Mental Health – Page 8

13Aug2020

Mobile Mental Health Apps: Weighing the Pros and Cons

By: Randolph Edmead, MS and Laura LaRue Gertz, MSW, LCSW

As symptoms of stress, anxiety, and depression are increasing during the global COVID-19 pandemic, people may be exploring technology-based strategies to relieve symptoms and to supplement mental health care. Increasingly, telehealth is a service covered by insurance providers. In addition, many people are interested in using mobile apps to supplement their care, track and improve their symptoms, and take proactive steps to improve their mental health through strategies such as stress reduction, relaxation, and cognitive behavioral techniques. Yet individuals may also be wondering how to evaluate if a mobile app is useful, evidence-based, and will safeguard their privacy.

Technology-based strategies such as mobile apps for mental health have many potential advantages. Technology has enormous capacity to gather assessment and monitoring data that can provide valuable insights about symptoms, useful strategies and could lead to more effective treatment. Technology can help overcome access barriers for individuals with mobility issues, for individuals living in rural areas or areas with a shortage of providers, and for individuals who have been reluctant to seek conventional mental health services. And now, mobile access is even more important as individuals may be simultaneously coping with increased symptoms of stress, anxiety, and depression during the pandemic, while experiencing isolation and reduced access to their usual support systems due to physical distancing.

Although there are many potential advantages of mobile apps to supplement mental health care, there are still many barriers and risks, including lack of effectiveness data; challenges with reproducibility, implementation, and dissemination; concerns about the privacy and confidentiality of data and use or misuse of data; and challenges with integration of technology strategies and data into the treatment plan and the health care system. However, there are useful, accessible strategies that can help people assess the safety and usefulness of a mobile app.

The APA App Evaluation Model is an evaluation roadmap to guide informed decision-making in choosing mobile apps in clinical care. The guideline provides a series of questions, organized by levels, that help consumers and providers decide whether to use a mobile app (Torous et al., 2018). This model does not endorse specific apps, but rather promotes a systematic approach to evaluating apps.

The five levels of the APA App Evaluation Model are:

Access and Background: Assesses background information needed prior to evaluation
Privacy and Security: Considers many aspects of app security and privacy
Clinical Foundation: Evaluates any evidence for potential benefits
Usability: Evaluates how usable the app is for the consumer
Data Integration towards Therapeutic Goal: Examines whether the app’s output can be used in a clinically meaningful way

The PsyberGuide, developed through Northwestern University’s Center for Behavioral Intervention Technologies with funding from the One Mind Institute, reviews and rates apps that claim to treat mental health conditions. The publicly available guide helps consumers make informed choices. PsyberGuide provides app ratings based on three metrics:

Credibility: Evaluates the strength of the scientific research for the app, as well as the therapeutic interventions provided by the app
User Experience: Uses the Mobile App Rating Scale (MARS) developed by Stoyanov et al. (2015) to assess the design and user interface
Transparency: Evaluates the clarity of the app’s privacy policy regarding data storage and collection procedures of the app and associated servers

Technology will not replace the human connection that is a central part of the care of individuals experiencing stress, anxiety, and depression. But when technology-based strategies are thoughtfully developed, evaluated, and implemented, they have tremendous potential to augment and expand care, to enhance engagement and treatment, and to improve the quality of life for individuals living with mental health conditions.

Randolph Edmead, MS, Vice President of Federal Government Programs. Randolph Edmead has an extensive background managing large teams in the mental health treatment, substance abuse prevention and treatment, policy, and evaluation service areas. Mr. Edmead has over 18 years of experience developing, implementing, and managing the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Centers for Mental Health Services and Substance Abuse Treatment and Prevention programs; providing curricula and training to SAMHSA and health care providers and staff on leading practices, human resources, accreditation survey support, skills development, and cultural competency; and consulting with healthcare organizations and treatment facilities. Mr. Edmead holds a Master of Science Degree in Clinical Psychology.

