Mental health care and technology
IT’S ESTIMATED that at least 25 per cent of Jamaicans have mental illness. Still, we hear that many disorders such as anxiety and depression go undiagnosed, and so when we think about, much more of our population could be experiencing some form of mental illness at points in their life. The Ministry of Health has been moving towards more of a community mental-health approach, allowing patients to be reintegrated into their community after treatment rather than being kept at specialised facilities indefinitely.
There are several problems that we face with respect to community mental health: the high levels of violence in some communities prevent healthcare workers from carrying out such functions safely and many times result in closure of clinics.
Patients are sometimes dangerous and carry weapons, as we experienced with the recent maiming of the police officer in Christiana, Manchester. There have in the past been reports of workers being injured while trying to provide support to a patient and often the services of the police have to be requested as escorts.
Another major issue is the absence of consistent and accessible support to patients, families and community members. This is not to say that workers are not available on call; however, when it is not quite at emergency level, there should be some means of quick and useful intervention. Coupled with this is the need for proper education and information regarding mental health.
People will always fear what they do not understand and oftentimes this is the case with someone with mental-health problems. We stand off to the side because we fear the unpredictable behaviour. A lack of understanding often also leads to stigma and discrimination, which impedes the recovery and wellbeing of persons and sometimes even their families. Another issue is simply the scarcity of trained mental-health workers to deal with the current demand and to provide even basic mental health care.
INTEGRATING TECHNOLOGY
Technology can be integrated into the already existing methods of intervention, support and treatment of mental-health issues to alleviate some of these problems. Tele-health, mobile technology and remote care management tools can be useful in offering care and support.
Our present technology allows for remote access to health workers in a searchable and geographically retrievable format. So, if a person is searching for a psychiatrist close to where they live, for example, the system allows them to do so.
Through telemedicine, patients can access a medical professional through videoconferencing and also text messaging. This is a way to effectively make use of the limited human resources we have in this area as geographic location is no longer an issue for care and intervention. Our telemedicine system allows for the complete experience, including payment and follow-up with the possibility of the encounter being added to a patient’s electronic medical records. Telehealth can significantly improve access, overcome some of the issues of worker safety and has the ability to provide electronic prescriptions.
INTERNET-BASED SUPPORT
There are other options for those who need ongoing support. Internet-based support groups are becoming more and more popular and should become a standard feature of any community mentalhealth strategy. Given the present stigma, it can be difficult for persons to open up about mentalhealth issues in an ‘in-person’ setting. Plus, this access can allow for quicker intervention when needed to stave off a more severe problem developing.
Mobile apps can also add convenience to this in addition to provide education information to tackle stigma and discrimination. The mental-health field covers several conditions and illnesses, and a mobile app can allow persons to get information about these in an easily accessible and understood format. The apps also allow access to programmes and regimes to help persons cope, share with others in similar situations and better understand their own.
The data collected through these can help physicians and experts get valuable research information to make further improvement to how we care for and treat persons affected by mental illness.
Delivering care, especially at the community level with limited resources and a growing problem is difficult. Incorporating technology should be an integral part of the solution as it can positively affect mental-health outcomes as it has been doing for physical ailments.