UNLOCKING DIGITAL MENTAL HEALTH: USER INSIGHTS ON MOBILE APPS, VR, AND WEB-BASED-PLATFORMS FOR PSYCHOSIS: A SYSTEMATIC REVIEW
Main Article Content
Keywords
Digital mental health, psychosis, Synthesis, Experiences, Technology, Qualitative, Quantitative
Abstract
Background: Despite of the significant advancements being made in the development of the digital mental health interventions or DMHI’s for various mental disorders, there is an evidential void in the progression of digital therapeutics for severe mental illnesses. While evidence exists on the use of digital interventions for psychosis, there is no comprehensive review addressing the differences between types of interventions and user experiences. This review synthesizes both qualitative and quantitative data, including previously unexamined comparisons of VR/AR interventions to thoroughly research on the diverse experiences psychosis patients have with the use of an array of different digital interventions.
Methods: A systematic review of articles was conducted related to user experiences of DMHI’s for people with psychosis published between 2015-2024 using google scholar, JSTOR, science direct and PLOS.
Results: A thematic synthesis of 20 studies conclusively devised 6 themes relating to different experiences of digital tool usage including; reliance anchor, facets and features, engagement, machine vs. man synergy, self-direction and destigmatization.
Conclusions: The findings suggest that individuals with psychosis had a higher preference for using mobile applications in comparison to web-based platforms and had a greater disposition towards immersive VR stimulations. In addition, the participants reported the best experiences with apps that offered personalized features, psychoeducation, self-management tools, therapist support, scheduling reminders, and a user-friendly design. A common barrier to the usability and engagement for all DMHIs was the users' prior experience with technology. The effectiveness and experiences of the various digital interventions as per user reviews have been discussed along with the potential inadequacies that arose that can be rectified for the development of future technology-based interventions.
References
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20. Eisner E, Drake RJ, Berry N, Barrowclough C, Emsley R, Machin M, et al. Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse. JMIR mHealth and uHealth. 2019 Mar 29;7(3): e11568.
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24. Lipschitz JM, Pike CK, Hogan TP, Murphy SA, Burdick KE. The Engagement Problem: a Review of Engagement with Digital Mental Health Interventions and Recommendations for a Path Forward. Current Treatment Options in Psychiatry. 2023 Aug 25;10(3):119–35.
25. Is a mobile app as good as a therapist? [Internet]. Harvard Health. 2022. Available from: https://www.health.harvard.edu/blog/is-a-mobile-app-as-good-as-a-therapist-202202072683
26. Cohen KA, Stiles-Shields C, Winquist N, Lattie EG. Traditional and Nontraditional Mental Healthcare Services: Usage and Preferences Among Adolescents and Younger Adults. The Journal of Behavioral Health Services & Research. 2021 Jan 20;48(4):537–53.
27. Highton-Williamson E, Priebe S, Giacco D. Online social networking in people with psychosis: A systematic review. International Journal of Social Psychiatry. 2014 Nov 6;61(1):92–101.
28. Morales-Pillado C, Fernández-Castilla B, Sánchez-Gutiérrez T, González-Fraile E, Barbeito S, Calvo A. Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis. Psychological Medicine. 2022 Dec 6;1–12.
29. Arboleya-Faedo T, Ana Gónzalez Menéndez, González-Pando D, Paíno M, Fernando Alonso Pérez. Experiences of Self-Stigma in People with Chronic Psychosis: A Qualitative Study. International Journal of Environmental Research and Public Health [Internet]. 2023 Apr 29;20(9):5688–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178090/
30. Austin SF, Frøsig A, Buus N, Lincoln T, von Malachowski A, Schlier B, et al. Service User Experiences of Integrating a Mobile Solution (IMPACHS) Into Clinical Treatment for Psychosis. Qualitative Health Research. 2021 Jan 23;31(5):942–54.
31. Kidd SA, Feldcamp L, Adler A, Kaleis L, Wang W, Vichnevetski K, et al. Feasibility and outcomes of a multi-function mobile health approach for the schizophrenia spectrum: App4Independence (A4i). Bearden CE, editor. PLOS ONE. 2019 Jul 15;14(7): e0219491.
