JMIR Publications

ABSTRACT

Background:

For WHO, e-health would be seen as an effective way to improve therapeutic practices and prevention in health. Digital tools lead to major changes in the field of mental medicine. Specific analyses are required to understand and well accompany these changes.

Objective:

Our objective was to highlight representations, actual uses and usability of e-health services and tools by the different stakeholders of the mental health care system, as well as to establish professional/user group profiles of these representations and uses.

Methods:

In order to access the representations, expectations and actual uses of different categories of actors, we carried out a qualitative study based on 10 Focus Groups (n=70, from 3 to 12 persons per group) composed of: general practitioners, psychiatrists, psychologists, social workers, occupational therapists, nurses, caregivers, users, user representatives, general public. The analyses of focus group discussions were performed independently by 4 investigators through a common analysis grid. The Constant Comparative Method was adopted in this framework.

Results:

The interviewees expressed different lines of tension that new technologies engender in the field of mental health. What was previously strictly under the jurisdiction of physicians tends to be fragmented and distributed over different actors and locations. New technologies reposition care in the field of domestic rather than therapeutic activities. The conception of care as an autonomous activity in the subject's life is thus questioned. The ideal of social autonomy through technology is part of the new logic of health democracy and empowerment, linked to a strong contemporary aspiration to performance. Participants emphasize the risk of a social injunction to autonomy for the digitally engaged patient, while empowerment may become a set of obligations.

Conclusions:

This qualitative research highlights the heterogeneity of opinions among the groups and inside each group. It suggests that the representations on e-mental health devices are still far from being stabilized and that a change management process should be set up to regulate the development and facilitate the optimal use of these tools.