Background: Digital psychiatry, or telepsychiatry, is defined as a set of digital technologies that are used for diagnosis, assessment and therapy in psychiatry. The tools and modalities are varied and very diverse, ranging from video conferencing to self-help apps, from digital phenotyping to iCBT apps. There is increasing evidence of how a digital approach to mental health can increase the accessibility and effectiveness of services, but the implementation of digital mental health tools in clinical practice is proving not without difficulties, lacking fundamental elements for practitioners such as training, guidelines, real-world studies and evidence on the application of digital psychiatry in daily practice. Materials and methods: for this study, psychiatrists and psychologists were examined, to whom a specially created questionnaire was administered, investigating the operators' knowledge of the subject, the use of digital psychiatry, the difficulties in its use and the satisfaction levels of those who had used it. In addition, performance data for the month of October 2024 in the services of the CSM of Ulss 1 and the Ser.D of Ulls 4 were analysed, to find any evidence of digital psychiatry in clinical practice. Aim of the study: Apart from the discrepancies between clinical trials and the implementation of digital psychiatry tools in clinical practice, this study aims to analyse the attitude towards digital mental health on the part of mental health professionals, especially psychiatrists and psychologists. It is then intended to give an overview of the state of the art in the Veneto Region, to understand the difficulties in the implementation of digital pathways, and the barriers experienced by professionals. Results: Forty-eight psychologists and psychiatrists responded to the study. Of these, 20 participants (41%) had used a digital therapy tool at least once. 16 of these were fairly satisfied, 3 not very satisfied and 1 very satisfied. The main difficulties were lack of information about the tools (47%), unclear directions for use (20%), difficulties of the patients (25%), access to the devices or wi-fi (18%) and technical difficulties in using the tools (14%). Only 4% participated in training or education on digital psychiatry. As regards the results of the study of services in the services of Ulss 1 and Ulss 4, the number of services carried out remotely was 144, of which the majority were team meetings, and only 6 psychiatric control visits (0.65 % of the total number of psychiatric control visits). Conclusions: The results show how the attitude of psychiatrists and psychologists towards digital mental health is still one of mistrust, and highlight the barriers they find in approaching it: lack of training, lack of clear indications, lack of guidelines, perplexity about the effectiveness and applicability in daily practice of digital psychiatry tools. This attitude is reflected in the actual use, even embryonic, of digital tools, which is almost totally absent in the services analysed. It is therefore certainly necessary, in order to make the most of the potential of these tools, to strengthen research with real-world studies that can show how to apply these tools in a community service model, just as it is necessary for training and the creation of specific and precise guidelines and protocols to be implemented.
Background: La digital psychiatry, o telepsichiatria, è definita come un insieme di tecnologie digitali che vengono utilizzate per la diagnosi, l’assesment e la terapia in ambito psichiatrico. Gli strumenti e le modalità sono vari e molto diversi tra loro, dalle videoconferenze, alle app di self help, dal digital phenotyping alle app di iCBT. Ci sono sempre più evidenze di come un approccio digitale alla salute mentale possa aumentare l’accessibilità e l’efficacia dei servizi, ma l’implementazione di strumenti di digital mental health nella pratica clinica si sta rivelando non priva di difficoltà, mancando elementi fondamentali per gli operatori come formazione, linee guida, studi in real – world ed evidenze sull’applicazione della digital psychiatry nella pratica quotidiana. Scopo: Al netto delle discrepanze tra i trial clinici e l’implementazione degli strumenti di digital psychiatry nella pratica clinica, questo studio ha l’obiettivo di analizzare l’atteggiamento nei confronti della digital mental health da parte di operatori della salute mentale, in particolar modo psichiatri e psicologi. Si vuole poi dare una panoramica sullo stato dell’arte nella Regione Veneto, per comprendere nelle specificità territoriali le difficoltà nella realizzazione di percorsi digitali, e le barriere vissute dai professionisti. Materiali e metodi: per questo studio sono stati presi in esame in particolar modo psichiatri e psicologi, a cui è stato somministrato un questionario creato appositamente, che indaga la conoscenza degli operatori del tema, l’utilizzo di digital psychiatry, le difficoltà nell’utilizzo e i livelli di soddisfazione di chi ne ha fatto uso. Inoltre, sono stati analizzati i dati di prestazioni del mese di Ottobre 2024 nei servizi dei CSM dell’Ulss 1 e del Ser.D dell’Ulls 4, per trovare un eventuale riscontro di digital psychiatry nella pratica clinica. Risultati: Hanno risposto allo studio 48 psicologi/e e psichiatri/e. Di questi, 20 partecipanti (41%) hanno utilizzato almeno una volta uno strumento di terapia digitale. 