ABSTRACT
BACKGROUND: Digital psychiatry, defined as the application of health technologies to the prevention, assessment, and treatment of mental health illnesses, is a growing field. Interest in the clinical use of these technologies continues to grow. However, psychiatric trainees receive limited or no formal education on the topic. OBJECTIVE: This study aims to pilot a curriculum on digital psychiatry for a US-based psychiatry residency training program and examine the change in learner confidence regarding appraisal and clinical recommendation of digital mental health apps. METHODS: Two 60-minute sessions were presented through a web-based platform to postgraduate year 2-4 residents training in psychiatry at a US-based adult psychiatry residency program. Learner confidence was assessed using pre- and postsession surveys. RESULTS: Matched pre- and postsession quizzes showed improved confidence in multiple domains aligning with the course objectives. This included the structured appraisal of digital mental health apps (P=.03), assessment of a patient's digital health literacy (P=.01), formal recommendation of digital health tools (P=.03), and prescription of digital therapeutics to patients (P=.03). Though an improvement from baseline, mean ratings for confidence did not exceed "somewhat comfortable" on any of the above measures. CONCLUSIONS: Our study shows the feasibility of implementing a digital psychiatry curriculum for residents in multiple levels of training. We also identified an opportunity to increase learner confidence in the appraisal and clinical use of digital mental health apps through the use of a formal curriculum.
ABSTRACT
Community mental healthcare around the world has been strained as people need more help and experience more barriers to access due to COVID-19. The rapid shift to telehealth services necessitated by the pandemic has made these difficulties even more pronounced. While this transition presented challenges for nearly every healthcare system, it has proven especially difficult for low resource settings such as community health centers. This article is a critical observational study of the care transformation of a state-funded safety net psychiatric system responding to the clinical needs of patients during the COVID-19 pandemic. By discussing the challenges, opportunities, and creative solutions for staff and patients, the article highlights the new importance of technology and adaptability in clinical care and outlines clear recommendations to ensure vulnerable populations do not fall into the "digital divide."
ABSTRACT
Over the last decade, nonconsensual porn (NCP), or the sharing of sexually explicit material without a person's consent, has become a growing problem with potentially far-reaching adverse consequences for victims. The purpose of this article is to propose and consider a framework for advancing the field's understanding of NCP within the context of intimate relationships including situating NCP relative to other forms of relational abuse. Specifically, we examined the extent to which NCP in intimate partner relationships was perpetrated using tactics from the Power and Control Wheel through a summative content analysis of U.S. news stories on NCP from 2012 to 2017. This analysis established that NCP has been perpetrated using all eight of the abuse metatactics in the Power and Control Wheel, with the three most common being emotional abuse, coercion and threats, and denial/blame/minimization. Treating NCP in relationships as a potential form of partner violence provides a basis on which to understand the etiology, manifestation, motives, and impact of this form of abuse and informs practitioners' ability to design prevention efforts and engage a trauma-informed response to survivors.
