We Are At The Beginning Of A Global Mental Health Revolution
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The digital revolution is evolving at an unstoppable pace. Alongside the unprecedented explosion of digital technology facilities and systems, mental health care is under greater pressure than ever before. With its emphasis on big data, computing power, mobile technology, and network information, digital technology is set to transform health care delivery. This article reviews the field of digital health technology assessment and intervention primarily in secondary service mental health care, including the barriers and facilitators to adopting and implementing digitally mediated interventions in service delivery. We consider the impact of digitally mediated communication on human interaction and its potential impact on various mental states such as those linked to mood, anxiety but also well-being. These developments point to a need for both theory- and data-driven approaches to digital health care. We argue that, as developments in digital technology are outpacing the evaluation of rigorous digital health interventions, more advanced methodologies are needed to keep up with the pace of digital technology development. The need for co-production of digital tools with and for people with chronic and mental health difficulties, and implications of digital technology for psychotherapy practice, will be central to this development. PRACTITIONER POINTS: Mental health problems are one of the main causes of global and societal burden and are a growing public health. People with mental health problems around the world have limited, if any, chance of accessing psychological help at all. Technological innovations and solutions are being considered in an attempt to address the size and scale of the mental health crisis worldwide. Digital platforms allow people to self-monitor and self-manage in a way that face-to-face/paper-based methods of assessment have up until now not allowed. We provide examples of digital tools that are being developed and used in the secondary setting and identify a number of challenges in the digital health field that require careful consideration.
We cannot transform mental health solely through the health care system. We must also address the determinants of behavioral health, invest in community services, and foster a culture and environment that broadly promotes mental wellness and recovery. This crisis is not a medical one, but a societal one. In December 2021, the Surgeon-General released an Advisory on Protecting Youth Mental Health that outlined a wide range of causes for the national youth mental health crisis and underscored growing concern about the harms of digital technologies, particularly social media, to the mental health and well-being of young people, as well as calling for practical action from technology companies to address these concerns.
We need a whole-of-society effort to address these concerns: to expand prevention programs and actions that improve mental health at every age and across settings; and to enhance programs that support recovery, especially for populations at increased risk during vulnerable transition periods. The Biden-Harris Administration will:
Five years ago, a group of 25 leaders across Johnson & Johnson convened for a unique summit in New York City. Each brought to bear their diverse expertise and experiences on one of the most stubborn and critical issues facing humanity: the global burden of mental illness and the historic lack of investment in mental healthcare.
Indeed, according to statistics from the World Health Organization (WHO), there is a long way to go. In WHO's most recent Mental Health Atlas, a compilation of data that serves as a guide for the development and planning of mental health services, only 52% of 194 Member States surveyed met the agreed-upon 80% target relating to mental health promotion and prevention programs for 2020.
The full realization of precision medicine for mental health will go beyond selecting patients based on their symptoms and move toward integrating additional data including genetics, biomarkers, digital health information and neuroimaging to understand which people will respond to which treatments and, further, who needs treatments that do not even exist today.
The more support that healthcare workers receive, the better the support their patients can receive in turn. Virginia Smith-Swintosky, Ph.D., Mental Health Franchise Leader, Global Public Health, Johnson & Johnson, and team are currently piloting a program in partnership with the Rwandan Ministry of Health to address the urgent need for mental health understanding and services in the country by focusing on three key areas: improving data collection so the government can understand the true scope of the need, bringing mental healthcare into communities outside of urban centers by training community healthcare workers and enabling access to essential and innovative medicines.
So far, the partnership has led to the creation of the first National Mental Health Survey in Rwanda, trained 50,000 community health workers on the signs and symptoms of mental illness through an innovative phone-based training program and successfully transitioned a group of schizophrenia patients who participated in a Janssen-sponsored clinical trial to long-acting injectable antipsychotics developed by Janssen.
In 2020, CVT cared for 78 clients in Atlanta. Our focus on refugees and asylum seekers allows us to reach survivors of torture early in their resettlement process, allowing healing to begin sooner than occurs in other locations. Over time, these early interventions help prevent the immense costs that come with unmet needs for mental health care.
Sugary drinks are a major driver of the global epidemic of chronic conditions like obesity and diabetes. One way to keep consumption under control is through fiscal policies like taxes on these health harming beverages. Francine Charles from the Heart and Stroke Foundation of Barbados was at the frontline of the effort to move the Barbados sugary drinks tax increase forward. In this interview, she explains how they did it and how they are now working to see the implementation of diverse healthy food policies to reduce chronic disease and build a healthier population.
Chronic diseases like cancer, diabetes and cardiovascular disease cause 41 million deaths per year, or 74% of all deaths globally. Out-of-pocket health costs are often catastrophic, driving millions of people into poverty every year. Yet they are the most underfunded global health issue. In this podcast, we hear from diverse NCD champions on the urgent need to close this funding gap - and solutions that can make it happen, like fiscal policies for health, innovative partnerships and integrated care. In the lead up to the Second Global NCD Financing Dialogue that will take place in 2023, the time is now to put our minds together and take a new approach to global health financing.
The question of how to address mental health issues has existed since antiquity; the answers have evolved across cultures and millennia, adapting as the understanding of the human condition has changed in the face of advances in science, chemistry, medicine, and psychology. The history of mental health and the evolution of treatment is not always a flattering story, but it explains a great deal about how and why the landscape of mental health treatment is what it is today and where it could possibly go next.
Regrettably, the social stigma attached to mental health problems is still prevalent in countries and cultures that place a strong emphasis on family honor, where marriages are less a union of love and more a tool for forging alliances and sending off daughters.
For that reason, mentally unhealthy family members were (and still are) brutally and mercilessly ostracized. It was not unheard of for some families to turn their loved ones into the police, for fear that the mental health disorder could be considered dangerous or too difficult to manage at home.
However, there were some options for treatment beyond the limitations of family care (or custody). These included putting up the mentally unhealthy in workhouses, a public institution where the poorest people in a church parish were given basic room and board in return for work. Others were checked into general hospitals, but they were often abandoned and ignored.
Pinel developed a hypothesis that mentally unhealthy patients needed care and kindness in order for their conditions to improve; to that effect, he took ownership of the famous Hospice de Bicêtre, located in the southern suburbs of Paris.
Notwithstanding the end of the moral treatment movement, at this point in the history of mental health, the conversation about treatment was ready to take a big step forward. A major figure in that progression was Sigmund Freud.
One of the most infamous chapters in the history of mental health treatments was psychosurgery. First developed in the 1930s, a patient would be put into a coma, after which a doctor would hammer a medical instrument (similar to an icepick) through the top of both eye sockets.
The drug did not cure psychosis but proved better at controlling the symptoms than any other method that had been tried. It was the earliest sign of the rise of (modern) psychopharmacology and changed the landscape of mental health treatment.
As lithium became the standard for mental health treatment, other drugs like chlorpromazine (better known as Thorazine), Valium and Prozac became household names during the middle and latter decades of the 20th century, becoming some of the most prescribed drugs for depression across the world.
There are now hundreds of psychoactive drugs in circulation, all targeting a variety of mental health disorders and allowing patients a degree of comfort and privacy with how their conditions are treated.
As welcome as this was, it created the problem of people with severe mental health problems, but with no social or family networks to support their recovery (or who could not afford the fees or insurance plans for rehabilitation) being moved to jails and prisons.15 2b1af7f3a8
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