Digital Mental Health Interventions Show Potential Benefits for Adults With Intellectual Disabilities

Given the right opportunity, digital mental health interventions (DMHI) have the potential to support adults with intellectual disabilities in addition to in-person therapy, according to a review.

“This systematic review was carried out to identify and collate the views and experiences of people with intellectual disabilities about accessing digital mental health interventions,” wrote the authors of this review. “Narratives reflected themes relating to participants’ experience using technology, types of relationships fostered during digitally assisted therapy, and the psychological benefits of engaging in DMHI.”

The results of this qualitative systemic review were published in the Journal of Applied Research in Intellectual Disabilities.

Using electronic databases MEDLINE, PsycINFO, CINAHL, and SCOPUS searched in March 2022, the authors of this review identified 1044 studies, of which all but 5 were excluded after screening for duplicates and evaluation of the abstract or title.

These 5 studies had 3 main narrative themes: user experience with DMHI (personal experience, digital experience), types of relationships fostered through technology (interpersonal support, relating to virtual characters, and using a computer as a skilled helper), and psychological benefits of digital mental health interventions (new skills development and personal autonomy development).

The studies included a total of 64 participants (40 female and 24 male), with a median age of 44.5 years. All studies reported user experience with and opinions of DMHI for people with intellectual disabilities. Additionally, 3 of the studies reported therapist/support worker viewpoints on participant engagement and experiences with DMHI.

Regarding patient experience, most participants reported a positive experience with computer games or digital activities focused on coping skills, as well as mood management computer programs. However, some patients reported dissatisfaction, such as technical issues or difficulty hearing the voice-over recordings. