JMIR Publications

ABSTRACT

Background:

The Covid-19 pandemic has required psychiatric and mental health professionals to change their practices to reduce the risk of transmission of SARS-CoV-2, in particular by favoring remote monitoring and assessment via digital technologies.

Objective:

As part of a research project that was co-funded by the French National Research Agency (ARN) and the Centre-Val de Loire Region, we carried out a systematic literature review to investigate how such uses of digital technologies have been developing.

Methods:

The present systematic review was conducted following the PRISMA guidelines. The search was carried out in MEDLINE (PubMed) and Cairn databases, as well as in a platform specializing in mental health, Ascodocpsy. The search yielded 558 results. After applying inclusion and exclusion criteria, first on titles and abstracts, and then on full texts, 61 articles were included.

Results:

The analysis of the literature revealed a heterogeneous integration of digital technologies, not only depending on countries, contexts, and local regulations, but also depending on the modalities of care. Notwithstanding these variations, the use of videoconferencing has developed significantly, affecting working conditions and therapeutic relationships. For psychiatric and mental health professionals, the pandemic has been an opportunity to build up an experience of remote care, and thus better identify the possibilities and limits of these digital technologies.

Conclusions:

This unprecedented situation raises a series of ethical questions, including the legitimacy of remote care – the effectiveness of which has not been demonstrated –, confidentiality and protection of personal data, and equity in access to health care. The use of technologies essentially consists in a transition from the classic consultation model towards teleconsultation and makes less use of the specific potential of artificial intelligence. Thus, the health crisis questions how the organization of health care integrates the possibilities offered by digital technology, in particular so as to promote the autonomy and empowerment of mental health service users. It opens up new research questions about the quality of health care as well as how health care systems are reorganized by the integration of digital technologies.