Rise of the Machine – The Good, The Bad, and The Ugly of Increasing Technology in Mental Health Care

The rise of technology in mental health care has been a rapidly growing trend in recent years, with a growing number of mental health professionals and patients turning to technology to support their care. While technology has the potential to greatly improve access to care and enhance the quality of care, it also raises important questions about the role of technology in mental health care and its potential impact on the therapeutic relationship.

The increasing reliance on technology in mental health care has both positive and negative aspects, which can be summarized as the Good, The Bad, and The Ugly.

The Good: Access and Data

1. Telehealth: Increased access and convenience to care

Ever since Covid-19 started, telehealth technology has greatly increased access to mental health care, especially for individuals who live in rural or underserved areas, have limited mobility, or face other barriers to in-person care. Even for folks living in the city or suburban, technology has made it easier for individuals to receive mental health care from the comfort of their own homes or any other location with an internet connection.

2. Data-driven approach: Use of data analytics

Machine learning and artificial intelligence to inform and improve diagnosis, treatment planning, and outcomes. One of the main benefits of data-driven mental health care is the ability to collect and analyze large amounts of data, which can help mental health professionals to make more informed and evidence-based decisions about care. For example, data analytics can be used to identify patterns and trends in client behavior and symptoms, which can inform the development of more personalized treatment plans.

Additionally, data-driven mental health care can improve the accuracy and efficiency of mental health care delivery. For example, machine learning algorithms can be used to analyze data from electronic health records to identify clients who may be at risk for certain mental health conditions, allowing for earlier intervention and improved outcomes.

The bad: The Hidden cost of telehealth mental health care

1. Telehealth Reduces Human Connection:

Technology can reduce the human connection and empathy that are critical components of effective mental health care, potentially impacting the therapeutic relationship.

One reason why some therapists may view telehealth sessions as "soul-crushing" is that they feel that they are not able to establish the same level of connection and rapport with their clients as they can in an in-person session. The lack of physical presence and non-verbal cues can make it more difficult for therapists to build trust and a therapeutic alliance with their clients.

2. Therapists experience burnout and fatigue with telehealth sessions

Telehealth sessions can be mentally and emotionally taxing for therapists, especially if they are not properly equipped or supported. It's important for mental health professionals to take steps to protect their own well-being and to prioritize self-care, especially if they are experiencing fatigue or burnout after telehealth sessions. There are several reasons why therapists may experience fatigue after telehealth sessions:

• Increased screen time: Telehealth sessions often involve prolonged periods of screen time, which can be mentally and physically exhausting.

• Technical difficulties: Technical difficulties and distractions during telehealth sessions, such as poor internet connections or interruptions from notifications, can cause therapists to feel frustrated and drained.

• Reduced sense of connection: Therapists may feel a reduced sense of connection with their clients during telehealth sessions, which can make the sessions feel less fulfilling and leave them feeling emotionally drained.

• Lack of physical presence: Telehealth sessions lack the physical presence of the client, which can make it more difficult for therapists to engage with and understand their clients, leading to increased mental effort and fatigue.

3. Telehealth Mental Health care lack of privacy and security

Technology may store or share confidential information without proper safeguards, which could compromise the privacy and security of clients' personal and medical information. While telehealth platforms generally use secure methods of communication, there is still a risk of hacking or data breaches that could compromise confidential information. Additionally, telehealth sessions may be less private than in-person sessions, as they are often conducted in a home or public setting, where others may be able to hear or see what is being discussed.

4. Telehealth can be less effective

Another reason why some therapists may view telehealth sessions as challenging is that they can be less effective in addressing certain types of mental health concerns, such as trauma or severe anxiety, that require a more immersive and sensory-rich therapeutic experience.

It's important to keep in mind that some therapists have adapted well to telehealth and have found it to be a valuable and effective way of providing care to their clients. However, it's also important to acknowledge the challenges that telehealth can pose and to ensure that mental health professionals are adequately supported in providing high-quality care through telehealth platforms.

The Ugly: Dependence and Unregulated and untested technology

1. Dependence on technology especially the chatbot:

The increasing reliance on technology in mental health care may lead to a dependence on technology, potentially reducing the importance of human interaction and connection in mental health care. Especially the increasing use of chatbots to support the delivery of mental health care and the potential for individuals to become reliant on these tools.

While chatbots can offer some benefits in terms of accessibility and convenience, they also have several limitations that make them less suitable for mental health care than human therapists. For example, chatbots lack the capacity for empathy and emotional intelligence, which are critical components of effective mental health care. Additionally, chatbots may not be able to accurately diagnose or treat complex mental health conditions, which could lead to harm or misdiagnosis.

