SmartSDM: The use of digital tools and wearables for people with severe mental illnesses

A BFH research project has investigated how digital tools and wearable devices are used by people with severe mental illness.

Digital transformation and severe mental health problems

People with severe mental illnesses such as psychosis or severe depression have hardly benefited from advances in digital healthcare to date. While numerous apps and online services have been developed for people with mild to moderate mental health problems, for example for self-help or to supplement traditional therapies, a particularly vulnerable group has largely been left out. It is estimated that this problem affects up to two per cent of the adult population ^[1].

A research team at Bern University of Applied Sciences (BFH) wants to close this gap and is specifically investigating how digital technologies can be made useful and suitable for everyday use for people with complex mental illnesses. The focus is not only on the question of technical feasibility, but also on acceptance, accessibility and the specific benefits for those affected.

The aim of the project is to better understand which digital devices and applications these people are already using, what hurdles exist, for example in dealing with technology or trusting data protection, and how digital services would have to be designed to actually help. The project is therefore making an important contribution to making digital healthcare more inclusive and including people with severe mental illnesses in the digital future of the healthcare system.

Step 1: Survey

The first step was to conduct a survey ^[2]. The study is based on a survey of 68 participants (27% response rate) from a psychiatric rehabilitation centre in Switzerland, who were asked how they use digital devices and applications. The respondents stated that they mainly owned smartphones, but only had limited access to wearables such as smartwatches or Fitbits – these were used much less frequently.

In terms of software applications on these devices, the focus was primarily on communication, everyday organisation and health: many used digital tools to manage appointments or search for information on health topics. Fears regarding data protection or technical overload were expressed, which can be an obstacle to the use of such devices and services.

Overall, the survey shows that people with severe mental illness in Switzerland do use digital devices, especially smartphones, in their everyday lives and welcome offers to support their health – however, barriers such as lack of access to wearables, uncertainties about data protection and limited digital skills are important factors that need to be taken into account.

Step 2: Pilot study

In a second step, a pilot study was conducted ^[3]. The researchers equipped 10 people from a Swiss psychiatric rehabilitation centre with wearables and conducted a survey to investigate whether and how often the devices were worn.

The results show that the time spent wearing the wearables was encouragingly high overall: on average, the participants used the devices for around 20 hours a day. This result is encouraging, as regular and reliable use forms the basis for ensuring that the data collected can actually be used to support health-related decisions.

The study showed a wide range in the use of wearables: not all participants used the devices to the same extent. This variability emphasises that digital technologies in the health sector must meet high standards in order to actually become established in everyday life. For wearables to be accepted by those affected and used on a permanent basis, they must offer clearly recognisable, direct added value, for example through individually relevant information or concrete support in everyday life. It is precisely this requirement that makes the development and research of such technologies for specific target groups particularly challenging.

What next?

A larger-scale study is needed to investigate how wearables can be used for people with mental health problems and what barriers may exist. It is crucial to involve those affected, who are best placed to define how and on which technological platform support is expedient.

Links

Research project: https://www.bfh.ch/de/forschung/forschungsprojekte/2022-873-154-790/

References:

^[1] Gühne, U., Becker, T., Salize, H. J., & Riedel-Heller, S. G. (2015). How many people in Germany are severely mentally ill? Psychiatric Practice, 42(08), 415-423.

https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0035-1552715

^[2] Richter, D., Schwarze, T., & Kurpicz-Briki, M. (2024, May 6). Use of digital devices and applications by people with severe mental illness in Switzerland. https://doi.org/10.31234/osf.io/n8t6h

^[3] Richter, D., Hasler, M., & Kurpicz-Briki, M. (2024, May 11). Adherence to wearables by people with severe mental illness in Switzerland: Time-use study. https://doi.org/10.31234/osf.io/bjzrh