Saad A, Bruno D, Camara B, D’Agostino J, Bolea-Alamanac B. Self-directed Technology-Based Therapeutic Methods for Adult Patients Receiving Mental Health Services: Systematic Review. JMIR Ment Health 2021;8(11):e27404. https://mental.jmir.org/2021/11/e27404 DOI: 10.2196/27404
A review was conducted to identify evidence-based, self-directed digital therapeutics for adult patients after they are discharged from mental health services. The studies included in the systematic review are interventions that are automated without human input, self-directed (patients can implement on their own) and treat mental health conditions. Thirty-six papers met eligibility. Included studies used technologies such as websites, automated text messages, mobile apps, videos, computer software, and integrated voice response. Twenty-two of the studies evaluated internet-based cognitive behavioral therapy compared to waitlist, human-delivered therapy, or other active intervention control groups. Of the 9 studies that compared a digital therapeutic to a waitlist control, 8 found the digital treatment showed a positive effect. Of the 8 studies that compared guided versus unguided digital care, results were mixed; 3 showed no difference, 3 favored guided interventions, and 2 favored unguided interventions. Across studies, dropout rates were high (up to 80%), which suggests possible issues with intervention acceptability. Overall, self-directed interventions have potential benefits such as accessibility, lower costs in health care, and improved healthcare equity.