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 Table of Contents  
PERSPECTIVE
Year : 2016  |  Volume : 32  |  Issue : 3  |  Page : 270-272

Advancing social psychiatry in a fragmented world: Can information technology do it?


Centre Françoise Minkowska, Paris, France

Date of Web Publication3-Nov-2016

Correspondence Address:
Rachid Bennegadi
Medical Referent of the Françoise Minkowska Institute, 12 rue Jacquemont, Paris
France
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9962.193274

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  Abstract 

Modern technology (internet, smartphones, etc.) already has an impact on communication and health care services throughout the world. Evidently, everyone knows what it means to be able to better communicate with new technology (such as Facebook, Twitter, LinkedIn etc.). The problem is not here. It is evident that science advances quickly and turns peoples’ lives upside down, even if these advances have never had much of an impact on social, cultural, and psychological dimensions of the individual, the family, and the social group. At what point, then, do these advances in science have an impact for us, the mental health professionals? We will soon find ourselves in a situation where we will be obliged to accept the new methods of communication being presented to us, not only by policy makers, but also by patients and their families. Therefore, we must look at how we both have been integrating the advances of Information Technology into social psychiatry, but also how we can do so in the future.

Keywords: information technology, mental health, social psychiatry


How to cite this article:
Bennegadi R. Advancing social psychiatry in a fragmented world: Can information technology do it?. Indian J Soc Psychiatry 2016;32:270-2

How to cite this URL:
Bennegadi R. Advancing social psychiatry in a fragmented world: Can information technology do it?. Indian J Soc Psychiatry [serial online] 2016 [cited 2021 Jun 15];32:270-2. Available from: https://www.indjsp.org/text.asp?2016/32/3/270/193274


  Questions raised by information technology Top


Although the field of social psychiatry’s need to embrace this technological revolution is clear, it cannot help but raise questions about certain imperative aspects of the field. An inevitable shift in psychiatry from the interpersonal connection to the practical distance begs the question of whether empathy will be perceived the same through telepsychiatry as it is in person? Will people still have the same trust and confidence in psychotherapy if it is done through an electronic device, as they do when it is done face to face? Another question, particularly for those of us that are in the field of social psychiatry is how will we be able to participate in the process of rehabilitation and social reintegration, and therefore accompany people with disabilities – those who have been excluded or stigmatized by society, rejected by the world of employment, and marginalized in political decisions. Are the tools that have been made available thanks to internet technology going to give a new hope to the individual who has been marginalized or excluded because of a mental illness? We can begin to imagine the extraordinary impact that prevention policies for mental illness and promotion strategies for mental health will have due to new technology.

The formalities themselves of information technology also lead us to many questions; in regards to confidentiality, how are we to protect privacy and anonymity of patients? How will we be able to impartially assess and evaluate the results? Do we need a particular training to be able to use these new tools being provided to us? The other question we will never be able to avoid is that of the ethical dimension of this new manner of putting caretakers and the cared for in relation to each other. We cannot ignore the perverse effects in the interpersonal, human-to-human relationship; however, what is harder to manage is the perverse effects in the digital-interpersonal relationship.

Regardless of all these uncertainties presented by the introduction of information technology to the world of psychiatry, the essential point that remains is the economical dimension concerning, first, the individuals directly in need of mental health services; and second, the professionals of social psychiatry. The development of a cultural competence will be necessary should one want to intervene in a manner that takes into account the social representations of disability and mental illness, on the one hand, and the cultural representations of disability and mental illness on the other. A last factor that is of a fundamental importance but that may appear trivial, is the inherently necessary freedom of dialogue in the context of healthcare – the total liberty and right of a patient to make a remark that is uncensored by any state or authority.

One last element that is maybe not as evident as the rest, as a worry regarding the advancement of information technology in relation to social psychiatry, is how to articulate and accurately express the progress of this technologically enhanced field within the medical, psychological, and ethical disciplines. It will take some more time before we will have regulated and efficient standards that would promote and aid globalization. In other words, a clear consensus on practices, a set understanding of the theoretical aspects, a certain equality among the healthcare offers and accessibility, and a global agreement on the necessity of the evaluation.


