Cited by 112Digital Mental Health InterventionsMobile Health and mHealth ApplicationsTelemedicine and Telehealth Implementation

Use of the Internet and Mobile Phones for Self-Management of Severe Mental Health Problems: Qualitative Study of Staff Views

Open access
Berry, Natalie, Bucci, Sandra, Lobban, Fiona·2017·JMIR Mental Health

Abstract

BACKGROUND: Researchers are currently investigating the feasibility, acceptability, and efficacy of digital health interventions for people who experience severe mental health problems such as psychosis and bipolar disorder. Although the acceptability of digital health interventions for severe mental health problems appears to be relatively high and some people report successfully using the Internet and mobile phones to manage their mental health, the attitudes of mental health care staff toward such approaches have yet to be considered. OBJECTIVE: The aim of this study was to explore mental health care staff experiences of clients with severe mental health problems engaging with the Internet and mobile phones to self-manage their mental health and their views toward these behaviors. The study also sought to examine the opinions expressed by mental health care staff toward digital health interventions for severe mental health problems to identify potential facilitators and barriers to implementation. METHODS: Four focus groups were conducted with 20 staff working in mental health care services in the North West of the England using a topic guide. Focus groups involved 12 staff working in secondary care psychological services (7 participants in focus group 1 and 5 participants in focus group 4), 4 staff working in a rehabilitation unit (focus group 2), and 4 staff working in a community mental health team (focus group 3). Focus groups were transcribed verbatim, and transcripts were analyzed thematically to identify key themes that emerged from the data. RESULTS: Four overarching themes, two with associated subthemes, were identified: (1) staff have conflicting views about the pros and cons of using Web-based resources and digital health interventions to manage mental health; (2) digital health interventions could increase access to mental health support options for severe mental health problems but may perpetuate the digital divide; (3) digital health interventions' impact on staff roles and responsibilities; and (4) digital health interventions should be used to enhance, not replace, face-to-face support. CONCLUSIONS: This study is the first, to our knowledge, to qualitatively explore the experiences and attitudes of mental health care staff toward individuals with severe mental health problems using the Internet, mobile phones, and digital health interventions to self-manage their mental health. Understanding the positive and negative experiences and views shared by staff toward both current and potential digital health intervention use has enabled the identification of several considerations for implementation. Additionally, the findings suggest mental health care staff need clear guidance and training in relation to their responsibilities in recommending reputable and secure websites, forums, and digital health interventions and in how to manage professional boundaries on the Internet. Overall, the study highlights that digital health interventions could be well received by staff working in mental health services but importantly, such management options must be presented to frontline staff as an avenue to enhance care and extend choice, rather than as a method to reduce costs.

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  • In 6 studies, users stated a preference for DMHI as a complement to existing in-person therapy rather than a replacement for in-person therapy.

    “In 6 studies, users stated that they would prefer if an intervention served as a complement to existing, in-person therapy rather than a replacement for in-person therapy [30,122,134,139,166,183].”

    From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [183]

    The Results (Thematic Analysis; page not supplied) report that staff preferred digital health interventions to enhance, rather than replace, face-to-face support. The claim attributes that preference to intervention users, whereas this study gathered staff views. The count of six studies belongs to the citing sentence as a whole, not to this source alone. (LLM, conf=0.87)

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  • These findings are consistent with the view that digital mental health solutions have the potential to enhance healthcare but not to replace other existing services.

    “These findings are consistent with the view that digital mental health solutions have the potential to be adopted to enhance healthcare but not to replace other existing services [69,70].”

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Authors
Berry, N., Bucci, S., & Lobban, F.
Affiliations
  • University of Manchester (GB)
  • Greater Manchester Mental Health NHS Foundation Trust (GB)
  • Lancaster University (GB)
Corresponding author
Berry, Natalie
Venue
JMIR Mental Health
Published
2017-11-01
Volume
4
Issue
4
Pages
e52
ISSN
2368-7959 (ISSN-L)
OpenAlex
W2766249802
Cited by
112
References
50
Citations by year
2026: 6 · 2025: 11 · 2024: 15 · 2023: 20 · 2022: 10 · 2021: 14 · 2020: 9 · 2019: 16 · 2018: 10 · 2017: 1
FWCI
11.27
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Mental Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion, other-oa)
  • Lancaster EPrints (Lancaster University) (submittedVersion)
Funders
  • National Institute for Health and Care Research (HS&DR/14/04/16, PB-PG-0807-14075, 14/04/16, 14/49/34)
  • Medical Research Council (MR/K006665/1, MR/P026664/1, MR/L005301/1)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
self-management, severe mental illness, digital health interventions, internet use, mobile devices, psychosis, bipolar disorder, digital divide, staff roles and responsibilities, face-to-face support, professional boundaries, implementation barriers and facilitators, employee training, mental health services, online mental health services, employee experience

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