Psychology: The problem briefly

As our world rapidly changes, mental health problems continue to rise. Between 1990 to 2013, there was a significant increase in the prevalence of common mental health disorders worldwide, surging by 50% [1]. When people experience mental health issues, they may not always be willing to seek counseling services or ask for help in general. The percentage of people who received mental health treatment in U.S. was 27% in 2002 to 41% in 2020 [2].

• In 2019, a billion people worldwide were living with a mental health disorder.

• Suicide accounted for 1% of deaths.

• 71% of people with psychosis worldwide, do not receive mental health services.

• Even in high-come countries, depression treatment is received by only one third of people who are suffering. [3]

Why People Hesitate to Seek Help

• Not enough information: People might not know the criteria for a mental disorder. Even if they know, they might not know the importance of working on these problems.

• Economics: Therapy sessions and counseling services are mostly expensive services.

• No professionals: Not having a professional on the subject of psychology can prevent the help-seeker from starting a therapy session. This is also a logistics problem.

• Not enough time: Counseling services' times are decided with the therapist and the client, but people might not have time or want to reserve time for this.

• Logistics: Being far away to a counseling service might be a problem, this problem could be about an emergency or a general burnout/tiredness from traveling far distances.

With the advent of online platforms, some of these problems are being mitigated. Online counseling and intervention services are proving to be less time-consuming and more affordable compared to traditional face-to-face methods.

The Role of Technology in Mental Health

With almost two-thirds of the world population (4.9 billion people) connected to the internet in 2021 [4], providing mental health solutions online has become increasingly feasible.

• Currently, there are fewer than 3 billion people who are still not connected to the internet. Most of these individuals are located in Southern and Eastern Asia, as well as Africa.[5]

The Growth of Online Counseling

With the increase of internet usage around the world, it is easier to provide for mental health problems.

• There has been an increase in online counseling in the last 15 years [6].

• In the COVID-19 pandemic outbreak, there has been an increase in online mental health services, and the positive effect they had compared to face-to-face counseling [7].

This rise can be because the accessibility of these online services have increased; or it can be because people find online services to be more effective over the years. Regardless of the reason, technology has provided a lot for the mental health services, but how are these mental health services presented in the online platforms?

Online Platforms for Mental Health

Technology offers various methods for mental health services to operate online.

Therapy services: These platforms connect professional therapists with clients, offering a choice of therapists, cost transparency, and security[8,9]

• Therapy services are beneficial because people can see multiple techniques and choose the therapist that they think is best for them.

• These services can help taking the first step, which could be scary.

mHealth: Mobile mental health applications serve different purposes and come in various varieties. The most common use is for educating users about preventive healthcare. However, these apps are also important tools for disease surveillance, treatment support, and chronic disease management. [10].

mHealth applications could use wearable technology devices (smart watch etc.) and collect physiological feedback about the user.

mHealth applications have solutions for specific problems, some of the solutions they aim to provide:

• Lowering symptoms of depression and anxiety,

• Reducing feelings of loneliness,

• Managing stress,

• Lowering alcohol consumption [11].

Merging Technology with Psychology

Advantages of Online Platforms over Traditional Methods

Online platforms offer several benefits compared to traditional face-to-face mental health services:

• Anonymity & disinhibition: The opportunity for the client to be anonymous,

• Convenience and flexibility: Easily accessible; appropriate for one to attend in their own environment,

• Self-paced approach: Can continue in client’s own pace; has no travel time,

• Loss of cues: Reduced levels of social cues (verbal, visual) can help the client have a greater sense of control over the process [6].

• Cost-effectiveness: Reduces the economic disadvantage aspect [12].

Online interventions and online counseling are two most important and common mental health service provided in an online environment.

Innovative Online Interventions

Psychological Online Interventions are used as a stand alone programs or as guided programs to aid other intervention or therapy programs. As it is in face-to-face interventions, online interventions' most common methods are cognitive-behavioral therapy methods and mindfulness methods.

