TagGratzer

Open for Business: Chatbots, E-therapies, and the Future of Psychiatry

While not offering a solution for every patient in every circumstance, digital psychiatry may even be attractive to a subset of patients who would prefer a digital interaction to a human one, whether for financial and other pragmatic considerations (e.g., a single parent of 3 children, on public assistance, for whom getting to an office appointment is a major logistical problem and even financial hardship) or for more psychological and interpersonal reasons (e.g., someone with autism spectrum disorder for whom the lack of human connection with a chatbot may be helpful).

I’ve just edited an “in review” series for The Canadian Journal of Psychiatry considering digital psychiatry.

With my colleague Dr. David Goldbloom, I’ve co-written an editorial to open the series.

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You can find our paper (which is open access) here:

https://journals.sagepub.com/doi/full/10.1177/0706743719850057

The Andersson et al. paper is here:

https://journals.sagepub.com/doi/full/10.1177/0706743719839381

The Vaidyam et al. paper is here:

https://journals.sagepub.com/doi/full/10.1177/0706743719828977

Our Globe Essay: “For better mental-health care in Canada, look to Britain”

It may be the biggest change to mental-health-care services in five decades. Earlier this month, Quebec Minister of Health Gaétan Barrette announced that his province would publicly fund psychotherapy for people with depression and anxiety provided by psychologists, nurses and social workers. Ontario made a similar, if smaller, promise earlier this year and other provinces are considering similar initiatives. But how can we turn these big promises into big help for the hundreds of thousands of Canadians who could benefit? Two words of advice: go British.

So begins my new op ed, co-written with CAMH’s David Goldbloom, from Monday’s Globe and Mail.

The full piece can be found here:

https://www.theglobeandmail.com/opinion/for-better-mental-health-care-in-canada-look-to-britain/article37358415/

Canadian Journal of Psychiatry: “Telepsychiatry 2.0”

‘Closed-circuit television has been introduced into the field of mental hygiene as a medium for the administration of therapy to a mass audience. The present evidence indicates that that the use of this type of television may promote the development of new and more effective methods for the treatment of the mentally ill.’ This hopeful statement appeared at the beginning of a 1957 peer-reviewed paper. Four years later, the potential of telepsychiatry ‘as a means of extending mental health services to areas that are remote from psychiatric centers’ was described. Six decades later, where are we?

So begins an editorial in the current issue of The Canadian Journal of Psychiatry.  I’ve co-authored the paper; Dr. David Goldbloom is the first author.

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Drawing on the Serhal et al. paper on telepsychiatry in Ontario, we consider the current state:

Consider: of the more than 48,000 people in need of psychiatric care (defined by the authors as psychiatric or primary care within a year after a psychiatric hospitalisation), fewer than 1% saw a psychiatrist through telepsychiatry—and 39% saw no psychiatrist. We note the marked contrast with the United States, where telepsychiatry has been rapidly growing.

And we consider how to move forward. We propose a four-point plan, including “a province-wide strategy that has defined clinical priorities, geographic rationales, and measured outcomes.”

You can find our editorial here:

http://journals.sagepub.com/doi/full/10.1177/0706743717714469

Note: open access.

Public Coverage for Evidenced-based Therapies for Depression and Anxiety?

Should there be public coverage for evidenced-based psychotherapies for major depressive disorder and generalized anxiety disorder? The Ontario Health Technology Advisory Committee recommended yes in a new draft paper, and gave comment on ways of doing this.

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The Committee asked for public feedback. In my submission, I noted: “The recommendations of the Ontario Health Technology Advisory Committee are reasonable and thoughtful.”

You can find my full submission here:

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My Globe essay: “Mr. Trudeau: Canada’s mentally ill need a new approach to care” – co-written with Dr. David Goldbloom

With a new government in Ottawa, Dr. David Goldbloom of CAMH and I consider what could be done to help those with mental illness.

Here’s the link for our Globe essay:

http://www.theglobeandmail.com/globe-debate/a-new-approach-to-helping-canadas-mentally-ill/article27629866/

National Post essay: Our next great national project: let’s end homelessness

In today’s National Post, I have an op ed on homelessness and Housing First in light of our national effort to take in and house 25,000 refugees.

Here’s the link:

http://news.nationalpost.com/full-comment/david-gratzer-our-next-great-national-project-lets-end-homelessness

The article follows. Continue reading