Monthly Archives: August 2022

App for serious mental illness starts clinic-training phase

The Patient-Centered Outcomes Research Institute (PCORI) announced funding ($1.8 million) to bring a mental health smartphone app into real world practice. The app is called FOCUS, which has shown promise as a supportive therapy for people who have serious mental illness such as schizophrenia and bipolar disorder. 

The development team,headed by Dror Ben-Zeev, Ph.D. a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, have guided the app’s development through early user studies, the most recent of which showed that patients found the digital therapy more engaging than a scheduled trip to the clinic — the far more resource-intensive conventional care.

The next step for FOCUS involves rolling out a system aimed at teaching clinicians how to engage patients to use the app confidently and how to get the most information from patients’ use.

“We demonstrated that FOCUS is clinically potent in several studies, but to move this from academic research to real-world practice, we need an implementation approach that includes digital trainings for clinicians who are not used to mental health apps. This will support their journey as digital health adopters, which is a daunting task for some. We’re creating evergreen materials so any clinician will be able to get FOCUS up and running with their patients quickly,” Ben-Zeev said.

Part of the study is to understand how different clinic staff might need different information upfront about FOCUS to introduce it in a compelling way to their colleagues.

“It could be frontline clinicians or admin support people or team leaders, so we need to ensure that we finely tune the information that helps FOCUS make the greatest impact it can,” Ben-Zeev said.

The FOCUS app has written and video content adapted from in-person, evidence-based interventions. Its treatment domains address:

  • auditory hallucinations (“hearing voices”)
  • mood problems (typically depression and anxiety)
  • sleep
  • social functioning such as social skills training or paranoia
  • medication use (reminders and information to examine counter-therapeutic beliefs that people might have about their medications)

The App is Always Available

The app’s 24/7 availability is a huge advantage for patients who may have mental health needs outside clinic hours and who otherwise might need to wait several weeks or more to address an episode in a clinic environment. 

Moreover, many patients with serious mental illness receive services at community mental health centers. These facilities often are under-resourced and less able to provide continuity of care due to high turnover rates among their staff. FOCUS can provide continuity of care as clinical staffing ebbs and flows, Ben-Zeev said. 

The study will be conducted in collaboration with the adult outpatient programs at community mental health agencies in New Hampshire and Missouri that care for people with serious mental illness: 

Sources:

UW Medicine Newsroom

PCORI News

BRITE Center (Focus Developers)

Study Finds Use of Digital Devices Could Help Improve Memory Skills

Contrary to previously expressed concerns that the overuse of technology could result in the breakdown of cognitive abilities and cause “digital dementia”, research, published in Journal of Experimental Psychology: General, showed that digital devices help people to store and remember very important information. This, in turn, frees up their memory to recall additional less important things.

The study used a memory task to be played on a touchscreen digital tablet or computer. The test was undertaken by 158 volunteers aged between 18 and 71.

Participants were shown up to 12 numbered circles on the screen, and had to remember to drag some of these to the left and some to the right. The number of circles that they remembered to drag to the correct side determined their pay at the end of the experiment. One side was designated ‘high value’, meaning that remembering to drag a circle to this side was worth 10 times as much money as remembering to drag a circle to the other ‘low value’ side.

Participants performed this task 16 times. They had to use their own memory to remember on half of the trials and they were allowed to set reminders on the digital device for the other half.

The results found that participants tended to use the digital devices to store the details of the high-value circles. And, when they did so, their memory for those circles was improved by 18%. Their memory for low-value circles was also improved by 27%, even in people who had never set any reminders for low-value circles.

However, results also showed a potential cost to using reminders. When they were taken away, the participants remembered the low-value circles better than the high-value ones, showing that they had entrusted the high-value circles to their devices and then forgotten about them.

According to the authors, “we wanted to explore how storing information in a digital device could influence memory abilities. We found that when people were allowed to use an external memory, the device helped them to remember the information they had saved into it. This was hardly surprising, but we also found that the device improved people’s memory for unsaved information as well.

This was because using the device shifted the way that people used their memory to store high-importance versus low-importance information. When people had to remember by themselves, they used their memory capacity to remember the most important information. But when they could use the device, they saved high-importance information into the device and used their own memory for less important information instead.”

Dupont, D., et al. (2022) Value-based routing of delayed intentions into brain-based vs external memory stores. Journal of Experimental Psychology. doi.org/10.1037/xge0001261