JMIR Publications

ABSTRACT

Background:

Over the past few years, digital interventions for substance use disorders have exploded onto the scene. Smartphones are now a vehicle for telepsychiatry visits, measuring health metrics, and communicating with providers. There are also thousands of downloadable mental health applications and many digital psychiatry interventions now in development to target addiction. Especially in light of the COVID-19 pandemic and the movement towards virtual and hybrid clinic visits and meetings, it becomes especially salient to assess phone ownership among individuals with substance use disorders and how comfortable and open they are to navigating phone functionality and using it for mental health purposes.

Objective:

The aim of this study was to summarize the current literature around smartphone ownership, utilization, and acceptability of using the smartphone for mental health purposes, and assess these variables across two disparate substance use treatment sites.

Methods:

We performed a search of two academic databases (PubMed and Google Scholar) for publications since 2007 on the topic of smartphone ownership, utilization and acceptability of using mobile apps for mental health purposes among the substance use population. 1,820 unique abstracts were identified of which 8 were relevant to include in the review. In addition, we conducted a cross-sectional survey study that included 51 participants across two sites: an inpatient detoxification unit at Brigham and Women’s Faulkner Hospital which predominantly treats patients with alcohol use disorder, and an outpatient methadone maintenance treatment (MMT) clinic in Rutland, Vermont (West Ridge Clinic).

Results:

Prior studies indicate that mobile phone ownership among the substance use population between 2013-2019 ranged from 83-94% while smartphone ownership was 57-94%. Results from our study across the two sites indicated 96.1% mobile phone ownership and 92.16% smartphone ownership among the substance use population. While most (87.8%, n=43) patients across both sites endorsed currently using apps on their phone, only a minority (39.6%, n=19) reported previously using any apps for mental health purposes. More than half of participants endorsed feeling at least neutrally comfortable with a mental health app gathering information regarding appointment reminders, medication reminders, and symptom surveys. Most patients indicated being concerned about privacy (66.7%, n=34) and reported being uncomfortable with an app gathering information about location (61.7%, n=30) and social information (57.4%, n=28) for healthcare purposes.

Conclusions:

A vast majority of respondents reported owning a mobile phone and smartphone, consistent with prior studies. Most respondents felt comfortable with mental health apps gathering most forms of personal information such as symptom surveys, coaching for healthy living, mindfulness or therapy exercises, communications with clinician about their mental health, medication reminders. Differential results from the two sites, namely greater concerns about cost of mental health apps among the MMT cohort and less experience with downloading apps among the older inpatient detoxification cohort may indicate that clinicians should tailor technological interventions based on local demographics and practice sites and that there may not be a one-size-fits-all digital psychiatry solution.