As technology has evolved, so has the way people seek out mental health treatment.
Mental health issues in the U.S. are on the rise. According to Mental Health America's 2021 State of Mental Health in America report, from January to September 2020, there was a 62% increase in people screening for depression and a staggering 93% increase in screenings for anxiety compared to 2019.
During lockdowns from the COVID-19 pandemic, access to mental health treatments, like therapy, mostly were limited to telehealth – telephone calls and/or virtual meetings. Though telehealth isn't a new avenue of treatment, it became necessary in 2020.
However, not everyone was able to access telehealth-based treatments. In some rural areas, for instance, service interruptions interfered with connectivity. Thus, the technology couldn't completely solve the problem of lack of access to mental health treatments
“Even before the COVID 19 pandemic, but especially because of it, there's been increasing recognition that we are facing a global mental health care crisis,” said Emma Bedor Hiland, a lecturer in Communication Studies in the College of Media & Communication at Texas Tech University. “Technologies like smartphones and social media apps aren't effective Band-Aids. They can't solve or address health disparities or inequities that predate them.”
Technology tends to create new problems we aren't equipped to address, Bedor Hiland said.
“There are a lot of populations that are left out of the equation due to factors like the digital divide – the lack of internet access and internet connectivity problems people continue to face,” she said.
“We tend to become really excited by new innovations and technologies. Then, we want to direct a lot of resources – time and money and energy and gathering public support and legislative support – for furthering those technologies, and we start to think exclusively about the novelty of the tools themselves. But, we wind up forgetting about the people who need increased access to affordable, usable mental health care services.”
Telehealth and mental health
Bedor Hiland explores these topics and expands upon other technological uses for mental health in her book, “Therapy Tech: The Digital Transformation of Mental Healthcare.”
“The book examines a range of mental health technologies and services,” she said. “They include smartphone applications, which are available for free or at low cost from the Google Play or iTunes stores. I also analyze artificially intelligent therapeutic chat bots that we can message with from our phones, laptops or other smart devices.
“I have another chapter that looks at how we engage in surveillance of others' mental states on social media based on status updates and content they share. That's a process and behavior I termed ‘psychosurveillance.' I also write about how members of the public are encouraged to spend time volunteering on platforms providing psychosurveillance. Then, the final chapter of the book is about an industry called telemental health care services where therapy or psychiatric services are delivered via screen-based modalities, and that's increasingly normative and accepted, especially due to the COVID pandemic.”
Bedor Hiland notes that these new technologies come at a cost to mental health professionals.
“Service providers themselves have to take on a whole bunch of risks that include deciding whether or not to treat patients who are not geographically proximate, who are sometimes in other countries, and there aren't a whole lot of guidelines and regulations for telehealth services, especially telemental health services,” she said. “The book offers in-depth studies and analyses of each of these types of technologies, but it also is a larger-scale critique of them as well.”
Bedor Hiland's book was inspired by her evolving interest in mental health while she was pursuing her doctoral degree.
“Over the years, I started to become more interested in depictions of mental health and mental distress because, as I studied bioethics in graduate school, I learned how what we consider mental distress, disorders or illnesses are, a lot of the time, culturally contingent,” she said. “There tend to be phenomena like the medicalization of mental states where we assign psychiatric labels to things that, perhaps, we shouldn't. For example, social anxiety tends to be highly medicalized when, in the past, it used to be conceptualized as shyness.
“That's not to say there is no such a thing as a diagnosis of social anxiety or anxiety in general, just that we have a tendency to take things we experience in our day-to-day lives and then we like to apply medical frameworks to them in order to better understand them and think they are treatable.”
Easy to read
Bedor Hiland wrote her book in such a way that anyone interested in mental health and telehealth can read and comprehend it.
“I wrote with a lot of different readers in mind,” she said. “It was important to me that the book be accessible in terms of the language I use and the way it's written. I wanted it to be captivating so people with no knowledge of any of these technologies or fields could learn from it, as well as people who are more specialized and work in these digital technology and digital health fields.”
Bedor Hiland would like her book to bring about important conversations.
“My hope is that it is capable of inspiring conversations about the role of technologies in our lives and why we seem to accept so readily that technological solutions are perhaps the best solutions to medical problems, including mental distress, when that's not the case,” she said. “Regardless of whether you work in medicine or related fields, use technology in any capacity in your life, or work in a more specialized, niche field like those I write about, analyze and talk about – I really think there's something in it for everybody.”