Using technology to expand children’s mental health care

Using technology to expand children’s mental health care

BETSY attractive family computerLess than half of Americans with a mental disorder receive any treatment for their condition in a given year. Among those who do receive care, the median delay in treatment initiation after initial onset of disorder is typically 1-2 decades. Such failures and delays in the utilization of mental health care can be attributed in large part to problems in care availability. Inadequate numbers of mental health professionals, particularly in rural and other remote regions, impinge on the availability of care. Systematic barriers of geography and treatment availability interfere with the provision of needed treatment for affected youth. Long wait-lists at underfunded clinics can substantially slow the speed with which services are delivered. Quality of care further constrains treatment delivery to affected individuals. Those who do receive psychological treatments are not necessarily receiving evidence-based practices. Regrettably, programs showing the strongest support are not widely disseminated, while many widely used approaches show limited support. Limitations in the availability of supported psychosocial treatments place heavy clinical demands on the pharmacologic dimensions of mental health care. Primary care physicians typically fill geographic workforce gaps in mental health care, but lack the training and time to adequately address the needs of those seeking mental health care.

The MINT Program is actively engaged in a number of funded clinical trials evaluating the enormous potential of harnessing new technologies in order to overcome traditional barriers to mental health care for large numbers of children in need. Much of our research in this regard has focused on the utilization of videoconferencing technologies to deliver real-time, therapist-led treatment directly to families in their own homes, regardless of their geographic proximity to expert mental health care.

Representative publications on the use of new technologies for expanding the scope and accessibility of evidence-based care (for a complete list of studies, click here):

Comer, J.S., Furr, J.M., Kerns, C.E., Miguel, E., Coxe, S., Elkins, R.M., Carpenter, A.L., Cornacchio, D., Cooper-Vince, C.E., DeSerisy, M., Chou, T., Sanchez, A.L., Khanna, M., Franklin, M.E., Garcia, A.M., & Freeman, J.B. (in press). Internet-delivered, family-based treatment for early-onset OCD: A pilot randomized trial. Journal of Consulting and Clinical Psychology.

Comer, J.S., & Myers, K.M. (2016). Future directions in the use of telemental health to improve the accessibility and quality of children’s mental health services. Journal of Child and Adolescent Psychopharmacology, 26, 296-300.

Myers, K., & Comer, J.S. (2016). The case for telemental health for improving the accessibility and quality of children’s mental health services. Journal of Child and Adolescent Psychopharmacology, 26, 186-191.

Crum, K.I., & Comer, J.S. (2016). Using synchronous videoconferencing to deliver family-based mental health care. Journal of Child and Adolescent Psychopharmacology, 26, 229-234.

Cooper-Vince, C., Chou, T., Furr, J.M., Puliafico, A.C., & Comer, J.S. (2016). Videoteleconferencing early child anxiety treatment: A case study of the Internet-delivered CALM (I-CALM) Program. Evidence-Based Practice in Child and Adolescent Mental Health, 1, 24-39.

Chou, T., Comer, J.S., Turvey, C.L., Karr, A., & Spargo, G. (2016). Technical considerations for the delivery of real-time child telemental health care. Journal of Child and Adolescent Psychopharmacology, 26, 192-197.

Comer, J.S., Furr, J.M., Cooper-Vince, C., Madigan, R.J., Chow, C., Chan, P.T., Idrobo, F., Chase, R.M., McNeil, C.B., & Eyberg, S.M. (2015). Rationale and considerations for the Internet-based delivery of Parent-Child Interaction Therapy. Cognitive and Behavioral Practice, 22, 302-316.

Comer, J.S. (2015). Introduction to the special section: Applying new technologies to extend the scope and accessibility of mental health care. Cognitive and Behavioral Practice, 22, 253-257.

Gallo, K.P., Comer, J.S., Barlow, D.H., Clarke, R.N., & Antony, M.N. (2015). Direct-to-Consumer marketing of psychological treatments: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 83, 994-998.

Comer, J.S., & Barlow, D.H. (2014). The occasional case against broad dissemination and implementation: Retaining a role for specialty care in the delivery of psychological treatments. American Psychologist, 69, 1-18.

Comer, J.S., Furr, J.M., Cooper-Vince, C., Kerns, C., Chan, P.T., Edson, A.L., Khanna, M., Franklin, M.E., Garcia, A.M., & Freeman, J.B. (2014).  Internet-delivered, family-based treatment for early-onset OCD: A preliminary case series. Journal of Clinical Child and Adolescent Psychology, 43, 74-87 .

Barlow, D.H., Bullis, J.R., Comer, J.S., & Armetaj, A.A. (2013). Evidence-based psychological treatments: An update and the way forward. Annual Review of Clinical Psychology, 9, 1-27.

Gallo, K.P., Comer, J.S., & Barlow, D.H. (2013). Direct-to-consumer marketing of psychological treatments for anxiety disorders. Journal of Anxiety Disorders, 27, 793-801.

Comer, J.S., Elkins, R.M., Chan, P.T., & Jones, D.J. (in press). New methods of service delivery for children’s mental health care. In C.A. Alfano & D. Beidel (Eds), Comprehensive evidence-based interventions for school-aged children and adolescents. New York: Wiley.

Elkins, R.M, & Comer, J.S. (in press). Internet-based implementation: Broadening the reach of Parent-Child Interaction Therapy for early child behavior problems. In R.S. Beidas & P.C. Kendall (Eds.), Child and adolescent therapy: Dissemination and implementation of empirically supported treatments. New York: Oxford.