The recent convergence between technology and medicine is offering innovative methods and tools for behavioral health care. Among these, an emerging approach is the use of virtual reality (VR) within exposure-based protocols for anxiety disorders, and in particular posttraumatic stress disorder. However, no systematically tested VR protocols are available for the management of psychological stress. Objective: Our goal was to evaluate the efficacy of a new technological paradigm, Interreality, for the management and prevention of psychological stress. The main feature of Interreality is a twofold link between the virtual and the real world achieved through experiential virtual scenarios (fully controlled by the therapist, used to learn coping skills and improve self-efficacy) with real-time monitoring and support (identifying critical situations and assessing clinical change) using advanced technologies (virtual worlds, wearable biosensors, and smartphones).
Full text paper available at: http://www.jmir.org/2014/7/e167/
In his Science editorial (A perverted view of 'impact,' Science, 2013 Jun 14, p. 1265), cell biologist and biochemist Marc Kirschner warns against National Institute of Health's recent introduction of ''impact and significance'' as an explicit criterion to funding decisions.
According to Kirschner, overemphasis on short-term impact (especially in fundamental research) can lead applicants to overstate potential benefits of their proposals. Moreover, as Kirschner notes, scientists working in fundamental research can rarely anticipate future applications of their eventual discoveries. A further risk related to the introduction of this criterion is that increasing investments in areas that are considered impactful will in-evitably decrease resources for other fields. As a result, diversity in science will be reduced as well as productivity.
Although I tend to resonate with Kirschner's general argument, I also believe that there are compelling reasons in favor of introducing (maintaining) impact as a criterion in funding decisions.
First, at least some scientists, if not all of them, might have a clear view about the significance of their research.
Second, resources for science are scarce. Since choices need to be made, concentrating funding on research that has more promising applications is meaningful. As in the popular Nasruddin's tale, no matter where we may have lost the key, we all prefer to begin under the street light where we can see—and so it is for funding bodies.
Third, however, this strategy does not prevent the fact that some resources are dedicated to high risk/high impact projects; see, as an example, the European Commission Future and Emerging Technologies Flagships' initiatives.
Fourth, the growing gap between science and the public could be reduced if researchers would better explain the significance of their work for society. This is especially true in times of economic depression: early evidence suggests that citizens of regions more affected by crisis are more likely to express support for increases in government investments in research (L. Sanz-Menéndez, G. G. Van Ryzin, Economic crisis and public attitudes toward science: a study of regional differences in Spain. Public Underst Sci. 2013 Jun 21).
We are aware that impact and significance are ill-defined concepts. However, researchers are good at measuring things. They could put more effort in trying to define better indicators for these issues, making impact review a less arbitrary system.
Actually, according to my experience, citizens and public stakeholders are not well-informed or educated about mHealth. For example, to many people the idea of using phones to deliver mental health programs still sounds weird.
Yet the number of mental health apps is rapidly growing: a recent survey identified 200 unique mobile tools specifically associated with behavioral health.
These applications now cover a wide array of clinical areas including developmental disorders, cognitive disorders, substance-related disorders, as well as psychotic and mood disorders.
I think that the increasing "applification" of mental health is explained by three potential benefits of this approach:
In short, I believe that mental mHealth has the potential to provide the right care, at the right time, at the right place. However, from my personal experience I have identified three key challenges that must be faced in order to realize the potential of this approach.
I call them the three "nEEEds" of mental mHealth: evidence, engagement, enactment.
Being myself a beneficiary of EC-funded grants, I can recognize that R&D investments on mHealth made by EC across FP6 and FP7 have contributed to position Europe at the forefront of this revolution. And the return of this investment could be strong: it has been predicted that full exploitation of mHealth solutions could lead to nearly 100 billion EUR savings in total annual EU healthcare spend in 2017.
I believe that a progressively larger portion of these savings may be generated by the adoption of mobile solutions in the mental health sector: actually, in the WHO European Region, mental ill health accounts for almost 20% of the burden of disease.
For this prediction to be fulfilled, however, many barriers must be overcome: thethree "nEEEds" of mental mHealth are probably only the start of the list. Hopefully, the Green Paper consultation will help to identify further opportunities and concerns that may be facing mental mHealth, in order to ensure a successful implementation of this approach.