Juan F. Samaniego
From a virtual reality chatbot to a telemedicine platform for rural populations, technology can help prevent and improve mental health issues
Experts from the SDG3 cluster on health and wellbeing analyse the rise of mental health problems and the contribution made by eHealth to addressing them.
The World Health Organization (WHO) announced the end of the COVID-19 pandemic on 23 May 2023. However, the challenges created by the health emergency, such as the increase in mental health problems, remain as demanding as ever. Given the difficulties that healthcare systems have in responding to the increased demand for mental health services, experts emphasize the importance of establishing preventive measures and improving access to care - areas in which eHealth can be very useful.
In order to study this issue and the challenges involved in greater depth, the SDG3 cluster on health and wellbeing of the International Association of Universities, promoted by the eHealth Center at the Universitat Oberta de Catalunya (UOC), organized the webinar entitled The Mental Health Crisis: building resilience in a changing world, which took place on 16 November. The event was chaired by Marta Aymerich, director of the eHealth Center, and the participants included Hilligje van't Land, Secretary General of the International Association of Universities.
"We're very happy and pleased to have launched the Sustainable Development Goals global cluster in 2018. And the SDG3 cluster on health and wellbeing led by the UOC is very active, and is doing extraordinary work to address the key issues that have emerged since the appearance of COVID-19 in our lives", said Hilligje van't Land at the opening of the webinar.
Other experts and members of the institutions that make up the SDG3 cluster on health and wellbeing participating in the online event were Carlos Contreras, researcher and member of the Department of Sociology of the Universidad Autónoma Metropolitana of Mexico, Diana Setiyawati, director of the Centre for Public Mental Health and leader of the Mental Health working group of the Universitas Gadjah Mada in Indonesia, Óscar Mauricio Castaño Ramírez, psychiatrist in the Department of Mental Health and Human Behaviour of the Universidad de Caldas in Colombia, Sofía Seinfeld, researcher and member of the Faculty of Psychology and Education Sciences at the UOC, and Tania Perich, researcher and member of teaching staff at the School of Psychology at Western Sydney University in Australia.
These are the five main key factors that they set out in their presentations on mental health and eHealth, which are important lessons for strengthening resilience and adaptive capacity at the individual, family and community levels and for improving care for psychological and emotional well-being:
1. The importance of finding the right tool
At the height of the pandemic, the Centre for Public Mental Health (CPMH) at Universitas Gadjah Mada in Indonesia noticed a sharp increase in stress and anxiety levels among a significant proportion of its students. They creat ed a telephone hotline to address this issue, but levels of use were very low. As a result, they then decided to adopt a new approach, and began providing care via an Instagram chat. The response from the students was very positive, highlighting the importance of finding the right digital tool for each context and community.
"After that, we decided to try something that would generate even more engagement, and the students suggested creating a chatbot based on artificial intelligence", explained Diana Setiyawati, the director of the CPMH. "The idea is to provide an automated care service that will help us identify mental health problems quickly and provide initial support. We're continuing to develop it, and we're currently trying to integrate it into the university system".
2. Universities, social media and building resilience
Mexico City is an unequal megacity, in which 50% of the population lives below the poverty line and most of the wealth is concentrated in a small percentage. However, the pandemic proved that health problems are not a matter of being rich or poor. They are cross-cutting, and building resilience requires everyone's cooperation. Mexican universities played a central role in this situation, acting as a meeting point and providing mental health services for both patient care and professional training.
"At the Universidad Autónoma Metropolitana we launched a programme to study how social media can help strengthen this resilience to an even greater extent", said Carlos Contreras, a researcher and member of the Department of Sociology at the Mexican university. "Increasing community resilience helps us reduce the prevalence of anxiety and depression. To do this, we need to have models that understand that resilience is a process, and we need profiles with influence over the community, and over the youngest members in particular, to get involved".
3. eHealth for increasing access to mental health care
After decades of armed conflict, Colombia is one of the Latin American countries with the highest incidence of mental health disorders. According to the country's Ministry of Health and Social Welfare, almost one in two minors has a psychological problem, with post-traumatic stress disorder, anxiety and depression being the most prevalent. The population living in isolated rural areas, where infrastructure is limited, are particularly prone to these disorders. The COVID-19 pandemic simply made the situation more difficult.
"The use of mental health services increased by 30% in the wake of the pandemic. Rates of depression and suicide attempts are worse now than before COVID-19. In an attempt to improve these conditions, at the Universidad de Caldas we're implementing some eHealth alternatives to increase access to mental health care", said Óscar Mauricio Castaño, a psychiatrist in the Department of Mental Health at this university. The initiatives being developed include telemedicine services in rural areas, mobile applications to assess individuals' moods, and treatment services for young people with problematic substance use based on mindfulness, and acceptance and commitment therapies.
4. Challenges in sustaining the use of digital tools over time
"We know that young people experience high levels of stress, anxiety and depression. In Australia, the government has allocated significant funding to the development of apps and online platforms to improve access to mental health services for young people. However, our research tells us that the levels of use of these tools are much lower than one might expect", explained Tania Perich, a researcher and senior lecturer in the School of Psychology at Western Sydney University.
According to the researcher, a majority of young people try out the apps and online platforms (and clearly prefer meditation apps), but few of them continue to use these services in the long term. "Apart from data on use and measurements, what we have to consider is that many young people aren't getting the care and treatment they need, either face-to-face or online", added Tania Perich.
5. Virtual reality and AI: the role of emerging technologies
Trends in eHealth are largely driven by the development of technology. And there are two emerging factors in digital health that are increasingly important: virtual reality and artificial intelligence. "We've known that virtual reality is a powerful therapeutic tool for some time. It lets people experience a very strong sense of presence, or in other words it allows them to feel that they really are in the virtual environment, and provides experiences that are difficult to create in the real world", said Sofia Seinfeld, a member of the UOC's Faculty of Psychology and Education Sciences.
Among other use cases, Seinfeld has worked on how virtual reality can be applied to rehabilitation therapies with people who have abused their partner or a child, and to study ways to lower levels of racism. Likewise, there is now emerging research on the development of automated therapists, in combination with artificial intelligence tools, that could support mental health care services and help meet the current high levels of demand.
Apart from the importance of technologies, the role of eHealth in improving mental health care and the new challenges presented by digital health, all the participants in the webinar The Mental Health Crisis: building resilience in a changing world agreed on another issue: more research and collaboration between institutions and universities are needed to find answers to the challenges of the present and the future.
"Today we've witnessed how the merging of different technologies and perspectives can be very important for building resilience in a changing world", concluded Marta Aymerich, director of the eHealth Center. "The great transformative potential of digital solutions in mental health lies in transcending geographic barriers. Let's take the debate beyond screens, and continue to foster collaborative efforts that prioritize inclusion. The challenges are universal, and cooperation is our greatest strength."