Laura LaRue Gertz, MSW, LCSW, Public Health Analyst/Scientific Writer. Laura LaRue Gertz has over 30 years of experience in health and mental health, as a clinician, analyst, writer, researcher, and project manager. She developed literature reviews and reports on evidence-based treatments for individuals with serious mental illness for a federal contract with the SAMHSA Center for Mental Health Services (CMHS). She has also worked on contracts with the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), and numerous other U.S Department of Health and Human Services (HHS) agencies. Ms. Gertz holds a Master of Social Work Degree and is a Licensed Clinical Social Worker.

The Bizzell Group (Bizzell) was founded by President & CEO Anton C. Bizzell, M.D., a leading behavioral health expert and former Medical Officer for the U.S. Department of Health and Human Services (HHS). Bizzell’s team of public health experts have created and led comprehensive behavioral health prevention and treatment initiatives and education and training programs. Bizzell’s recent work includes systematic, integrated approaches designed to effect lasting change in health and behavioral health care through work with the Substance Abuse and Mental Health Services Administration (SAMHSA), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the Department of Defense (DOD). Learn more about how Bizzell advances data-driven, research-informed, innovative solutions to solve complex-real-world challenges: https://BizzellUS.com/

References

Stoyanov, S. R., Hides, L., Kavanagh, D. J., Zelenko, O., Tjondronegoro, D., & Mani, M. (2015). Mobile app rating scale: A new tool for assessing the quality of health mobile apps. JMIR mHealth and uHealth, 3(1), e27.

Torous, J. B., Chan, S. R., Gipson, S. Y. M. T., Kim, J. W., Nguyen, T. Q., Luo, J., & Wang, P. (2018). A hierarchical framework for evaluation and informed decision making regarding smartphone apps for clinical care. Psychiatric Services, 69(5), 498-500.

side view of a person's head with a sunset image in it

30Jul2020

Supporting Teen Mental Health During a Pandemic

Young girl feeling alone and solitude at home

Written By: Todd W. Mandell, MD and Rhonda Waller, PhD

The global COVID-19 pandemic is casting new urgency on the topic of teen mental health. Adolescence is already a time of significant physical, mental, emotional, and social development. It is normal for teens to experience a wide range of emotions and unpredictable moods. The COVID-19 pandemic has added a new set of challenges as teens navigate disruptions to their usual school, extracurricular, and social routines due to lockdowns, social distancing restrictions, and uncertainty about the future. According to a review of relevant research published in June 2020, many teens may experience isolation and loneliness which could lead to or exacerbate feelings of depression and anxiety. Currently, there is little data that examines the impact of pandemics such as COVID-19 on teens’ mental health, though some researchers are starting to explore this topic. Oxford University recently initiated a study that will track adolescents’ mental health to identify factors that hinder and promote resilience during the pandemic. In the meantime, we know that rates of teen depression and anxiety have risen during the past decade.

A 2019 study that examined National Survey on Drug Use and Health (NSDUH) data found that from 2005 to 2017, the percentage of adolescents (12 to 17 years old) experiencing at least one major depressive episode increased from 8.7 percent to 13.01 percent—a 52% increase. In 2018, the rate was 14.4 percent—roughly 3.5 million adolescents. The National Institute of Mental Health reports that nearly one-third (32 percent) of adolescents 13-18 years old experience an anxiety disorder. A 2018 study that examined data from the National Survey of Children’s Health (2003, 2007 and 2011-2012) found that anxiety similarly appears to be on the rise.

While there is no conclusive answer for why teen depression and anxiety are rising, some common themes in research include:

Increased awareness about mental health issues might increase disclosure of symptoms and identification of mental health disorders.
Continuous exposure to social media and news that may have an adverse impact on teen’s mental health.
Increased social and academic pressures and expectations for youth may contribute to depression and anxiety.

In addition, health inequities and social determinants of health such as socioeconomic status, education, social support networks, and access to health care can influence adolescent mental health.

