Mobile mental health: a challenging research agenda

The field of mobile health (“m-Health”) is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally (“g-Health”). However, few of the mobile applications (apps) have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools—targeting screening, assessment, prevention, and treatment—are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability) and the market-driven wish to have mobile apps in the “App Store” yesterday rather than tomorrow.

移动健康（m-Health）领域正快速演进，市场中心理类工具呈现爆发式增长。令人振奋的高科技进展可识别症状、助力个体自主管理心理健康、鼓励主动求助，并提供预防性与治疗性干预措施。此类发展有望成为高效且具成本效益的解决方案，既能缩减候诊队列规模，又能服务全球范围内的大量人群，即“全域健康（g-Health）”。然而，当前鲜有移动应用（apps）经过严格评估。关于筛查与评估工具的有效性、哪些移动干预应用切实有效，抑或是移动应用相较于面对面治疗的效果优劣，现有相关信息均十分匮乏。但面对政策制定者、商业伙伴及用户对快速上线的日益增长的需求，开展严谨的科学评估究竟具备多大可行性？本文针对聚焦筛查、评估、预防与治疗的移动健康工具的发展现状展开综述，并结合创伤与创伤后应激障碍（posttraumatic stress disorder）领域的相关实例进行说明。本文同时探讨了移动健康工具开发与评估过程中面临的学术挑战，并指出亟需基于证据的研究设计指导，以克服部分公共伦理层面的挑战（如公平性、可及性），以及市场驱动下追求移动应用“今日上架App Store”而非明日的迫切诉求。