32. Williams A, Fossey E, Farhall J, Foley F, Thomas N. Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website. JMIR Mental Health. 2018 May 8;5(2): e37.
33. Bond RR, Mulvenna MD, Potts C, O’Neill S, Ennis E, Torous J. Digital transformation of mental health services. npj Mental Health Research [Internet]. 2023 Aug 22;2(1):1–9. Available from: https://www.nature.com/articles/s44184-023-00033-y#citeas
34. Thompson A, Elahi F, Realpe A, Birchwood M, Taylor D, Vlaev I, et al. A Feasibility and Acceptability Trial of Social Cognitive Therapy in Early Psychosis Delivered Through a Virtual World: The VEEP Study. Frontiers in Psychiatry. 2020 Mar 25;11.
35. Zhang X, Lewis S, Chen X, Zhou J, Wang X, Bucci S. Acceptability and experience of a smartphone symptom monitoring app for people with psychosis in China (YouXin): a qualitative study. BMC psychiatry. 2024 Apr 9;24(1).
36. Bucci S, Morris R, Berry K, Berry N, Haddock G, Barrowclough C, et al. Early Psychosis Service User Views on Digital Technology: Qualitative Analysis. JMIR Mental Health. 2018 Oct 31;5(4): e10091.
37. Lal S, Tobin R, Tremblay S, John, D’Alfonso S, Etienne G, et al. Experiences of a Digital Mental Health Intervention from the Perspectives of Young People Recovering from First-Episode Psychosis: A Focus Group Study. 2023 May 8;20(9):5745–5.
38. Sedgwick O, Hardy A, Greer B, Newbery K, Cella M. “I wanted to do more of the homework!”—Feasibility and acceptability of blending app‐based homework with group therapy for social cognition in psychosis. Journal of Clinical Psychology. 2021 Jun 8;
2. APA Dictionary of Psychology [Internet]. dictionary.apa.org. 2018. Available from: https://dictionary.apa.org/psychosis
3. Wies B, Landers C, Ienca M. Digital Mental Health for Young People: A Scoping Review of Ethical Promises and Challenges. Frontiers in Digital Health. 2021 Sep 6;3.
4. Dennard S, Patel R, Philippa Garety, Edwards C, Gumley A. A systematic review of user’s experiences of using digital interventions within psychosis: a thematic synthesis of qualitative research. Social psychiatry and psychiatric epidemiology. 2024 May 27;
5. Asensio-Aguerri L, Beato-Fernández L, Stavraki M, Rodríguez-Cano T, Bajo M, Díaz D. Paranoid Thinking and Wellbeing. The Role of Doubt in Pharmacological and Metacognitive Therapies. Frontiers in Psychology. 2019 Sep 12;10.
6. Stubbe DE. Enhancing Adherence: Using Mobile Health Technology to Improve Self-Management for Individuals with Schizophrenia. FOCUS. 2020 Oct;18(4):424–7.
7. Firth J, Cotter J, Torous J, Bucci S, Firth JA, Yung AR. Mobile Phone Ownership and Endorsement of “mHealth” Among People with Psychosis: A Meta-analysis of Cross-sectional Studies. Schizophrenia Bulletin. 2015 Sep 22;42(2):448–55.
8. Rus-Calafell M, Ehrbar N, Ward T, Edwards C, Huckvale M, Walke J, et al. Participants’ experiences of AVATAR therapy for distressing voices: a thematic qualitative evaluation. BMC Psychiatry. 2022 May 24;22(1).
9. Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Aucott L, et al. The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomized controlled trial in Scotland and Australia. The Lancet Psychiatry. 2022 Jun;9(6):477–86.
10. Valentine L, McEnery C, Bell I, O’Sullivan S, Pryor I, Gleeson J, et al. Blended Digital and Face-to-Face Care for First-Episode Psychosis Treatment in Young People: Qualitative Study. JMIR Mental Health. 2020 Jul 28;7(7): e18990.
11. Lal S, Gleeson JF, D’Alfonso S, Lee H, Etienne G, Joober R, et al. Digital health innovation to prevent relapse and support recovery in young people with first-episode psychosis: A pilot study of Horyzons-Canada. Schizophrenia [Internet]. 2023 Apr 7;9(1):1–10. Available from: https://www.nature.com/articles/s41537-023-00352-1
12. García AS, Fernández-Sotos P, Vicente-Querol MA, Sánchez-Reolid R, Rodriguez-Jimenez R, Fernández-Caballero A. Co-design of avatars to embody auditory hallucinations of patients with schizophrenia. Virtual Reality. 2021 Jul 8;27(1):217–32.
