More people than ever are online and are using the Internet as a health resource. They are using their smartphones to access information, downloading health apps and even beginning to look for mHealth solutions with their clinicians. Vast numbers of people every day use social networking sites to connect to their friends or communities. Prof Damon Centola has researched the transfer of health information and found that, unlike other types of information, the close networks of friends and repeated exposures of information on social networking sites is the best way for this data to be assimilated. Patterns of behaviours from the moment they start to the moment they end can be picked up, and the study and analysis of 'big data' has become an important resource. The Catalan Institute of Health are using existing databases to collect information on behaviour change and a paper on finding depressive states from the Facebook activity of users is currently being reviewed. Positive changes in behaviour can be analysed and predictors found using this 'big data' which uses information from the masses to personalise for the individual.
Predictors that we do know of, that are inevitably linked to poor health, include stress. Throughout Europe the mantra "no health without mental health" has been repeated again and again and we must consider it of primary importance. There is evidence to show that online management of stress is extremely effective and there have been studies that found playing a simple game (now available on mobile) can also alleviate stress - so Angry Birds inclusion in the European Directory of Health Apps has good cause. Mental health interventions have notoriously low levels of adherence but studies show that computerised smoking cessation and therapy for depression in young people have high adherence - perhaps due to the fact that it is both convenient and personalised.
Perceived stigma is also a barrier to individuals taking that first step to recovery and programmes like Time to Change are attempting to alleviate experiences of discrimination. Internet support groups can provide a place free of discrimination, one where people can find the help they need and the motivation to approach their clinician or therapist with confidence. Face to face rarely happens until it is needed so it also provides prevention or at least protects against worsening. Games such as Actual Sunlight and SPARX which address subjects like depression could give individuals more confidence discussing the issues that they are dealing with and in turn prevent these issues from becoming more of a problem. Perhaps they can teach people processes to work on it themselves. Better awareness can also help us overcome stigma - an understanding of mental illness leads to more positive interactions.
Most people only go for help when there is already a problem. By providing a convenient low cost and self-motivating way of preventing a problem it allows the responsibility of health to lie with the individual - in a way it bypasses the voice in our head saying that it is our future self who has to deal with the repercussions. Funding discrepancies between mental health and other health areas are considerable and not at all comparable to the burden it can be on an individuals life. With this massive gap in care there is need of something to fill that, and it appears self care through eMental Health can provide that. The convenience of online therapies and mobile apps as well as the record of adherence certainly hints at a very important area that requires more research. Unfortunately a problem prevented is not exactly easy to measure but if we look at the way that changes in behaviour and management of stress can help alleviate mental health problems this may provide us with enough data over time to say once and for all that...
Prescribing an app for prevention can lead to better health.