Priority Given to Technology in Government-Based Mental Health and Addictions Vision and Strategy Documents: Systematic Policy Review

Abstract

Background The use of information and communication technologies (ICTs) to deliver mental health and addictions (MHA) services is a global priority, especially considering the urgent shift towards virtual delivery of care in response to the COVID-19 pandemic. It is important to monitor the evolving role of technology in MHA services. Given that MHA policy documents represent the highest level of priorities for a government’s vision and strategy for mental health care, one starting point is to measure the frequency with which technology is mentioned and the terms used to describe its use in MHA policy documents (before, during, and after COVID-19). Yet, to our knowledge, no such review of the extent to which ICTs are referred to in Canadian MHA policy documents exists to date. Objective The objective of this systematic policy review was to examine the extent to which technology is addressed in Canadian government–based MHA policy documents prior to the COVID-19 pandemic to establish a baseline for documenting change. Methods We reviewed 22 government-based MHA policy documents, published between 2011 and 2019 by 13 Canadian provinces and territories. We conducted content analysis to synthesize the policy priorities addressed in these documents into key themes, and then systematically searched for and tabulated the use of 39 technology-related keywords (in English and French) to describe and compare jurisdictions. Results Technology was addressed in every document, however, to a varying degree. Of the 39 searched keywords, we identified 22 categories of keywords pertaining to the use of technology to deliver MHA services and information. The 6 most common categories were tele (n=16/22), phone (n=12/22), tech (n=11/22), online (n=10/22), line (n=10/22), and web (n=10/22), with n being the number of policy documents in which the category was mentioned out of 22 documents. The use of terms referring to advanced technologies, such as virtual (n=6/22) and app (n= 4/22), were less frequent. Additionally, policy documents from some provinces and territories (eg, Alberta and Newfoundland and Labrador) mentioned a diverse range of ICTs, whereas others described only 1 form of ICT. Conclusions This review indicates that technology has been given limited strategic attention in Canadian MHA policy. Policy makers may have limited knowledge on the evidence and potential of using technology in this field, highlighting the value for knowledge translation and collaborative initiatives among policy makers and researchers. The development of a pan-Canadian framework for action addressing the integration and coordination of technology in mental health services can also guide initiatives in this field. Our findings provide a prepandemic baseline and replicable methods to monitor how the use of technology-supported services and innovations emerge relative to other priorities in MHA policy during and after the COVID-19 pandemic.

The role of sociodemographic factors on the acceptability of digital mental health care: A scoping review protocol

“…There will be no studies excluded based on the specific digital care medium used to deliver the mental health intervention. Some examples of DMHI include, but are not limited to, internet-based cognitive behavioral therapy, chatbots for mental health support, smartphone applications that support ecological momentary assessment, web-based psychotherapeutic platforms, psychosocial assessments through video conferencing solutions, and exposure therapy assisted by virtual reality [22][23][24].…”

“…For the topic of digital technology, 10 indexed keyword headings (e.g., Internet-based interventions, mobile applications) were searched (lines 6,7,8, 9,10,11, and 12) along with one set of search terms incorporating many concepts related to digital technology (e.g., digital, bots) (line 13). This set of search terms was complemented by a list of keywords proposed by Lal et al [23] in a systematic review pertaining to the priority afforded to technology in government-based mental health strategy documents. The indexed keyword headings relating to digital technology along with the related set of search terms were then linked with the Boolean operator "OR" (line 14).…”

“…To address this limitation, A1 and A2 collaborated with an experienced librarian to develop a search strategy that will be adapted and implemented in four electronic databases. The search strategy was also supplemented with search terms put forth in a systematic review by Lal et al [23]. However, given the rapid evolution of technological advancements, eligible studies may still go undetected and hence not be included in the proposed scoping review.…”