Must write a thoughtful response to classmates post below, related to youth mental health technology, and offer orignal feedback about how this would be useful for our targeted group of teens 12-17. IN TEXT CITATIONS WITH RELEVANT SOURCES
1st Classmates post
https://www.talkspace.com/online-therapy/teens
Although mental health visits have been historically in person, platforms such as Talkspace, have adapted telehealth talk therapy online, making therapy more accessible. According to Health People 2023, a key Social Determinant of Health (SDoH) is healthcare access and quality (Health.gov, n.d.). Telehealth addresses this gap in care by making access to mental health more accessible to those in rural areas or those who cannot travel to appointments. Considering our group’s topic of depression in girls ages 12-17, teletherapy is a great use of technology to help this population. It has been proven that psychotherapy, or talk therapy plays a key role in treating depression (Mayo Clinic, 2022). Therapy addresses and helps teens work through difficult situations, explore relationships and develop healthy coping mechanisms (Mayo Clinic, 2022).
Talkspace for teens is specifically helping teenagers get access to teletherapy. It is a website and app that is subscription based with online access to therapy over the phone via video chat (Talkspace, n.d.). Talkspace for teens offers therapy to those individuals ages 13-17 and matches them with licensed clinicians that specialize in treating teens (Talkspace, n.d). First, an online assessment is performed and they are matched with a therapist. They can contact them and share what is on their mind so that their virtual appointments can be more constructive (Talkspace, n.d.). Online therapy allows more flexibility than in-person therapy. If a teenager does not have access to a car, or has a busy after school schedule, they do not have to worry about traveling to an appointment. Moreover, they are not limited to therapists in their local area which is helpful in finding a therapist who is a good fit for their needs (Martinelli, 2022). With Talkspace, they can text therapists between appointments and switch therapists if needed (Talkspace n.d.). Another benefit is the comfort of being at home, which allows teens to be more open than if they were in an unfamiliar office (Martinelli, 2022). Talkspace is covered by many insurances that are outlined on their website, as well as covered by some employee assistance programs (Talkspace, n.d.). They have even launched free online therapy for teens in New York ages 13-17 (Talkspace, n.d.). Out of pocket prices range 99 dollars to 109 dollars a week depending on the services used such as in person therapy or mental health workshops (Talkspace, n.d.).
Talkspace cites past studies that prove the efficacy of their platform, including one done by Columbia University, stating that 80% of users found Talkspace to be as effective as traditional therapy (Talkspace, n.d.). They are also currently conducting research provided by a grant from the National Institutes of Health (NIH) with the goal of delivering quality mental health care (Talkspace, n.d.). Although these statistics are encouraging, it is important to investigate this from a different source other than their website to avoid bias.
A systematic review done by Orsolini et al., 2021, aimed to answer the question: is Telemental Health (TMH) as effective as in person mental health visits? A total of 56 studies were reviewed and 24 of those studies specifically related to depression (Orsolini et al., 2021). The review looked at 8432 individuals throughout various studies and concluded that TMH-based interventions yielded an improvement in symptoms of depression compared to face-to-face treatment over a short-term follow up period (Orsolini et al., 2021). The author does acknowledge that more research should be done regarding longer follow up periods after therapy to fully illustrate the efficacy of TMH interventions.
Telehealth is of interest to me because of the long history of telephone use in nursing. Telephones have been an important part of the nursing profession ever since they were invented and implemented in healthcare in the early 1900s (Sandelowski, 2000). At the end of World War II, nurses championed “telephone therapy” which gave patients bedside access to telephones so that the nurses could ease anxieties and answer questions (Sandelowski, 2000, p. 84). Telephone use has evolved into an important part of the nursing role and has certain protocols in place for receiving a diagnosis, advice and delivering bad news. (Sandelowski, 2000). Telephones enable nurses to connect with patients more easily and maintain a coordination of care that would be unattainable with just seeing patients in person. Most recently, telehealth has become more popular with evidence indicating that it provides an increased quality of care, a decrease in hospital readmissions and savings for the provider and the patient (Hyder & Razzak, 2020). Technology and its role in primary health care has evolved over time, and it is important that as technologies change, nursing knowledge surrounding the development of new technologies evolves as well (ICN, 2008). Although telehealth seems to be somewhat of a recent invention, it is rooted in the history of telephones and the important role they play in healthcare by enabling providers to connect with patients in a much more timely and efficient manner.
Reflecting on our team’s topic, online therapy via telehealth is an effective and important way to address depression in girls ages 12-17 by increasing accessibility to therapy. Moreover, since therapy can be intimidating and potentially uncomfortable, having the ability to access it in the comfort of their own homes is beneficial.
References
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease
Prevention and Health Promotion. (n.d.) https://health.gov/healthypeople/priority-areas/social-determinants-health
Hyder, M. A., & Razzak, J. (2020). Telemedicine in the United States: An Introduction for
Students and Residents. Journal of Medical Internet Research, 22(11), e20839.https://doi.org/10.2196/20839
International Council of Nurses. (2008). Nursing perspectives and contribution to
primary health care. Geneva: International Council of Nurses. (pp. 25-29). ICN (2008) Nursing Perspectives and Contribution to Primary Health Care. https://classes.pace.edu/d2l/le/content/393107/viewContent/2618185/View
Martinelli, K. (2022). Telehealth for Kids. Child Mind Institute.
https://childmind.org/article/telehealth-for-kids/#what-are-some-pros-and-cons-of-telehealth-for-kids
Mayo Clinic. (2022). Teen Depression.
https://www.mayoclinic.org/diseases-conditions/teen-depression/diagnosis-treatment/drc-20350991
Orsolini, L., Pompili, S., Salvi, V., & Volpe, U. (2021). A Systematic Review on TeleMental
Health in Youth Mental Health: Focus on Anxiety, Depression and Obsessive-Compulsive Disorder. Medicina, 57(8), 793. https://doi.org/10.3390/medicina57080793
Sandelowski, M. (2000). Thermometers & Telephones: A Century of Nursing and Technology.
