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Smartphone apps in mental healthcare: the state of the art and potential developments

  • Melvyn W. B. Zhang, Cyrus S. H. Ho, Christopher C. S. Cheok and Roger C. M. Ho
Summary

Previous studies have demonstrated that smartphones are useful tools in everyday, evidence-based medical practice. This article gives an overview of the current use in psychiatry of smartphone apps aimed at patients and the general public, highlighting associated benefits and disadvantages. It also outlines how practising psychiatrists could embrace such technologies at an individual, organisational and national level.

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Copyright
Corresponding author
Dr Melvyn Zhang Weibin, National Addictions Management Service (NAMS), Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, Singapore 539747. Email: melvynzhangweibin@gmail.com
Footnotes
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LEARNING OBJECTIVES

• Recognise the current uses of smartphone technologies in psychiatry and their inherent advantages and disadvantages

• To empower practising psychiatrists to create evidence-based mental health apps for patient care

• Understand how smartphone technologies could be used at an organisational and a national level to add value to current service provision

Declaration of Interest

M.W.B.Z. designed and created the Royal College of Psychiatrists' Mental Health Key Facts app. The creation of this app is supported by the College's Public Education Engagement Board, and the author received no payment for this work.

For a related commentary, see pp. 359–360, this issue.

Footnotes
References
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BinDhim, NF, Shaman, AM, Trevena, L et al (2015) Depression screening via a smartphone application: cross-country user characteristics and feasibility. Journal of the American Medical Informatics Association, 22: 2934.
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Edgar, S, Swyka, T, Fulk, G et al (2010) Wearable shoe-based device for rehabilitation of stroke patients. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society: 3772–5.
Faurholt-Jepsen, M, Frost, M, Vinberg, M et al (2014) Smartphone data as objective measures of bipolar disorder symptoms. Psychiatry Research, 217: 124–7.
Grünerbl, A, Muaremi, A, Osmani, V et al (2015) Smartphone based recognition of states and state changes in bipolar disorder patients. IEEE Journal of Biomedical and Health Informatics, 19: 140–8.
Health on the Net Foundation (2008) HONCode. HON (https://www.healthonnet.org/HONcode/Webmasters/intro.html).
Huang, CC, Lee, PY, Chen, PY et al (2012) Design and implementation of a smartphone-based portable ultrasound pulsed-wave Doppler device for blood flow measurement. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, 59: 182–9.
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BJPsych Advances
  • ISSN: 2056-4678
  • EISSN: 2056-4686
  • URL: /core/journals/bjpsych-advances
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Smartphone apps in mental healthcare: the state of the art and potential developments

  • Melvyn W. B. Zhang, Cyrus S. H. Ho, Christopher C. S. Cheok and Roger C. M. Ho
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eLetters

Smartphone apps in mental healthcare: the state of the art and potential developments

Hinesh Topiwala, Specialty Registrar (ST5) in Old Age Psychiatry, Stratheden Hospital, Stratheden, Cupar, KY15 5RR, UK
Tom Russ, Marjorie MacBeath Intermediate Clinical Fellow, Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, UK
24 September 2015

We enjoyed reading Zhang et al.’s (2015) outline of the current use in psychiatry of smartphone apps aimed at patients and the public. However, we noticed there was little comment on the emerging role of tablet and mobile phone apps in dementia.



The National Dementia Strategy was launched in March 2012 by Prime Minister David Cameron at the meeting of the G8 countries in London (Department of Health 2012). Exploring the role of technology, including smartphone apps, in dementia was one of its core goals. The Dementia Challenge issued at this meeting focused on three main areas for action: driving improvements in health and care; creating dementia-friendly communities; and improving dementia research. The dementia-friendly communities strand led to the production of the Dementia Friendly Technology Charter (Alzheimer’s Society 2014), the goal of which is to provide information for people with dementia and their carers on how to make technology work for them.



The Charter describes that in early dementia, brainteaser games or apps, life history exploration and recording tools can stimulate memory and cognition. In late-stage dementia it is noted that various apps can provide visual or auditory stimulation and can also aid communication (Alzheimer’s Society 2014). However, the charter does name specific apps which could be of benefit. Thus, for people with dementia and clinicians alike, it is easy to see how it could be hard to locate the most relevant app – both the iOS App Store and Google Play have in excess of one million apps available to download!



To help make it simpler to find safe and trusted apps, the NHS launched the Health Apps Library (http://apps.nhs.uk/) in March 2013. It recently contained 26 apps categorised under mental health and three apps separately categorised under dementia: Talking Point; Coventry and Warwickshire Dementia Information Portal; and iReminisce (accessed 17th September 2015).



Talking Point (available from the both the iOS App Store and Google Play) is an app to access the vast amount of information in the Alzheimer’s Society’s online support and discussion forum. The Coventry and Warwickshire Dementia Information Portal app does not appear to be available from the usual outlets. However, a link on the Coventry and Warwickshire Dementia Information Portal Health Apps Library page leads to a website about living well with Dementia. The iReminisce app (which requires a £12 annual subscription) allows one to create a video/photo/audio diary, browse stock photos, audio clips and video from different eras, and create a family tree. The developer claims this app will help alleviate loneliness, promote socialisation, and that “it is proven to improve wellbeing for those living with a cognitive impairment such as dementia”. They cite no evidence to support this claim.



As outlined in the Dementia Friendly Technology Charter, there is great scope for use of technology (in particular tablet and mobile phone apps) to improve the lives of individuals with dementia. The launch of the NHS Health Apps Library is a welcome step in helping guide the public and clinicians to helpful smartphone apps. However, we found very few dementia-related apps and none supported by an evidence base. Thus, it remains a challenge for clinicians to know which apps, if any, we should be recommending to our patients. There is a gap in the market for a dementia app supported by a robust evidence base!



References:



Alzheimer’s Society (2014) Dementia-friendly technology charter. London: Alzheimer’s Society.



Department of Health (2012) Prime Minister’s challenge on dementia: delivering major improvements in dementia care and research by 2015. London: Department of Health.



Zhang MWB, Ho SHC, Cheok CCS, et al. (2015) Smartphone apps in mental healthcare: the state of the art and potential developments. Advances in Psychiatric Treatment, 21: 354–8.
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