E-mental health implementation in inpatient care: Exploring its potential and future challenges

Abstract

BackgroundThere is a great evidence base today for the effectiveness of e-mental health, or the use of technology in mental healthcare. However, large-scale implementation in mental healthcare organisations is lacking, especially in inpatient specialized mental healthcare settings.AimThe current study aimed to gain insights into the factors that promote or hinder the implementation of e-mental health applications on organisational, professional and patient levels in Belgium.MethodsFour Belgian psychiatric hospitals and psychiatric departments of general hospitals invited their professionals and patients to use Moodbuster, which is a modular web-based platform with a connected smartphone application for monitoring. The platform was used in addition to treatment as usual for three to four months. The professionals and patients completed pre- and post-implementation questionnaires on their reasons to participate or to decline participation and experiences with the Moodbuster platform.ResultsMain reasons for the organisations to participate in the implementation study were a general interest in e-mental health and seeing it is a helpful add-on to regular treatment. The actual use of Moodbuster by professionals and patients proved to be challenging with only 10 professionals and 24 patients participating. Implementation was hindered by technical difficulties and inpatient care specific factors such as lack of structural facilities to use e-mental health and patient-specific factors. Professionals saw value in using e-mental health applications for bridging the transition from inpatient to outpatient care. Twenty-two professionals and 31 patients completed the questionnaire on reasons not to participate. For the patients, lack of motivation because of too severe depressive symptoms was the most important reason not to participate. For professionals, it was lack of time and high workload.ConclusionsThe current implementation study reveals several important barriers to overcome in order to successfully implement e-mental health in inpatient psychiatric care.

Blended-ALMAMAR app for inpatient mental health care for refugees: study protocol for a multicenter implementation study within the I-REACH consortium (Internet based REfugee mentAl healtH Care)

“…Two recent international implementation studies in Belgium [ 16 ] and Canada [ 17 ] emphasized hindering factors regarding the implementation process of internet-based applications in inpatient mental healthcare settings. Professionals mentioned high patient turnover in the acute inpatient setting [ 16 ], lack of time and a high workload for professionals, technical difficulties and insufficient structural facilities for the use of e-mental health as barriers [ 17 ]. Insufficient staff qualification, lack of training and supervision, and other organizational and administrative factors may also hinder the clinical implementation of internet-based applications [ 18 ].…”

Does an Internet-Based Emotion Regulation Intervention Provide Added Value for Acute Psychiatric Inpatient Care? Protocol for a Randomized Controlled Pilot Trial

“…A recent study by Becker and colleagues [ 29 ] showed that the number of diagnoses and symptom severity were associated with active or inactive participation in an online intervention during and after inpatient and day-clinic psychotherapeutic treatment. A lack of motivation due to symptom severity was also a reason for patients to decline participation in an inpatient study on e–mental health implementation by Van Assche et al [ 30 ]. According to Wentzel and colleagues [ 31 ], crisis risk and psychosocial problems are important factors to consider for a fit for blended treatment.…”