The bottom line, however, is that mental health disorders are a real concern for teens—and the COVID-19 pandemic may exacerbate these issues for some youth. Left untreated, mental health disorders can have a lifelong impact on health. Parents, teachers, coaches, and others who interact with teens should stay alert for signs of anxiety and depression. Warning signs and symptoms may include:

Loss of interest in activities previously enjoyed
Avoiding school, activities, and social interactions with friends and family
Changes in grades
Trouble sleeping/concentrating
Engaging in self-harming or risky behaviors such as substance abuse
Chronic physical complaints
Sleeping too much or too little
Increased irritability or moodiness

The American Academy of Pediatrics’ parenting website offers practical information from child health experts on how to support teens’ mental health during the COVID-19 pandemic, including strategies for healthy routines, effective communication, safe virtual connections, family support, and physical and emotional health. However, parents who observe or are concerned about signs of depression or anxiety in their teen should discuss this with their pediatrician or a health care provider. The U.S. Department of Health and Human Services has also compiled a comprehensive list of Resources to Support Adolescent Mental Health. In addition, the National Institute of Mental Health recommends that teens save several emergency numbers in their cell phones to ensure immediate help for themselves or a friend in an emergency—including the non-emergency local police department number, the Crisis Text Line (741741) and the National Suicide Prevention Lifeline (1-800-273-TALK).

From a public health perspective, increased screening for depression and anxiety and access to health care could result in earlier detection and treatment, which is particularly important during the pandemic. Many experts, including the U.S. Prevention Screening Task Force (USPSTF) and the American Academy of Pediatrics, recommend annual screening of teens for depression. Most insurance companies are now covering telehealth visits at the same rate as in-person visits, which may make screening and services more accessible for teens needing treatment. With growing awareness of the effects of the pandemic on mental health, it is now even more important that teens experiencing depression and anxiety get timely screening and treatment to improve their outcomes.

Todd W. Mandell, MD, Senior Associate, Addiction Medicine. Todd Mandell is a board-certified Psychiatrist with added qualifications in Addiction Medicine, and more than 30 years of experience in the field of co-occurring psychiatric and substance use disorders with a focus on direct patient service, program development, and administration. (LinkedIn)

Rhonda Waller, PhD, Senior Associate, Maternal and Child Health. Rhonda Waller is a psychologist with more than 25 years of professional experience in public health, education, and human services with an emphasis on program development, leadership development, capacity building, and training and technical assistance. (LinkedIn)

The Bizzell Group (Bizzell) was founded by President & CEO Anton C. Bizzell, M.D., a leading behavioral health expert and former Medical Officer for the U.S. Department of Health and Human Services (HHS). Bizzell’s team of public health experts have created and led comprehensive behavioral health prevention and treatment initiatives and education and training programs. Bizzell’s recent work includes systematic, integrated approaches designed to effect lasting change in health and behavioral health care through work with the Substance Abuse and Mental Health Services Administration (SAMHSA), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the Department of Defense (DOD). Learn more about how Bizzell advances data-driven, research-informed, innovative solutions to solve complex-real-world challenges: https://BizzellUS.com/

16Jun2020

Strategies to Reduce Anxiety and Depression During COVID-19

Written by: Randolph Edmead

The global COVID-19 pandemic has had profound social, economic, and health effects. A recent study found that 56% of U.S. adults reported that worry or stress related to the pandemic has caused them to experience at least one negative effect related to mental health and wellbeing. Physical distancing to reduce spread of COVID-19 increases social isolation and creates new challenges for individuals experiencing symptoms of anxiety and depression.

Some of the most prevalent concerns people have reported about managing during the COVID-19 pandemic are uncertainty about the future, not having control over the virus and its effects, and the economic ramifications of the pandemic. With widespread job loss, and the potential for the virus to cause serious illness and death, these concerns are not unfounded. The pandemic is having a significant effect on those who have not previously struggled with mental health issues, and the effects are exacerbated for those who have. As with other traumatic events, it has taken an exceptional toll on frontline health care workers and first responders.

The American Psychological Association says that it is critical to maintain social support and connections during physical distancing, and that it is important to know the signs of anxiety and depression so that individuals who may be experiencing these challenges can get timely help.

