Tuesday 13 August 2019

Designing and Using Digital Mental Health Interventions for Older Adults: Being Aware of Digital Inequality

an article by Alexander Seifert (University of Zurich, Switzerland; University of Cologne, Germany) and Dominique Alexandra Reinwand and Anna Schlomann (University of Cologne, Germany) published by Frontiers in Psychiatry

Background

Worldwide, approximately 15% of the people older than 60 suffer from a mental disorder, such as depression and anxiety disorders (1). A total of 322 million people worldwide are affected. The prevalence rates vary by age and peaks in older adults (2). Modern devices, such as smart phones and tablets, can be used to provide digital interventions for various health-related issues.

Digital interventions are promising in their ability to provide researchers, medical practitioners, and patients with a dynamic and individualizable tool for assessing behavior and behavioral change, consultation, treatment, and integrated care. These digital interventions can help patients manage their diseases or their general health as a form of disease prevention. This is particularly important in older people, as individuals often have to deal with highly complex interactions involved in managing their daily lives along with the consequences of a multitude of chronic diseases (3).

Digital interventions can, for example, assess, control, and positively influence mental health and well-being among older patients (4). Particularly with regard to mental health, digital mental health interventions (DMHIs) appear to close a gap in healthcare provision. Many patients with mental health problems have to wait a long time to get an appointment for initial counseling or therapy; in rural areas, older patients may face long travel distances, and many people are still afraid of stigmatization and avoid therapy completely (5). Reviews and meta-analyses have shown the benefits of DMHIs, for example, for people with depression and anxiety (6–8).

While DMHIs are becoming more important and popular, there exists a danger that older people will be excluded. When not comfortable with new technologies, older adults can experience barriers to accessing DMHIs, which might result in larger healthcare inequalities (9). This can happen if only already-advantaged populations use and benefit from these interventions. Therefore, this article will outline and discuss the problems in this field and make recommendations for future developments.

Full text (Downloadable PDF 4pp)


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