Wem nützt die App? Internet- und mobilgestützte Interventionen (IMIs) im Spannungsfeld von Autonomie und Patientenwohl

Translated title of the contribution: Who Benefits from the App? Internet- A nd Mobile-Based Interventions (IMIs) and the Tension between Autonomy and Patient Well-Being

Giovanni Rubeis, Daniel Ketteler

Research output: Journal article (peer-reviewed)Journal article

4 Citations (Scopus)

Abstract

Objective The use of internet- A nd mobile-based interventions (IMIs) is often considered as empowerment of patients and improvement of accessibility of mental health services. Risks for specific patient groups are seldom discussed. Aim of the study is to identify patient groups that do not benefit from IMIs given the tension between autonomy and patient well-being. Methods The ethical analysis is based on available empirical evidence (randomized control trials-RCTs, reviews) as well as ethical papers. Methodological background is the tension between patient autonomy and patient well-being, which is crucial to the therapeutic alliance. On this foundation, patient groups are identified that do not benefit from IMIs in terms of empowerment or accessibility. Results The evidence-based ethical analysis shows that patients with certain disorders or high symptom severity, patients with low level of education or a lack of technical skills, and patients with a migrant background do often not benefit from IMIs. Risks of IMIs are a lack of individualization of interventions given individual treatment needs, symptom deterioration, higher dropout-rate, and insufficient identification of emergency situations. Discussion Overemphasizing autonomy may compromize patient well-being in certain patient groups. This may lead to a situation where those patient groups whose inclusion into mental health service should be facilitated by IMIs might not be reached. These access barriers should be considered when designing IMIs, so that multimorbid marginalized groups are not forgotten in the necessary digitalization of the health market. Conclusion The application of IMIs depends on the individual resources of the patient. Should IMIs be further implemented within the German mental healthcare system, it is imperative that the patient well-being of those patient groups that do not benefit from IMIs is guaranteed. In addition, an early focus on marginalized groups may and the implementation of low-level access to counselling and treatment may provide chances for said groups.

Translated title of the contributionWho Benefits from the App? Internet- A nd Mobile-Based Interventions (IMIs) and the Tension between Autonomy and Patient Well-Being
Original languageGerman
Pages (from-to)467-474
Number of pages8
JournalPPmP Psychotherapie Psychosomatik Medizinische Psychologie
Volume70
Issue number11
DOIs
Publication statusPublished - 01 Nov 2020
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental Health
  • Clinical Psychology
  • Applied Psychology

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