Ĭonducting the research necessary to demonstrate the safety and clinical utility of novel smartphone interventions for people with SMI is challenging and costly.
Academic research groups and commercial companies are responding to the opportunity and have begun to develop and test a range of smartphone-supported digital health technologies for people with SMI, including illness self-management apps, virtual peer support platforms, and sensor-enabled remote patient monitoring systems. Survey studies conducted in recent years have shown that approximately two-thirds of people with SMI in the United States already own smartphones and that most are interested in leveraging them to support their health care. Owing to subsidy programs that offer people with disabilities access to mobile phones and data plans (eg, Federal Communications Commission Lifeline Program) and the dropping prices of mobile phones worldwide, people with SMI now have unprecedented opportunities to access information, stay connected to others, and potentially receive services remotely via personal mobile devices. People with SMI are not dramatically different from the general population in their use of mobile technologies. The consequence of these intersecting challenges is a vicious cycle in which those who are most impaired receive the least amount of support, thus deteriorating even more over time. People with SMI are often exposed to pervasive societal stigma about their conditions and therefore can be reluctant to openly seek services at a clinic if it risks them being labeled mentally ill. Barriers in the capacity to provide high-quality care on the provider’s side may be compounded by hesitancy around treatment seeking on the patient’s side. These public sector agencies are rarely able to meet the demand for services. Treatment of people with SMI typically takes place in publicly funded clinics and community mental health centers that are chronically underresourced, understaffed, and overextended.
SMI is often accompanied by functional and psychosocial impairments, housing and employment challenges, and poverty. People with serious mental illnesses (SMIs), including schizophrenia-spectrum disorders, bipolar disorder, and severe and persistent depression, experience significant psychiatric symptoms such as hallucinations, delusions, and severe mood episodes.
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