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      Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

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          Abstract

          Background

          Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this end, a qualitative analysis of focus group discussions regarding the Mental Health Engagement Network, a web-based personal health record and smartphone intervention, is presented here.

          Methods

          Individuals living in the community with a mood or psychotic disorder ( n = 394) were provided with a smartphone and access to an electronic personal health record, the Lawson SMART Record, for 12 to 18 months to manage their mental health. This study employed a delayed-implementation design and obtained both quantitative and qualitative data through individual interviews and focus group sessions. Participants had the opportunity to participate in voluntary focus group sessions at three points throughout the study to discuss their perceptions of the technologies. Qualitative data from 95 focus group participants were analysed using a thematic analysis.

          Results

          Four overarching themes emerged from focus group discussions: 1) Versatile functionality of the Lawson SMART Record and smartphone facilitated use; 2) Aspects of the technologies as barriers to use; 3) Use of the Mental health Engagement Network technologies resulted in perceived positive outcomes; 4) Future enhancement of the Lawson SMART Record and intervention is recommended.

          Discussion

          These qualitative data provide a valuable contribution to the understanding of how smarttechnologies can be integrated into usual mental health care. Smartphones are extremely portable andcommonplace in society. Therefore, clients can use these devices to manage and track mental health issuesin any place at almost any time without feeling stigmatized.

          Conclusions

          Assessing clients’ perspectives regarding the use of smart technologies in mental health care provides an invaluable addition to the current literature. Qualitative findings support the feasibility of implementing a smartphone and electronic personal health record intervention with individuals who are living in the community and experiencing a mental illness, and provide considerations for future development and implementation.

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          Most cited references32

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          mHealth for mental health: Integrating smartphone technology in behavioral healthcare.

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            A quality of life interview for the chronically mentally ill

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              Community Attitudes to the Appropriation of Mobile Phones for Monitoring and Managing Depression, Anxiety, and Stress

              Background The benefits of self-monitoring on symptom severity, coping, and quality of life have been amply demonstrated. However, paper and pencil self-monitoring can be cumbersome and subject to biases associated with retrospective recall, while computer-based monitoring can be inconvenient in that it relies on users being at their computer at scheduled monitoring times. As a result, nonadherence in self-monitoring is common. Mobile phones offer an alternative. Their take-up has reached saturation point in most developed countries and is increasing in developing countries; they are carried on the person, they are usually turned on, and functionality is continually improving. Currently, however, public conceptions of mobile phones focus on their use as tools for communication and social identity. Community attitudes toward using mobile phones for mental health monitoring and self-management are not known. Objective The objective was to explore community attitudes toward the appropriation of mobile phones for mental health monitoring and management. Methods We held community consultations in Australia consisting of an online survey (n = 525), focus group discussions (n = 47), and interviews (n = 20). Results Respondents used their mobile phones daily and predominantly for communication purposes. Of those who completed the online survey, the majority (399/525 or 76%) reported that they would be interested in using their mobile phone for mental health monitoring and self-management if the service were free. Of the 455 participants who owned a mobile phone or PDA, there were no significant differences between those who expressed interest in the use of mobile phones for this purpose and those who did not by gender (χ21, = 0.98, P = .32, phi = .05), age group (χ24, = 1.95, P = .75, phi = .06), employment status (χ22, = 2.74, P = .25, phi = .08) or marital status (χ24, = 4.62, P = .33, phi = .10). However, the presence of current symptoms of depression, anxiety, or stress affected interest in such a program in that those with symptoms were more interested (χ2 1, = 16.67, P < .001, phi = .19). Reasons given for interest in using a mobile phone program were that it would be convenient, counteract isolation, and help identify triggers to mood states. Reasons given for lack of interest included not liking to use a mobile phone or technology, concerns that it would be too intrusive or that privacy would be lacking, and not seeing the need. Design features considered to be key by participants were enhanced privacy and security functions including user name and password, ease of use, the provision of reminders, and the availability of clear feedback. Conclusions Community attitudes toward the appropriation of mobile phones for the monitoring and self-management of depression, anxiety, and stress appear to be positive as long as privacy and security provisions are assured, the program is intuitive and easy to use, and the feedback is clear.
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                Author and article information

                Contributors
                cforchuk@uwo.ca
                Jeffrey.Reiss@lhsc.on.ca
                Tony.Oregan@lhsc.on.ca
                Paige.Ethridge@lhsc.on.ca
                ldonelle@uwo.ca
                harudnick@hotmail.com
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                14 October 2015
                14 October 2015
                2015
                : 15
                : 250
                Affiliations
                [ ]Lawson Health Research Institute, 750 Baseline Road East, London, ON Canada
                [ ]Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, ON Canada
                [ ]Department of Psychiatry, Schulich School of Medicine and Dentistry Western University, London, ON Canada
                [ ]Mental Healthcare Program, London Health Sciences Centre, London, ON Canada
                [ ]School of Health Studies, Faculty of Science, Western University, London, ON Canada
                [ ]Department of Psychiatry, University of British Columbia, Vancouver, BC Canada
                [ ]Mental Health and Substance Use Services, Vancouver Island Health Authority, Victoria, BC Canada
                Article
                614
                10.1186/s12888-015-0614-7
                4606496
                26467210
                3877f84c-b7d9-4f59-aa76-c51f1a047a99
                © Forchuk et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 January 2015
                : 21 September 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Clinical Psychology & Psychiatry
                qualitative analysis,personal health record,smartphones,tablets,mood disorders,psychotic disorders,mental illness

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