Digital health behaviour change interventions in severe mental illness: a systematic review

Abstract

The use of digital technologies as a method of delivering health behaviour change (HBC) interventions is rapidly increasing across the general population. However, the role in severe mental illness (SMI) remains overlooked. In this study, we aimed to systematically identify and evaluate all of the existing evidence around digital HBC interventions in people with an SMI. A systematic search of online electronic databases was conducted. Data on adherence, feasibility, and outcomes of studies on digital HBC interventions in SMI were extracted. Our combined search identified 2196 titles and abstracts, of which 1934 remained after removing duplicates. Full-text screening was performed for 107 articles, leaving 36 studies to be included. From these, 14 focused on physical activity and/or cardio-metabolic health, 19 focused on smoking cessation, and three concerned other health behaviours. The outcomes measured varied considerably across studies. Although over 90% of studies measuring behavioural changes reported positive changes in behaviour/attitudes, there were too few studies collecting data on mental health to determine effects on psychiatric outcomes. Digital HBC interventions are acceptable to people with an SMI, and could present a promising option for addressing behavioural health in these populations. Feedback indicated that additional human support may be useful for promoting adherence/engagement, and the content of such interventions may benefit from more tailoring to specific needs. While the literature does not yet allow for conclusions regarding efficacy for mental health, the available evidence to date does support their potential to change behaviour across various domains.

On the Road to Individualizing Pharmacotherapy for Adolescents and Adults with Schizophrenia – Results from an Expert Consensus Following the Delphi Method

“…[98][99][100] Such evolving tools, which may include smartphone apps, virtual reality, social media, chatbots, and the use of big data and machine learning approaches to electronic health record processing and digital phenotyping, are certain to play an important role in individualizing psychiatric care. Digital tools offer the opportunity for improved prevention, screening, and monitoring of symptom severity and response to treatment, 101,102 smoking cessation, 103 promotion of desired behavioral changes such as increased exercise, 104 and augmentation of pharmacotherapy by improving adherence, 105,106 psychoeducation, and peer support, among others. 100 In addition, online-delivered approaches, including telepsychiatry, may have the potential to be more cost-effective and destigmatizing, making them particularly attractive in low-resource settings with limited access to mental health care.…”