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Technology in Mental Health
Published Online: 5 December 2023

Digital Mental Health and Its Discontents: Assumptions About Technology That Create Barriers to Equitable Access

Abstract

Despite the potential of digital mental health interventions to aid recovery for people with serious mental illness, access to these digital tools remains a key barrier. In this column, the authors discuss three key assumptions that shape the integration of digital mental health tools into community health settings: clinical context, digital literacy, and financial burden. Clinical contexts have shifted with the increased use of telehealth, altering intervention environments; access to a mobile device is not the same as digital literacy; and digital mental health care is not necessarily affordable. Context-centered study design through ethnography will facilitate transfer of digital resources to real-world settings.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 299 - 302
PubMed: 38050440

History

Received: 23 May 2023
Revision received: 20 September 2023
Accepted: 24 October 2023
Published online: 5 December 2023
Published in print: March 01, 2024

Keywords

  1. Community mental health services
  2. Quality improvement
  3. Digital health care
  4. Qualitative methods
  5. Research design

Authors

Affiliations

Ellen E. Kozelka, Ph.D. [email protected]
Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song).
Stephanie C. Acquilano, M.A.
Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song).
Monirah Al-Abdulmunem, M.S.
Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song).
Sue Guarino, R.N.B.C.
Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song).
Glyn Elwyn, M.D., Ph.D.
Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song).
Robert E. Drake, M.D., Ph.D.
Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song).
Elizabeth Carpenter-Song, Ph.D.
Department of Anthropology, University of Vermont, Burlington (Kozelka); Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire (Acquilano, Elwyn); Westat, Lebanon, New Hampshire (Al-Abdulmunem, Drake); Mental Health Center of Greater Manchester, Manchester, New Hampshire (Guarino); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Drake); Department of Anthropology, Dartmouth College, Hanover, New Hampshire (Carpenter-Song).

Notes

Send correspondence to Dr. Kozelka ([email protected]).
The study data were presented at the Dartmouth Coproduction Laboratory Meeting on October 12, 2022, and at the University of California San Diego Psychological and Medical Anthropology Seminar on November 14, 2022.

Author Contributions

Dror Ben-Zeev, Ph.D., is editor of this column.

Competing Interests

Dr. Elwyn reports receiving royalties from Oxford University Press and Groups Radcliffe Press; owning copyright in measures of shared decision making; being the founder and director of &think L.L.C., which owns the registered trademark for Option Grids patient decision aids; consulting for EBSCO Publishing; and serving as chief clinical research scientist for Abridge AI Inc. The other authors report no financial relationships with commercial interests.

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