Digital Opportunities for Outcomes in Recovery Services (DOORS): A Pragmatic Hands-On Group Approach Toward Increasing Digital Health and Smartphone Competencies, Autonomy, Relatedness, and Alliance for Those With Serious Mental Illness

Supplemental Digital Content is available in the text. Digital health technologies such as smartphones present the potential for increased access to care and on-demand services. However, many patients with serious mental illnesses (eg, schizophrenia) have not been offered the digital health training necessary to fully utilize these innovative approaches. To bridge this digital divide in knowledge and skills, we created a hands-on and interactive training program grounded in self-determination theory, technology use cases, and the therapeutic alliance. This article introduces the need and theoretical foundation for and the experience of running the resulting Digital Opportunities for Outcomes in Recovery Services (DOORS) group in the setting of 2 programs: a first-episode psychosis program and a clubhouse for individuals with serious mental illness. The experience of running these 2 DOORS groups resulted in 2 publicly available, free training manuals to empower others to run such groups and adapt them for local needs. Future work on DOORS will expand the curriculum to best support digital health needs and increase equity of access to and knowledge and skills related to technology use in serious mental illness.

[1]  R. Drake,et al.  The technology specialist: a 21st century support role in clinical care , 2019, npj Digital Medicine.

[2]  John Torous,et al.  Creating a Digital Health Smartphone App and Digital Phenotyping Platform for Mental Health and Diverse Healthcare Needs: an Interdisciplinary and Collaborative Approach , 2019, Journal of Technology in Behavioral Science.

[3]  E. Chiauzzi,et al.  Mental Health Apps in Psychiatric Treatment: A Patient Perspective on Real World Technology Usage , 2019, JMIR mental health.

[4]  J. Torous,et al.  Augmenting Mental Health in Primary Care: A 1-Year Study of Deploying Smartphone Apps in a Multi-site Primary Care/Behavioral Health Integration Program , 2019, Front. Psychiatry.

[5]  S. Bucci,et al.  A qualitative exploration of service user views about using digital health interventions for self-management in severe mental health problems , 2019, BMC Psychiatry.

[6]  M. Keshavan,et al.  Mental Health Mobile Phone App Usage, Concerns, and Benefits Among Psychiatric Outpatients: Comparative Survey Study , 2018, JMIR mental health.

[7]  C. Hollis,et al.  Identifying research priorities for digital technology in mental health care: results of the James Lind Alliance Priority Setting Partnership. , 2018, The lancet. Psychiatry.

[8]  Danielle A Schlosser,et al.  Efficacy of PRIME, a Mobile App Intervention Designed to Improve Motivation in Young People With Schizophrenia , 2018, Schizophrenia bulletin.

[9]  Fiona Lobban,et al.  Use of the Internet and Mobile Phones for Self-Management of Severe Mental Health Problems: Qualitative Study of Staff Views , 2017, JMIR mental health.

[10]  N. Meyer,et al.  Developing digital interventions for people living with serious mental illness: perspectives from three mHealth studies , 2017, Evidence Based Journals.

[11]  John Torous,et al.  The WPA-Lancet Psychiatry Commission on the Future of Psychiatry. , 2017, The lancet. Psychiatry.

[12]  Patrick C. Staples,et al.  Characterizing Smartphone Engagement for Schizophrenia: Results of a Naturalist Mobile Health Study. , 2017, Clinical schizophrenia & related psychoses.

[13]  John Torous,et al.  The New Digital Divide For Digital Biomarkers , 2017, Digital Biomarkers.

[14]  John Torous,et al.  Needed Innovation in Digital Health and Smartphone Applications for Mental Health: Transparency and Trust. , 2017, JAMA psychiatry.

[15]  J. Torous,et al.  Digital Technology Use Among Individuals with Schizophrenia: Results of an Online Survey , 2016, JMIR mental health.

[16]  John A Naslund,et al.  Wearable Devices and Smartphones for Activity Tracking Among People with Serious Mental Illness. , 2016, Mental health and physical activity.

[17]  Over promised, over-sold and underperforming? – e-health in mental health , 2016, Journal of mental health.

[18]  J. Torous,et al.  Smartphone Apps for Schizophrenia: A Systematic Review , 2015, JMIR mHealth and uHealth.

[19]  R. Tamblyn,et al.  Preferences of Young Adults With First-Episode Psychosis for Receiving Specialized Mental Health Services Using Technology: A Survey Study , 2015, JMIR mental health.

[20]  M. Keshavan,et al.  Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics , 2014, JMIR mental health.

[21]  B. Schrank,et al.  How Patients With Schizophrenia Use the Internet: Qualitative Study , 2010, Journal of medical Internet research.

[22]  Cameron D. Norman,et al.  eHEALS: The eHealth Literacy Scale , 2006, Journal of medical Internet research.

[23]  E. Deci,et al.  Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. , 2000, The American psychologist.