User:Suzanne Lois Robson/sandbox

New Additions to E Mental Health Section
E Mental Health is frequently used to refer to internet based interventions and support for mental health conditions. However, it can also refer to the use of information and communication technologies that also include the use of social media, landline and mobile phones. E-health services can include information; peer support services, computer and internet based programs, virtual applications and games as well as real time interaction with trained clinicians. Programs can also be delivered using telephones and interactive voice response (IVR)

Mental illness includes a range of conditions such as alcohol and drug use disorders, mood disorders such as depression, dementia and Alzheimer’s disease, delusional disorders such as schizophrenia, and anxiety disorders. The majority of e mental health interventions however have focused on the treatment of depression and anxiety. There are, however, programs also for problems as diverse as smoking cessation gambling and post-disaster mental health.

E mental health has a number of advantages such as being low cost, easily accessible and providing anonymity to users. However, there are also a number of disadvantages such as concerns regarding user privacy and confidentiality. Online security involves the implementation of appropriate safeguards to protect user privacy and confidentiality. This includes appropriate collection and handling of user data, the protection of data from unauthorized access and modification and the safe storage of data.

E Mental Health has been gaining momentum in the academic research as well as practical arenas in a wide variety of disciplines such as psychology, clinical social work, family and marriage therapy, and mental health counseling. Testifying to this momentum, the E Mental Health movement has its own international organization, The International Society for Mental Health Online. It also has its own academic peer review journals, such as the Journal of Medical Internet Research.

There are at least four programs currently available to treat anxiety and depression. Two programs have been identified by the UK National Institute for Clinical Excellence as cost effective for use in primary care. The first is Fearfighter which is a text based CBT program to treat people with phobias and the second is Beating the Blues, an interactive text, cartoon and video Cognitive Behaviour Therapy (CBT)program for anxiety and depression. Two programs have been supported for use in primary care by the Australian Government. The first is Anxiety online ,a text based program for the anxiety, depressive and eating disorders, and the second is This Way Up, a set of interactive text, cartoon and video programs for the anxiety and depressive disorders.

There are a number of online programs relating to smoking cessation. QuitCoach is a personalised quit plan based on the users response to questions regarding giving up smoking and tailored individually each time the user logs in to the site. Freedom From Smoking takes users through lessons that are grouped into modules that provide information and assignments to complete. The modules guide participants through steps such as preparing to quit smoking, stopping smoking and preventing relapse.

Other internet programs have been developed specifically as part of research into treatment for specific disorders. For example, an online self-directed therapy for problem gambling was developed to specifically test this as a method of treatment. All participants were given access to a website. The treatment group was provided with behavioural and cognitive strategies to reduce or quit gambling. This was presented in the form of a workbook which encouraged participants to self-monitor their gambling by maintaining an online log of gambling and gambling urges. Participants could also use a smartphone application to collect self-monitoring information. Finally participants could also choose to receive motivational email or text reminders of their progress and goals.

An internet based intervention was developed for use after Hurricane Ike in 2009. During this study, 1,249 disaster-affected adults were randomly recruited to take part in the intervention. Participants were given a structured interview then invited to access the web intervention using a unique password. Access to the website was provided for a four month period. As participants accessed the site they were randomly assigned to either the intervention. those assigned to the intervention were provided with modules consisting of information regarding effective coping strategies to manage mental health and health risk behaviour.

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