Moreover, the dependence on chatbots in mental health care could reduce the importance of human interaction and connection in mental health care, potentially impacting the therapeutic relationship. This could lead to a reduced sense of accountability for the well-being of clients, as chatbots do not have the same level of responsibility as human therapists.

2. Unregulated and untested technology:

The rapid growth of chatbots and other new AI technologies in mental health care has raised several concerns about the quality and effectiveness of new and untested technologies in mental health care, as well as the potential for harm:

• Lack of evidence: Many new and untested technologies in mental health care have not been thoroughly researched or tested, and there may be limited evidence to support their efficacy or safety.

• Inaccurate or harmful information: New and untested technologies may provide inaccurate or harmful information, which could have a negative impact on a client's mental health.

• Limited ability to diagnose and treat: Some technologies may not be able to accurately diagnose or treat complex mental health conditions, which could lead to harm or misdiagnosis.

• Privacy and security concerns: New and untested technologies may store or share confidential information without proper safeguards, which could compromise the privacy and security of clients' personal and medical information.

• Potential for harm: Some new and untested technologies may not be properly designed or monitored, and there may be a risk of harm to clients if they are used inappropriately.

It's important to be cautious when using new and untested technologies in mental health care and to prioritize the well-being and safety of clients. Before using any new technology, it's essential to thoroughly research and understand its limitations and potential impact on mental health care. Additionally, it's imperative to seek care from a qualified mental health professional who has the training, experience, and skills to provide high-quality care.

Overall, the increasing reliance on technology in mental health care presents both opportunities and challenges, and it's important to consider both the benefits and drawbacks of technology in mental health care. While technology can enhance access to care and provide new therapeutic tools, it's essential to ensure that technology is used in a responsible and ethical manner and that the importance of human interaction and connection in mental health care is not diminished.

Why We Are Insisting on In-Person Therapy Whenever Possible

While we are using technologies like data-driven and evidence-based mental health care, and Telehealth has lower costs and can be more convenient, at Chesapeake Mental Health Collaborative (CMHC), we are insisting on in-person therapy sessions whenever possible.

In-person therapy offers several benefits that can be more challenging to achieve through telehealth or other remote forms of therapy. Some of the benefits of in-person therapy include:

1. Greater connection and rapport: In-person therapy allows for greater nonverbal communication and physical presence, which can help to build a stronger therapeutic relationship and sense of connection between therapist and client.

2. More comprehensive assessment: In-person therapy provides therapists with the opportunity to observe and assess their clients in a more comprehensive and nuanced way, which can be especially important in the treatment of complex mental health concerns.

3. Access to physical resources: In-person therapy sessions can provide clients with immediate access to physical resources, such as our resources library, props, games, and art supplies, which can be used to support the therapeutic process.

4. Reduced distractions: In-person therapy sessions are typically free from distractions such as notifications, calls, and interruptions, which can make it easier for clients to stay focused and fully engage in therapy.

5. Increased accountability: In-person therapy can increase accountability for both clients and therapists, as clients are more likely to attend scheduled sessions and therapists are more likely to prioritize their clients' well-being.

While telehealth has become a valuable resource for many individuals seeking mental health care, in-person therapy can still offer many benefits that are difficult to replicate through remote forms of therapy. It's important to choose the form of therapy that is best suited to your individual needs and circumstances.

We Have Gone Further to Encourage Outdoor Sessions (Nature Informed Therapy)

CMHC has established a division, Center for Nature Informed Therapy, to solely focus on integrating nature into therapies. Conducting therapy sessions outdoors can offer several unique benefits:

1. Increased exposure to nature: Spending time in nature has been shown to positively impact mental health and well-being, and outdoor therapy sessions can provide clients with increased exposure to nature.

2. Improved mood and focus: Fresh air, natural light, and the sights and sounds of nature can help to improve mood and focus, making it easier for clients to engage in therapy.

3. Increased physical activity: Outdoor therapy sessions can provide opportunities for physical activity, such as walking or hiking, which can be beneficial for both physical and mental health.

4. Reduced distractions: Outdoor therapy sessions can be free from the distractions of technology and the built environment, allowing clients to fully engage in therapy and focus on their well-being.

5. Increased sense of adventure: Conducting therapy sessions outdoors can provide clients with a sense of adventure and a break from the routine of everyday life, which can help to reduce stress and anxiety.

It's important to keep in mind that outdoor therapy may not be suitable for all individuals or in all weather conditions, and it's important to take appropriate precautions and consider the individual needs and preferences of each client. Additionally, outdoor therapy should only be done by therapists with special training like certified Nature Informed Therapists.