While many young adults will share the details of their daily lives with friends on Facebook, communicating with their doctors about mental illness is another story. E-SMART-MH, developed at Case Western Reserve University, might improve those communications.
"More than 4 million people between 18 and 25 have a mental illness," says Melissa Pinto-Foltz, a research scholar and instructor at the Frances Payne Bolton School of Nursing at Case Western Reserve University. "Seventy percent of them don't receive treatment."
Getting individuals in this age group the help and services they need inspired Pinto-Foltz. As a member of a group developing new patient communications tools, she saw potential for new computer-based techniques to reach young people already tied to their technology devices.
"Adolescents accept technology as part of their lives and are comfortable interacting with it," Pinto-Foltz said.
The group set out to construct and test a computer program called Electronic Self-Management Resource Training to Reduce Health Disparities (e-SMART-HD). The goal is to improve doctor-patient communications and, consequently, improve how people manage their health.
Young people are a particular concern, says Pinto-Foltz. As they gain independence, head off to college and become removed from parental oversight, they often struggle to stay on medication and to keep medical appointments.
The technology simulates patient-doctor dialogues, creating a virtual world that can teach patients how to interact with doctors, nurses and counselors.
What the individual sees on the computer monitor is a world similar to that seen through a camera lens; the patient is present but unseen on the screen. What the patient sees are avatars (virtual people) in a virtual environment interacting with them.
The avatars have the facial expressions, language and also body movements of real people. The technology guides the patient through interactions with virtual doctors and nurses, and whenever the communication hits a rough spot, virtual coaches pop up to guide the patient.
John Clochesy, the Independence Foundation Professor at the nursing school, originally developed the precursor to e-SMART-MH, called e-SMART-HD, with funding from the National Institutes of Health. LogicJunction, a software company in Beachwood, Ohio, is creating the virtual world and its people to interact with the patients.
The development of e-SMART-MH is being funded by a one-year, $7,500 grant from the American Nurses Foundation and the Midwest Nursing Research Society.
The next step in the development of e-SMART-MH is to conduct a pilot test with five patients between 18 and 25 to assess the effectiveness and acceptability of the dialogues and programming. Researchers will then recruit 40 participants newly diagnosed with depression or anxiety from area health organizations and a college campus. Half the group will use e-SMART-MH, and the other half will be given more standard interventions of screen information from videos and mental health literature.
"Our goal is to see which group is able to better manage their illness," says Pinto-Foltz.
She adds: "Instead of struggling with their mental illnesses, we want to see young adults reach their full potential and get the most out of life."
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