13. Garety P, Ward T, Emsley R, Greenwood K, Freeman D, Fowler D, et al. Digitally supported CBT to reduce paranoia and improve reasoning for people with schizophrenia-spectrum psychosis: the SlowMo RCT. Efficacy and Mechanism Evaluation. 2021 Aug;8(11):1–90.
14. Tatar O, Abdel-Baki A, Tra C, Mongeau-Pérusse V, Arruda N, Kaur N, et al. Technology-Based Psychological Interventions for Young Adults With Early Psychosis and Cannabis Use Disorder: Qualitative Study of Patient and Clinician Perspectives. JMIR Formative Research [Internet]. 2021 Apr 5;5(4): e26562. Available from: https://formative.jmir.org/2021/4/e26562
15. Holgersen G, Nordgreen T, ten Velden Hegelstad W, Bircow Elgen I. Views of Young People with Psychosis on Using Virtual Reality Assisted therapy. a Qualitative Study. Early Intervention in Psychiatry. 2022 Jun 16;17(4).
16. Taylor KM, Bradley J, Cella M. A novel smartphone‐based intervention targeting sleep difficulties in individuals experiencing psychosis: A feasibility and acceptability evaluation. Psychology and Psychotherapy: Theory, Research and Practice. 2022 Apr 28;95(3):717–37.
17. Xanthopoulou PD, Mbanu J, Chevalier A, Webber M, Giacco D. Social Isolation and Psychosis: Perspectives from People with Psychosis, Family Caregivers and Mental Health Professionals. Community Mental Health Journal. 2022 Jan 25;58(7).
18. Jankowski S, Ferreira K, Mascayano F, Donovan E, Rahim R, Birnbaum ML, et al. A Serious Game for Young People with First Episode Psychosis (OnTrack>The Game): Qualitative Findings of a Randomized Controlled Trial. JMIR Mental Health. 2022 Apr 6;9(4): e33526.
19. Lim MH, Gleeson JFM, Rodebaugh TL, Eres R, Long KM, Casey K, et al. A pilot digital intervention targeting loneliness in young people with psychosis. Social Psychiatry and Psychiatric Epidemiology. 2019 Mar 14;55(7):877–89.
20. Eisner E, Drake RJ, Berry N, Barrowclough C, Emsley R, Machin M, et al. Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse. JMIR mHealth and uHealth. 2019 Mar 29;7(3): e11568.
21. Stafford E, Hides L, Kavanagh DJ. The acceptability, usability and short-term outcomes of Get Real: A web-based program for psychotic-like experiences (PLEs). Internet Interventions. 2015 Sep;2(3):266–71.
22. Bell IH, Alvarez-Jimenez M. Digital Technology to Enhance Clinical Care of Early Psychosis. Current Treatment Options in Psychiatry [Internet]. 2019 Jul 11 [cited 2019 Aug 12]; Available from: https://link.springer.com/article/10.1007/s40501-019-00182-y
23. Lim MH, Penn DL. Using Digital Technology in the Treatment of Schizophrenia. Schizophrenia Bulletin [Internet]. 2018 Aug 20;44(5):937–8. Available from: https://academic.oup.com/schizophreniabulletin/article/44/5/937/5033917
24. Lipschitz JM, Pike CK, Hogan TP, Murphy SA, Burdick KE. The Engagement Problem: a Review of Engagement with Digital Mental Health Interventions and Recommendations for a Path Forward. Current Treatment Options in Psychiatry. 2023 Aug 25;10(3):119–35.
25. Is a mobile app as good as a therapist? [Internet]. Harvard Health. 2022. Available from: https://www.health.harvard.edu/blog/is-a-mobile-app-as-good-as-a-therapist-202202072683
26. Cohen KA, Stiles-Shields C, Winquist N, Lattie EG. Traditional and Nontraditional Mental Healthcare Services: Usage and Preferences Among Adolescents and Younger Adults. The Journal of Behavioral Health Services & Research. 2021 Jan 20;48(4):537–53.
