Prevention of Mental Health Disorders Using Internet- and Mobile-Based Interventions: A Narrative Review and Recommendations for Future Research

Abstract

Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD), their current impact on the reduction of disease burden is questionable. Possible reasons include that it is not practical to deliver those interventions to the community en masse due to limited health care resources and the limited availability of evidence-based interventions and clinicians in routine practice, especially in rural areas. Therefore, new approaches are needed to maximize the impact of psychological preventive interventions. Limitations of traditional prevention programs could potentially be overcome by providing Internet- and mobile-based interventions (IMIs). This relatively new medium for promoting mental health and preventing MHD introduces a fresh array of possibilities, including the provision of evidence-based psychological interventions that are free from the restraints of travel and time and allow reaching participants for whom traditional opportunities are not an option. This article provides an introduction to the subject and narratively reviews the available evidence for the effectiveness of IMIs with regard to the prevention of MHD onsets. The number of randomized controlled trials that have been conducted to date is very limited and so far it is not possible to draw definite conclusions about the potential of IMIs for the prevention of MHD for specific disorders. Only for the indicated prevention of depression there is consistent evidence across four different randomized trial trials. The only trial on the prevention of general anxiety did not result in positive findings in terms of eating disorders (EDs), effects were only found in post hoc subgroup analyses, indicating that it might be possible to prevent ED onset for subpopulations of people at risk of developing EDs. Future studies need to identify those subpopulations likely to profit from preventive. Disorders not examined so far include substance use disorders, bipolar disorders, stress-related disorders, phobic disorders and panic disorder, obsessive–compulsive disorder, impulse-control disorders, somatic symptom disorder, and insomnia. In summary, there is a need for more rigorously conducted large scale randomized controlled trials using standard clinical diagnostic instruments for the selection of participants without MHD at baseline and the assessment of MHD onset. Subsequently, we discuss future directions for the field in order to fully exploit the potential of IMI for the prevention of MHD.

Barriers of mental health treatment utilization among first‐year college students: First cross‐national results from the WHO World Mental Health International College Student Initiative

“…Two of the three most often mentioned reasons for not wanting to seek help, the wish to solve problems on one's own, and being too embarrassed, were also the only barriers independently associated with reduced intention to seek treatment after excluding students who reported that they definitely would seek treatment. It is plausible to think in light of this finding that digital delivered self‐help approaches, which do not require the patient to disclose their problems to others (Ebert et al, ; Ebert, Cuijpers, Muñoz, & Baumeister, ), might be ideally suited to students reporting such barriers, in which case offering such interventions might help increase treatment among this hard‐to‐reach segment of the student population. This possibility is in line with the findings of another paper in this issue in which approximately one third of the students participating in an internet‐based treatment for social anxiety disorder indicated that they would be unwilling to use face‐to face psychotherapy (Kählke et al, ).…”

Technology use and preferences for mental health self‐management interventions among older veterans

“…Still, the scarcity of geriatric mental health providers limits the scalability of telehealth as providers are needed to deliver telehealth services. While technology-delivered interventions may increase access to mental health care, 14,15 older adults are often omitted from this research due to barriers to accessing technology and sampling bias that may reflect ageist stereotypes of older adults' interest in technology. 9 A vast body of research supports self-management as efficacious for chronic health and mental health.…”

Digital Technology for Internet Access by Patients With Early-Stage Schizophrenia in Spain: Multicenter Research Study (Preprint)

“…However, due to the limited resources of medical and psychological care and availability of interventions, their enormous potential is restricted [9]. Interventions in mental disorders using Internet and mobile-based interventions offer an accessible, innovative and personalized option that addresses several devastating characteristics of mental illness, including associated stigma, its chronic nature and symptoms, this way empowering patients to participate actively in their recovery [10].…”