Envisioning a Path toward Equitable and Effective Digital Mental Health.
Envisioning a Path toward Equitable and Effective Digital Mental Health.
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展望一条通往公平和有效的数字心理健康的道路。
DOI：
10.1080/21507740.2022.2082597
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发表时间：
2022-07
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数字心理健康技术得到了推广，承诺提供更有效率和更有效的心理健康诊断和护理的广泛机会。在大流行期间，向远程医疗的快速和大规模转变，以及数字心理健康工具和应用程序的更多使用，考验了这一前景。虽然有一些数字精神健康工具提供了安全和有效的护理(马歇尔、邓斯坦和巴蒂克2021)；但也有许多组织、社区和个人没有足够的基础设施或资源来获取或利用有效的数字精神健康工具(Abraham等人)。2021年)。Skorburg和Yam(2022)概述了关于数字精神健康工具的安全性、有效性和公平性的重要问题，并提出了合理的怀疑。为了考虑是否以及如何使用数字心理健康工具来建立改进的心理健康护理系统，参与数字心理健康中更广泛的社会和系统挑战是有用的。安全和有效性一直是人们关注的问题，伦理学家和数字健康研究人员指出了来自数字健康生态系统的危害，在数字健康生态系统中，大多数心理健康应用程序没有有效的证据支持(Anths 2016；Martinez-Martin等人)。2020)。建立数字心理健康安全和监督的框架取决于开发和使用数字心理健康工具的背景，例如该工具是为直接面向消费者、临床还是研究应用而设计的。将用于临床目的的数字精神健康工具通常被归类为医疗设备，受到监管监督和临床验证
Digital mental health technologies have been promoted with the promise of delivering wide-scale access to more efficient and effective mental health diagnosis and care. During the pandemic, the rapid and largescale shift to telemental health, and increased use of digital mental health tools and apps, tested that promise. While there were some digital mental health tools that provided safe and effective care (Marshall, Dunstan, and Bartik 2021); there were also many organizations, communities, and individuals that had insufficient infrastructure or resources to access or utilize effective digital mental health tools (Abraham et al. 2021). Skorburg and Yam (2022) outline important issues regarding safety, effectiveness and equity in digital mental health tools, with justifiable skepticism. In order to consider whether and how digital mental health tools may be used toward building an improved system of mental health care, it is useful to engage the broader social and systemic challenges in digital mental health.Safety and effectiveness have been longstanding concerns, with ethicists and digital health researchers pointing out the harms that come from a digital health ecosystem in which the majority of mental health apps are not backed by evidence that they work (Anthes 2016; Martinez-Martin et al. 2020). The frameworks for establishing safety and oversight for digital mental health depend upon the context for which the digital mental health tool is developed and used, such as whether the tool is meant for directto-consumer, clinical or research applications. Digital mental health tools that would be used for clinical purposes generally are categorized as medical devices, subject to regulatory oversight and clinical validation