JMIR Publications

ABSTRACT

Background:

Video-algorithmic patient monitoring (VAPM) combines remote, non-contact sensors and algorithmic analysis, and is increasingly trialled in acute psychiatric and other care settings. While promoted for improving safety and reducing risk, it raises significant ethical concerns regarding privacy and surveillance. Little is known about how those encountering VAPM in mental healthcare contexts perceive its use and potential impact.

Objective:

This study aimed to explore the views of patients/mental health consumers, specialised mental health nurses and nurse academics, hospital managers, and technology vendors regarding the appropriateness and implications of VAPM in mental health inpatient care.

Methods:

This qualitative study identified key stakeholders in Australia via networking techniques for participation in a deliberative workshop. A deliberative workshop was held, with audio recorded, transcribed and thematically analysed, consistent with methods in health technology research, which enable exploration of different viewpoints, including convergences and divergences across stakeholder groups.

Results:

15 stakeholders participated, exploring themes concerning (1) contestation over the rationale for using VAPM in acute psychiatric settings; (2) humanising versus dehumanising effects; (3) perceived harms; (4) risk and protection; (5) support for observational assistance; (6) privacy implications; (7) the need for appropriate governance; and (8) potential service transformation. General views differed across groups. Patients/service users expressed concerns about privacy, coercion, and the potential to intensify stigma. Mental health nurses were cautious but interested in possible benefits for safety and suicide prevention. Hospital managers and technology vendors largely emphasised safety gains.

Conclusions:

Conclusions The findings suggest that the risks of VAPM are primarily experienced subjectively, as infringements on privacy, dignity, and trust, while purported benefits remain largely untested and unquantified. From a utilitarian perspective, direct comparison is therefore difficult – the risks are tangible in lived experience, whereas the benefits are still hypothetical. From this view, robust, independent evidence of real-world outcomes is required. Yet, for some participants, the very premise of such calculation was rejected, with privacy, dignity, and trust regarded as non-negotiable, rather than items for trade-off. If VAPM is to be pursued at all, it should proceed only with extreme caution, with transparent evidence of outcomes, and with meaningful participation from those whose lives and care are most directly impacted. Clinical Trial: N/A