Signs of anxiety include:

Persistent worry, feeling overwhelmed by emotions
Excessive worry about a number of concerns, general sense that something bad is going to happen
Restlessness, irritability
Difficulty concentrating, sleep problems, feeling on edge

Signs of depression include:

Lack of interest or pleasure in activities
Significant weight loss or gain
Lack of energy or difficulty concentrating
Insomnia or excessive sleeping
Feelings of worthlessness or excessive guilt
Recurrent thoughts of death or suicide

One unexpected consequence of the COVID-19 pandemic may be that the increased media attention on the mental health effects of the crisis is helping to reduce the stigma of talking about mental health issues. A new social media campaign through , “How are You, Really?”, aims to decrease the stigma of mental health issues by encouraging people to safely share their stories to show others that they are not alone.

Tips for Staying Mentally Healthy

The Director Dr. Joshua Gordon provides 5 tips for staying mentally healthy during the COVID-19 outbreak, which are timely for individuals struggling with anxiety or depression, as well as for those who are simply looking for positive strategies to cope with the challenges of the pandemic:

Avoid using alcohol or other drugs as coping mechanisms.
Maintain routines for meals, exercise, and sleep. Try to stay active.
Explore wellness programs, like meditation, yoga, muscle relaxation, or breathing exercises.
Stay connected. Talk by phone. Chat outside while maintaining recommended social distance. Join online gatherings.
Seek help right away if you have trouble coping or feel overwhelmed.

The Bizzell Group (Bizzell) was founded by President & CEO Anton C. Bizzell, M.D., a leading behavioral health expert and former Medical Officer for the U.S. Department of Health and Human Services (HHS). Bizzell’s recent work includes systematic, integrated approaches designed to effect lasting change in the field of behavioral health through work with the Substance Abuse and Mental Health Services Administration (SAMHSA), National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), and the Centers for Disease Control and Prevention (CDC). Learn more about how we develop data-driven, research-informed, innovative solutions to advance mental health, behavioral health, and other complex-real-world challenges: https://BizzellUS.com/.

29May2020

Maintaining Recovery from Substance Use Disorders During the COVID-19 Pandemic

Written by: Anton Bizzell, MD

The global COVID-19 pandemic has had a profound impact on health care delivery systems and on patterns of social support worldwide, creating an unprecedented set of challenges for individuals in recovery from substance use disorders (SUDs). In addition to managing the situational anxiety many people are facing with the unknowns of the pandemic, the social distancing that is vital to reduce the spread of the virus and protect vulnerable people, leaves individuals in recovery physically isolated from their health care providers and support system. Some people with SUDs may be at higher risk of relapsing with extended periods of time at home, uncertainty about work or finances, added stress on family relationships, or social isolation.

With this extraordinary situation, new resources and solutions are emerging to help people struggling with SUDs gain access to treatment in order to maintain their path to recovery.

New treatment access and guidelines during COVID-19. Health care and treatment of individuals with SUDs is evolving to meet the challenges of social isolation during the global pandemic:

Telehealth: Most insurance companies are now covering telehealth services at the same rate as traditional in-person visits with health care and behavioral health providers. Providers use secure virtual platforms to conduct a confidential video assessment, and to provide any necessary prescriptions or referrals to additional virtual or in-person treatment.
Take-home Medication-Assisted Treatment for Opioid Use Disorders: The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued Opioid Treatment Program guidance for states to be granted an exception to administer 14 to 28 days of take-home medication to individuals in an Opioid Treatment Program. This new guidance improves access to evidence-based Medication-Assisted Treatment for individuals with opioid use disorders (OUDs).
Treatment for Alcohol Withdrawal: The American Society of Addiction Medicine (ASAM) has issued a Clinical Guideline on Alcohol Withdrawal Management. Some states have closed liquor stores as part of COVID-19 restrictions, resulting in limited access; at the same time, individuals experiencing alcohol withdrawal may also have limited access to treatment and withdrawal management programs. The ASAM Guideline advises clinicians in decision-making and treatment, improving care for these individuals struggling with alcohol use and alcohol withdrawal.