The American Journal of Nursing, 100(10), 82–86. https://doi.org/10.2307/3522323
Talk Space. (n.d.). Online Therapy for Teens. https://www.talkspace.com/online-
therapy/teens?cta_source=home_hero_cta_teen
Talkspace. (n.d.). Research Center. https://www.talkspace.com/research
Talkspace. (n.d.) NYC teenspace: Free Online Therapy for Teens.
https://www.talkspace.com/coverage/nyc?utm_source=google&utm_medium=sembrand&utm_campaign=Search_Google_Brand_New_York_BS_Talkspace&utm_content=153589124065&utm_term=talkspace%20teen&e&c&sitelinkid=&locationid=9004331&gclid=CjwKCAjw_LOwBhBFEiwAmSEQAdmtOpZLOeOob-pHEkC_YZBG6qhaaCktJsoGcdi7e9JaHt7Y6M42yxoCjCAQAvD_BwE
2nd CLASSMATE POST NEEDING RESPONSE:
Technology is a key aspect to help develop a primary care health initiative. Thus far our team has identified how policies and coalitions can help form a primary care health initiative surrounding our focal group topic. Technology is a resource that can be adapted within school systems to help address the rising rates of depression, specifically amongst females ages 12-17. Depression can be measured using self-reports such as the PHQ9. However, with the advancements with technology, I believe there are other ways to identify early signs of depression. Sandelowski (2000) states, “the telephone was a communication device that, by the 1920s, was transformed into an instrument of sociability and by the mid-century had become a mode of health care delivery” (p.84). With the advancements in AI and facial recognition technology that are installed in most smartphones today, the telephone can play a role in identifying facial expressions that are associated with depression.
MoodCapture, a new app created by Dartmouth researchers, could be beneficial and an easy tool for school systems to use to help detect early warning signs of depression (Kelley, 2024). The app would use the phone’s camera to identify facial expressions and surroundings when opening the phone with FaceID (Kelley, 2024). AI will help detect clinical cues associated with depression by analyzing gaze, eye movement, positioning of the head, muscle rigidity, dominant colors, lighting, photo locations, and the number of people in the image. The technology then has the ability to analyze the photos over a period of time and can determine if the person is reflecting emotional or environmental changes that can be associated with depression (Kelley, 2024).
Nepal et al., (2024) published a study on the effects of MoodCapture and identified a small sample size of 177 participants. Out of the 177 participants, 153 identified as female making this study focused on our population at interest (Nepal et al., 2024). Kelley (2024) states the founders of MoodCapture conducted, “a study of 177 people diagnosed with major depressive disorder, the app correctly identified early symptoms of depression with 75% accuracy” (para 2). Although the accuracy was not 100%, it was more than half, which I believe is a step forward in advancement for detecting early signs of depression.
Although the app is not on the market yet, I believe it would be a cost-effective program within school systems. However, there are limitations that would need to be addressed. Yellowless et al. (2008) states, “the additional obstacles associated with developing a culturally appropriate e-mental health program are attitudes toward technology and the socioeconomic status of the population of interest” (p.489). Limitations of MoodCapture include cultural views of use of technology, socioeconomic status that could limit access to phones with facial recognition, agreeability for using the app, access to providers within the school system that could monitor for any students “flagged” with signs of depression, as well as accessibility to resources to provide students to help manage depression once flagged by the app. It would be beneficial for the founders of MoodCapture to identify partnerships and coalitions as well as policy makers to help address these limitations. With additional support, it would also be imperative for more studies to be completed to address the effectiveness of facial recognition/AI and its ability to detect early signs of depression.
As advanced practice nurses it is our role to incorporate primary health care within in our practice which can include, “appropriate use of technology to access health information and teaching tools” (Alberta College and Association of Registered Nurses, p.5, 2020). MoodCapture could be a beneficial advancement in healthcare technology for identifying early signs of depression in females ages 12-17 in the U.S. however further research needs to be completed. Overall, I believe implementing MoodCapture within school systems across the US could be a beneficial primary care initiative for our team topic.
References
Alberta College and Association of Registered Nurses. (2020). Incorporating Primary Health Care into Practice; An Approach to Improve Health. College and Association of Registered Nurses of Alberta.
Kelley, M. (2024). Phone App Uses AI to Detect Depression From Facial Cues. Dartmouth. https://home.dartmouth.edu/news/2024/02/phone-app-uses-ai-detect-depression-facial-cues
Nepal, S., Pillai, A., Wang, W., Griffin, T., Collins, A., Heinz, M., Lekkas, D., Mirjafari, S., Nemesure, M., Price, G., Jacobson, N., Campbell, A. (2024). MoodCapture: Depression Detection Using In-the-Wild Smartphone Images. ARXIV. https://arxiv.org/html/2402.16182v1#S4
Sandelowski, M. (2000). Thermometers & Telephones: A Century of Nursing and Technology. The American Journal of Nursing, 100(10), 82–86. https://doi.org/10.2307/3522323
Yellowlees, P., Marks, S., Hilty, D., & Shore, J. H. (2008). Using e-Health to Enable Culturally Appropriate Mental Healthcare in Rural Areas. Telemedicine and E-Health, 14(5), 486–492. https://doi.org/10.1089/tmj.2007.0070