The methods for online interventions are the same as face-to-face interventions. The way these methods are presented differs. Instead of face-to-face courses or group gatherings, online interventions provide e-learning platforms and forums.

Activities and methods used in online interventions:

• Daily meditation audio tracks,

• Reminder e-mails and tips for the tasks [13],

• Video calls, telephone calls with a professional (telehealth),

• Give information from webpage, or smartphone application [12],

The basic stages of online interventions:

1. Information stage: The participants of the intervention are informed about the problem they have with: short informative videos, written content or course material etc.

2. Treatment stage: A treatment is introduced to the participants, this stage needs the participant to act effectively on the suggested methods. On this stage participants do homework to practice skills of overcoming their problems.

3. Professional help: Some interventions provide the participant to contact with a professional for guidance, therapy sessions or individual coaching [12]. The professional can observe a participant's process, give feedback on the activities and homework they have done, and the participant can ask for aid from the professional [14].

   • Giving feedback to the participant have been found to be effective [15]

• Online interventions have shown positive effects on raising adherence to interventions [16].

Some examples for where online interventions are used in are: depression [12,13], anxiety [17], stress [13,15], burnout and efficacy [18], cancer interventions [19,20,21].

Online Counseling Benefits

Online counseling offers several unique advantages that people take into consideration when choosing between online and face-to-face counseling.

A benefit of written documents have been credited by online counseling clients. Since writing behavior can be synchronous or asynchronous, people felt they had more time to process the thoughts they had, compared to verbal communication.

The convenience of online counseling has been an advantage for both clients and therapists, removing barriers to mobility issues such as geographical isolation or physical disabilities [6].

Virtual Reality (VR) and Augmented Reality (AR) in Mental Health

Virtual Reality: A New Era in Mental Health Services

Virtual reality (VR) is a computer-generated simulation, where the user puts on a piece of wearable technological device, such as a headset, and enters the fabricated world. VR can provide online or offline experiences, and has multiple possible usages. It is used in entertainment, education and mental health areas etc..

Presence is an important factor about VR. Presence is what makes the user feel as if they are really in this fabricated world. When the feeling of presence increases, the entertainment or the benefit one gains from the application also increases.

The simulation VR provides is realistic, safe from dangers, and manipulative. These factors give the user a feeling of safety. Things that would make them uncomfortable in the physical world, are observed in VR but they are not real.

With VR technology, the sensory consequences of users’ actions are predicted; then VR shows the outcome the user expects in the real world [22]. Since this simulation is done in a safe environment, the user can learn to overcome these negative feelings induced by the events or things with the proper program.

Benefits of VR:

• Remote,

• Portable,

• Not expensive,

• High level of anonymity.

• Interactive,

• High level of control. [23]

Today, VR is used in treatment and intervention programs for multiple problems. Some examples are: treatment of phantom limb pain [24], phobias, providing a safe workout environment for people with ADHD [23] and counseling.

There has also been works on people with dementia. VR could be used for cognitive task exercises to enhance cognitive abilities such as: memory, attention etc. [25].

Older adults can also benefit from VR technology to do balance exercises, and do virtual meetings. The virtual meetings attended with VR has shown lower signs of loneliness in older adults too. [27]

Augmented Reality: Bridging the Gap between Virtual and Real

Augmented reality (AR) is another form of technology that is similar to VR. AR creates a mixed reality, where the user can perceive the real world as well.

Compared to VR, AR has less immersion, because the user can see the real world and their real bodies among with elements provided by AR.

Why use AR?

• Even less costly than VR,

• Can access through smartphones, tablets etc.,

• Low immersion can be a benefit.

AR is mostly studied with phobia treatments. Even though both AR and VR provide a safe environment, perceiving the real world simultaneously with the virtual elements help with people with phobias. [28]

Conclusion

The intersection of technology and psychology is bringing a revolutionary change in addressing mental health issues. From online platforms to VR and AR, these advancements not only provide innovative solutions but also make mental health services more accessible and affordable. With continual technological evolution, the future holds immense potential for improving mental health globally.

References

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