27. Highton-Williamson E, Priebe S, Giacco D. Online social networking in people with psychosis: A systematic review. International Journal of Social Psychiatry. 2014 Nov 6;61(1):92–101.
28. Morales-Pillado C, Fernández-Castilla B, Sánchez-Gutiérrez T, González-Fraile E, Barbeito S, Calvo A. Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis. Psychological Medicine. 2022 Dec 6;1–12.
29. Arboleya-Faedo T, Ana Gónzalez Menéndez, González-Pando D, Paíno M, Fernando Alonso Pérez. Experiences of Self-Stigma in People with Chronic Psychosis: A Qualitative Study. International Journal of Environmental Research and Public Health [Internet]. 2023 Apr 29;20(9):5688–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10178090/
30. Austin SF, Frøsig A, Buus N, Lincoln T, von Malachowski A, Schlier B, et al. Service User Experiences of Integrating a Mobile Solution (IMPACHS) Into Clinical Treatment for Psychosis. Qualitative Health Research. 2021 Jan 23;31(5):942–54.
31. Kidd SA, Feldcamp L, Adler A, Kaleis L, Wang W, Vichnevetski K, et al. Feasibility and outcomes of a multi-function mobile health approach for the schizophrenia spectrum: App4Independence (A4i). Bearden CE, editor. PLOS ONE. 2019 Jul 15;14(7): e0219491.
32. Williams A, Fossey E, Farhall J, Foley F, Thomas N. Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website. JMIR Mental Health. 2018 May 8;5(2): e37.
33. Bond RR, Mulvenna MD, Potts C, O’Neill S, Ennis E, Torous J. Digital transformation of mental health services. npj Mental Health Research [Internet]. 2023 Aug 22;2(1):1–9. Available from: https://www.nature.com/articles/s44184-023-00033-y#citeas
34. Thompson A, Elahi F, Realpe A, Birchwood M, Taylor D, Vlaev I, et al. A Feasibility and Acceptability Trial of Social Cognitive Therapy in Early Psychosis Delivered Through a Virtual World: The VEEP Study. Frontiers in Psychiatry. 2020 Mar 25;11.
35. Zhang X, Lewis S, Chen X, Zhou J, Wang X, Bucci S. Acceptability and experience of a smartphone symptom monitoring app for people with psychosis in China (YouXin): a qualitative study. BMC psychiatry. 2024 Apr 9;24(1).
36. Bucci S, Morris R, Berry K, Berry N, Haddock G, Barrowclough C, et al. Early Psychosis Service User Views on Digital Technology: Qualitative Analysis. JMIR Mental Health. 2018 Oct 31;5(4): e10091.
37. Lal S, Tobin R, Tremblay S, John, D’Alfonso S, Etienne G, et al. Experiences of a Digital Mental Health Intervention from the Perspectives of Young People Recovering from First-Episode Psychosis: A Focus Group Study. 2023 May 8;20(9):5745–5.
38. Sedgwick O, Hardy A, Greer B, Newbery K, Cella M. “I wanted to do more of the homework!”—Feasibility and acceptability of blending app‐based homework with group therapy for social cognition in psychosis. Journal of Clinical Psychology. 2021 Jun 8;
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Mar 25, 2024
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Mahnoor abid, & Ayesha Shahid Sheikh. (2024). UNLOCKING DIGITAL MENTAL HEALTH: USER INSIGHTS ON MOBILE APPS, VR, AND WEB-BASED-PLATFORMS FOR PSYCHOSIS: A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 31(3), 2482-2496. https://doi.org/10.53555/jptcp.v31i3.7218
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Author Biographies
Mahnoor abid
BSc Applied psychology, Student
Ayesha Shahid Sheikh
Clinical psychologist, Hameed latif hospital lahore.
How to Cite
Mahnoor abid, & Ayesha Shahid Sheikh. (2024). UNLOCKING DIGITAL MENTAL HEALTH: USER INSIGHTS ON MOBILE APPS, VR, AND WEB-BASED-PLATFORMS FOR PSYCHOSIS: A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 31(3), 2482-2496. https://doi.org/10.53555/jptcp.v31i3.7218