Virtual support during COVID-19. Many new resources are available to help individuals in recovery access support virtually:

SAMHSA Virtual Recovery Resources: SAMHSA notes that during the social distancing and isolation of COVID-19, it is still vital to continue social connections when recovering from SUDs and mental health conditions. This Tip Sheet describes resources for individuals in recovery and gives guidance for setting up a virtual recovery meeting.
National Alliance for Mental Illness (NAMI) COVID-19 Resource and Recovery Guide: Mental health support is a vital component of recovery. NAMI provides helpful tips for managing concerns about the virus, accessing virtual support, developing healthy daily routines, maintaining social support, and prioritizing self-care.
Alcoholics Anonymous Options for Meeting Online: During COVID-19, many Alcoholics Anonymous groups are exploring alternate ways to continue the community of support for recovery. This may involve phone calls, email, social media, and virtual meetings on digital platforms. Alcoholics Anonymous encourages groups to decide what will work best for them and provides information for groups making this change.
Virtual Narcotics Anonymous: This collaborative resource helps people find online and phone meetings of Narcotics Anonymous around the world. Narcotics Anonymous is for people who have any SUD and want support in their recovery.

Healthy habits to support recovery during COVID-19. Some people in recovery have found it helpful to take this time of social distancing to focus on healthy habits that will support recovery. These can include:

Manage News Consumption
- Check only established, reliable news sources. Set a timer to limit the amount of time you are reading the news. Avoid checking the news within one hour before bedtime, and instead focus on relaxing activities.
Get Ample Rest
- Get at least 7-8 hours of sleep each night. Make sure that your sleeping area is used only for sleep. Use calming routines at night such as reading, taking a bath, or talking with a friend.
Develop and Maintain a Daily Routine
- Keep a routine of getting up and getting dressed on a regular schedule each day. Set your alarm and start your day with a walk outside or your favorite breakfast. Take a shower, get dressed, and write out a plan for how you will spend your day.
Exercise Daily
- Get daily exercise, even if it is just a gentle walk or simple stretches. If you usually go to a gym, look for online exercise programs such as yoga, dance, chair exercises, or even a boot camp routine. Start a virtual exercise routine with a friend so that you can encourage and support each other.
Schedule Time to Connect with Loved Ones
- Schedule time for social connections each day, whether by phone, video, email, or text. Look for shared activities such as a book club, art activities, virtually movie night, or cooking that you can enjoy together remotely. Focus on connections with the people you can have honest conversations with about your feelings and struggles.
Other Mental Health Exercises
- Choose activities that will support your mental health, including breathing exercises, journaling, or meditation. Look for online books and workbooks on Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness, to help you manage your thoughts, worries, and behaviors during this challenging time. Notice what feels relaxing and restful for you, and intentionally choose those activities.

The COVID-19 pandemic has created new challenges for individuals in recovery; it has also fostered creative new approaches to treatment and support, many of which are reaching people in new ways that may continue beyond the end of social distancing. With continued integration of treatment, virtual support, and healthy habits, recovery can continue.

The Bizzell Group (Bizzell) was founded by President & CEO Anton C. Bizzell, M.D., a leading substance use disorders (SUDs) expert and former Medical Officer for the U.S. Department of Health and Human Services (HHS). Dr. Bizzell was selected as Maryland’s 2020 Small Businessperson of the Year by the U.S. Small Business Administration (SBA). Bizzell’s recent work includes systematic, integrated approaches designed to effect lasting change in the field of SUDs through work with the National Institute on Drug Abuse (NIDA), the National Cancer Institute (NCI), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the United States Chamber of Commerce Foundation (USCCF). Learn more about how we develop data-driven, research-informed, innovative solutions to SUDs and other complex-real-world challenges: https://BizzellUS.com/

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Tag Archives: Mental Health

Mobile Mental Health Apps: Weighing the Pros and Cons

Mobile Mental Health Apps: Weighing the Pros and Cons

Supporting Teen Mental Health During a Pandemic

Supporting Teen Mental Health During a Pandemic

Strategies to Reduce Anxiety and Depression During COVID-19

Strategies to Reduce Anxiety and Depression During COVID-19

Maintaining Recovery from Substance Use Disorders During the COVID-19 Pandemic

Maintaining Recovery from Substance Use Disorders During the COVID-19 Pandemic

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