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PREDICTION: Will We Be Treating Mental Health Patients by Smartphone before 2020 (Part I)

A recent PEW study reported that over one third (35%) of American adults age 18 and over own a smartphone of some kind. One quarter (25%) of smartphone owners report that their phone is where they do most of their online browsing.  When asked about how they feel about their devices, 72% of smartphone owners used a positive word (such as “good,” “great,” “excellent” or “convenient”) to describe their phones. Will anything stop these numbers from growing between now and 2020? The trend we are seeing is not likely to reverse.

treating Mental Health patientsWhen asked about how they feel about their devices, 72% of smartphone owners used a positive word (such as “good”, “great”, “excellent” or “convenient”) to describe their phones.More than 8 out of 10 people around the world currently make use of mobile devices, such as cell phones.  That is, out of 6.9 billion people on our planet, 5.6 billion currently use a mobile phone. Google Android chief Andy Rubin tweeted in June that “over 500,000 Android devices “are now activated each day around the world.”  Moreover, activations are growing at a rate of 4.4 percent week-over-week. On the other hand, only 3 out of 10 people around the world currently are connected to the internet, that is, less than 2 billion.

What’s Happening?

As a worldwide community, our telecommunication tools are being migrated to the “hip pocket.”  Largely dependent upon communication, mental health treatment will inevitably migrate to the hip pocket as well, and be transformed in the process. Why? Smartphones allow the user to carry their own, personalized computer anywhere, and keep their hands free. Users can carry analytic, memory retrieval and storage capacities, combined with instantaneous worldwide access, and still swing a golf club, pay for that Gatorade at the corner store or lift the baby.

As a tool, smartphones are already beginning to transform health care. In mental health, our services will grow from an in-office “privilege” enjoyed by the world’s fortunate few, to a computer-mediated staple of everyday existence for whomever is interested, whether people watching at the mall, floating on an iceberg in the Antarctic or traversing the Serengeti by camel.  Many of us, if not most of us, will be treating Mental Health patients by mobile device within this decade (before 2020), using mobile ‘apps’ for self-help or even delivering direct care.

Those services might involve self-help or psycho-educational, interactive games, lessons, journals or other behavior tracking systems. On the direct care side of the house, smartphone or other hand-held devices ( e.g. tablet PCs such as the iPad) might involve real-time (live) or “store-and-forward” forms of psychotherapy, where recorded portions of an interaction can be viewed by remote patients or practitioners and their supervisors or consultants.

How can I make this prediction?

Worldwide proliferation of these devices amongst consumers is not the only foreshadowing sign. Even within our own ranks, the numbers all point in the same direction. In 2008, a survey reported by the American Psychological Association showed 9.8% of practitioners were already using email to deliver psychological services (not scheduling, but “services.”

Note, that survey was taken 4 years ago. How many more clinicians are using email today?  How many will be using both email and video for patient services by 2020? How many will be using a combination of direct-case (psychotherapy) and “apps” tailored to their patient’s specific combination of diagnosis, age, gender, language, education etc.? If we project our services into the future, the specificity technology will allow within just another decade or two is jaw-dropping to consider.

For now, current technology is already jaw-dropping. For instance, there’s something magical about slipping a smartphone into one’s jacket pocket, knowing access to the world is just within reach of one’s fingertips anytime, anywhere. Sure, clinicians treating patients remotely may prefer conducting a full day’s sessions via a 54″ monitor to enhance visibility and avoid fatigue, but they still will be likely to use the smartphone at least part of the time. On-call docs can be available for video response via smartphones from the golf course or cross-country vacation. They then can switch carriers to connect to a desk-top PC anywhere to access needed records on the cloud — all without interrupting the connection to the patient. (Did you read that last sentence carefully? Such service is nothing less than jaw-dropping, and it is available today!) And the “store-and-forward” services described above also exist today for mental health in particular. (Attend our American Psychological Association CE Workshop on August 4, 2011, entitled, “Telehealth and Telepsychology Best Practices” for a live demo from a company currently offering such service.)

As noted above,  most consumers are already carrying a cell phone. It is only a matter of a few years before the basic cell phone of today is outdated and replaced by an upgraded, enhanced smartphone. These phones will most likely change in shape and offer many more features. In Part II and Part III of this blog series, I’ll outline what I see happening for clinicians in the next decade — and beyond.

These are some of my thoughts. What are yours?

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