suicide in some cases.

Even though effective treatments for depression exist, there is still much to learn concerning effective approaches to prevent or treat depression (Cuijpers et al., 2020). For example, the meta-analysis of Levkovitz et al. (2011) concluded that only 54% of adults show improvements after anti-depressive medication, and the meta-analysis of Cuijpers et al. (2014) demonstrated that only 62% of adults show improvement after psychotherapy.

The World Health Organization (2017a) states that depression is the leading cause of disability worldwide, estimated to affect 300 million people. It saw an increase of 18.4% in incidence between 2005 and 2015 (Vos et al., 2016), also establishing itself as the primary contributor to suicide with an approximate rate of 800 000 deaths per year (World Health Organization, 2017a).

Besides personal impact and disability, depression reflects its burden on society as a whole with tremendous expenses to families and national healthcare providers, as well as the loss of productivity (Gangan & Yang, 2018). This growing threat to economic welfare can disrupt healthcare providers and policymakers, and allied with demographic aging can unbalance many countries' economic well-being.

For all these reasons, it is vital to keep an eye out regarding new forms of treatment and especially to be aware of the frontiers that technology has opened. The sense is that mobile mental health can be simple and reach many people.

As a matter of fact, mobile health (mHealth) is an expanding field in the digital health sector, providing healthcare support, delivery, and intervention via mobile technologies such as smartphones and tablets.

Technology is seen as a potential method for recovering health disparities that are typically driven by limited resources and stigma. Innovative solutions for the self-management of mental health issues are beneficial and can be valuable for people who do not have access to the services they need (Bakker et al., 2016). Even when people are aware of their problems and are open to requesting help, support is not always easily accessible, geographically, financially, or socially.

All the possible applications of this technology indicate an opportunity to expand mental health treatment availability and quality. For that reason, the number of mobile health applications for mental health purposes increased at a quick pace in the last few years.

Believing that smartphones have revolutionized our lives, this chapter aims to understand which applications are most used in depression treatment and their potential effectiveness.

Key Terms in this Chapter

Self-Help App: A broad category of apps that aim to improve the users' ability to self-care.

Smartphone: A mobile device with traditional cellphone communicating capabilities such as voice call and short message service (SMS), internet access via wi-fi or mobile data, global positioning system (GPS), and app management accessibility.

Tablet: Usually a larger mobile device with access to the internet via wi-fi, with global positioning system (GPS) and app management accessibility. Some models have access to the mobile network, which grants the device voice call capabilities, short message service (SMS), and internet access via mobile data.

Toolkit App: An app category of mobile applications that usually present several digital tools.

mHealth Passive Data: Data that is usually gathered by an app using the phone's core functions or an external device such as a fitness band or smartwatch to manage or improve health.

Passive Phone Sensors (PPS): Sensors embedded in the mobile device generate data gathered without user involvement.

Mood Track: An app category that aims to gather data from the user about his mood. The app may prompt the user via a notification or not.

Mood Track and Alert (MTA): An extension of the capabilities of the mood track apps which gather data from the user about his mood and alerts the user or mental health provider about specific cases.

MHealth: mHealth (or mobile health) is the access to mobile technology such as smartphones and tablets to provide health solutions typically via applications (apps).

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