  Evaluation of information technology Top


Perhaps, it is best to begin at the foundation of psychiatry – the clinic. What has become of this integral, tangible part of psychiatry with these new advancements in information technology? It is evident that with the help of new gadgets and applications, the need for physical presence is decreasing. Psychiatry is becoming a mobilized field that can now enter the home, while still providing similar services as in-clinic therapy. Mental health services are now being brought to the patient through the framework of telemedicine, “…the use of electronic or digital communication technologies as a method of delivering health/medical education and medical care”.[1] Patients can videoconference with their psychiatrists, should they live far away or not have access to the necessary means for getting to the clinic. Telepsychiatry has created a level of accessibility that has never before been seen, widening the patient group exponentially thanks to its approach of “Home Care”.[1]

The Psychiatric Society for Informatics, an association meant to promote the understanding of information technology in psychiatry, has been gaining momentum, since its creation in 1995.[1] We cannot ignore the fact that information technology has found a home as a subgenre of psychiatry and has integrated into its core functions, such as psychological testing and even therapy. In fact, a West London clinic has successfully used a form of computer-based cognitive behavioral therapy to help individuals with panic disorder and phobias, generalized anxiety, obsessive compulsive disorder (OCD) and non-suicidal depression.[1] A significant improvement in the overall wellbeing of the individuals who participated in the trial was noted, as well as decreasing the workload for the therapists of the clinic.[1] We are beginning to see that through the digitalization of the clinic and of psychiatry and therapy in general, with technology being used as an extension as opposed to a replacement, beneficial advancements can be made.

Technology has seemingly become the method of communication with the younger generations that have grown up during this “internet revolution”. More specifically, today’s generation appears to have a special connection to social media, meaning that for mental health professionals, it can be a useful tool in understanding patients outside of a therapeutic setting, but rather in their social environment, and without the discrepancy of self-reporting.[2] In a recent study on what individuals’ relationships to Facebook reveal, conducted by researchers at the University of Missouri, Facebook was determined to provide a different perspective of a patient – a perspective illuminated by their usage, activity, and presence on the social media network.[2] Symptoms of social anhedonia have been linked through the study, to individuals on Facebook who had a significantly lesser presence on the website (less friends, less pictures, and less activity), whereas the concealment of certain Facebook activity from the researchers was linked with paranoia.[2]

Addiction to social media has been a thoroughly looked at issue, but its potential insight is something new. It is a prime example of psychiatry’s embracing of this rapidly changing world. If we can utilize something as popular as Facebook, and turn it into a tool to help mental health professionals better understand a patient, then we are very clearly demonstrating how information technology is in fact helping social psychiatry advance. In a recent study on the reaction of patients to telepsychiatry, conducted in Canada, it was confirmed that almost all patients included in the study were both satisfied and felt comfortable with the new approach of videoconferencing as a form of therapy.[3] Therefore, despite our own plausible reservations as mental health professionals about the impact of a lack of interpersonal connections, patients are seemingly adapting well to this new form of medicine.

Not only does the introduction of information technology into social psychiatry appear to be beneficial for the patients, but it appears to be beneficial for mental health professionals as well. A recurring theme throughout the possibility of a cohesive harmony of psychiatry and information technology is the need to specially educate mental health professionals on how to maximize the efficacy of all the tools being made available. We now have one big pool of resources – the internet – from which it is extremely easy to learn, understand, and communicate with other mental health professionals. Information technology, as we know, comes with both successes and faults, as do all great creations at their time of inception and evolution. The difference between information technology and past technological advancements is that once we have opened this door, we can no longer close it. The world of information technology is continuously expanding as we discover new tools, improvements on old ones, and ideas for new ones.

Nothing will be as it was before in social psychiatry, what with this new total implementation of Internet Technology. Not only will things be changing at the level of patients and their families, who will undoubtedly embrace these technological advancements, requesting their own participation in the world of internet technology almost immediately; things will also be changing at the professional levels as well. For psychiatrists, psychologists, social workers, and all other mental health professionals, it will be imperative that both training is provided to these individuals and funding is allocated so that the best software is made available, all to ensure the total mastery of the continuously changing field.

In classical psychiatry, it is agreed upon that the structure of the personality organizes itself with the maturation of the psyche, which is based upon the tripartite relationship of the symbolic, the real, and the imaginary. It would perhaps be beneficial to our keeping up with the changes in the environment of psychiatry, to add a fourth element to the interactive relationship, the virtual, which will be able to challenge the aspect of reality. Furthermore, it is the time to approach our perception of the individual through the true self and the false self, by adding the notion of the virtual self. We cannot be passive bystanders in a world that is rapidly changing, where individuals must adapt constantly. For social psychiatry to advance today, it must embrace and adapt just as individuals do, and information technology will provide the necessary platform for advancement.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest to declare.



 
  References Top

1.
Reddy A. Information Technology and psychiatry. Andhra Pradesh J Psychol Med 2010;11:7-11.  Back to cited text no. 1
    
2.
Martin EA, Bailey DH, Cicero DC, Kerns JG. Social networking profile correlates of schizotypy. Psychiatry Res 2012;200:641-46.  Back to cited text no. 2
[PUBMED]    
3.
Campbell, RO’ Gorman J, Cernovsky ZZ. Reactions of psychiatric patients to telepsychiatry. Ment Illn 2015;7:6101.  Back to cited text no. 3
    




 

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