Perspectives on the Emerging Digital Transformation of the Management of Psychiatric Comorbidities in Chronically Ill Populations

Abstract

Chronic mental health and medical conditions are widespread problems that often co-occur. More than 68% percent of adults with a mental health condition report also having at least one medical condition, and 29% with a medical condition reported also having a comorbid mental health condition. This perspective manuscript seeks to highlight the interrelatedness of chronic medical and mental health conditions and to discuss emergent digital solutions that can potentially provide comprehensive solutions to the problems of access to mental health care, scal-ability, and integration of medical and mental health services. Both mental health and medical symptoms impact psychosocial functioning and/or lead to maladaptive behaviors, and this is most often seen in the context of adherence to treatment. The medical conditions of diabetes and cardiovascular disease and their co-occurrences with depression, anxiety, and Posttraumatic Stress Disorder (PTSD) are explored as illustrations of this relationship. Despite the co-occurrence and the inherent treatability of depression, anxiety, and PTSD, there remain significant barriers to access and profound lack of integration between medical and mental health treatments. Advancements in technology provide an encouraging potential solution to problems of access, scalability, and integration. These advancements have come in waves, and we are currently cresting the third wave of digital behavioral health technologies and technology-enabled access. In the third wave of digital behavioral health technologies, the trend is towards addressing underlying mental health conditions and medical comorbidities by unifying the many factors that influence mental and physical health together under a single point of access, integrating the best aspects of individual and group psychotherapy. This third wave of digital delivery of evidence based mental healthcare programs will open up the possibility that businesses, schools, and even primary care settings can become the opportune point-of-care for mental healthcare and integrated rehabilitation and treatment services. The third wave of digital delivery of evidence-based mental healthcare has the capacity to treat, on a massive scale, the underlying traumas that result in high Adverse Childhood Experiences (ACE) scores, pre-disposing individuals to variety of chronic medical conditions, such as cardiovascular disease, diabetes, and cancer.