16 di questi sono rimasti abbastanza soddisfatti, 3 poco soddisfatti e 1 molto soddisfatto. Le difficoltà principali sono state la scarsa informazione sugli strumenti (47%), indicazioni di utilizzo poco chiare (20%), le difficoltà dei pazienti (25%), l’accesso ai device o al wi-fi (18%) e le difficoltà tecniche nell’utilizzo degli strumenti (14%). Solo il 4% ha partecipato ad un training o ad una formazione sulla digital psychiatry. Per quanto riguarda i risultati dello studio delle prestazioni nei servizi dell’Ulss 1 e dell’Ulss 4, il numero di prestazioni svolte in remoto è di 144, di cui la maggior parte incontri di equipe, e solo 6 visite psichiatriche di controllo (0,65 % del totale delle visite psichiatriche di controllo). Conclusioni: I risultati mostrano come l’atteggiamento di psichiatri e psicologi nei confronti della digital mental health sia ancora di diffidenza, ed evidenziano le barriere che trovano nell’approcciarvisi: mancanza di formazione, mancanza di indicazioni chiare, mancanza di linee guida, perplessità sull’efficacia e sull’applicabilità nella pratica quotidiana di strumenti di psichiatria digitale. Questo atteggiamento si riflette sull’effettivo utilizzo, anche solo embrionale, di strumenti digitali, che nei servizi analizzati è quasi totalmente assente. È quindi sicuramente necessario, per sfruttare al massimo le potenzialità di tali strumenti, potenziare la ricerca con studi in real-world che possano mostrare come applicare in un modello di servizi di comunità tali strumenti, così come è necessario che venga implementata la formazione e la creazione di linee guida e protocolli specifici e precisi.
Applicazione della digital mental health nei servizi di salute mentale: uno studio nella Regione Veneto
LONGOBUCCO, LUISA
2024/2025
Abstract
Background: Digital psychiatry, or telepsychiatry, is defined as a set of digital technologies that are used for diagnosis, assessment and therapy in psychiatry. The tools and modalities are varied and very diverse, ranging from video conferencing to self-help apps, from digital phenotyping to iCBT apps. There is increasing evidence of how a digital approach to mental health can increase the accessibility and effectiveness of services, but the implementation of digital mental health tools in clinical practice is proving not without difficulties, lacking fundamental elements for practitioners such as training, guidelines, real-world studies and evidence on the application of digital psychiatry in daily practice. Materials and methods: for this study, psychiatrists and psychologists were examined, to whom a specially created questionnaire was administered, investigating the operators' knowledge of the subject, the use of digital psychiatry, the difficulties in its use and the satisfaction levels of those who had used it. In addition, performance data for the month of October 2024 in the services of the CSM of Ulss 1 and the Ser.D of Ulls 4 were analysed, to find any evidence of digital psychiatry in clinical practice. Aim of the study: Apart from the discrepancies between clinical trials and the implementation of digital psychiatry tools in clinical practice, this study aims to analyse the attitude towards digital mental health on the part of mental health professionals, especially psychiatrists and psychologists. It is then intended to give an overview of the state of the art in the Veneto Region, to understand the difficulties in the implementation of digital pathways, and the barriers experienced by professionals. Results: Forty-eight psychologists and psychiatrists responded to the study. Of these, 20 participants (41%) had used a digital therapy tool at least once. 16 of these were fairly satisfied, 3 not very satisfied and 1 very satisfied. The main difficulties were lack of information about the tools (47%), unclear directions for use (20%), difficulties of the patients (25%), access to the devices or wi-fi (18%) and technical difficulties in using the tools (14%). Only 4% participated in training or education on digital psychiatry. As regards the results of the study of services in the services of Ulss 1 and Ulss 4, the number of services carried out remotely was 144, of which the majority were team meetings, and only 6 psychiatric control visits (0.65 % of the total number of psychiatric control visits). Conclusions: The results show how the attitude of psychiatrists and psychologists towards digital mental health is still one of mistrust, and highlight the barriers they find in approaching it: lack of training, lack of clear indications, lack of guidelines, perplexity about the effectiveness and applicability in daily practice of digital psychiatry tools. This attitude is reflected in the actual use, even embryonic, of digital tools, which is almost totally absent in the services analysed. It is therefore certainly necessary, in order to make the most of the potential of these tools, to strengthen research with real-world studies that can show how to apply these tools in a community service model, just as it is necessary for training and the creation of specific and precise guidelines and protocols to be implemented.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/86972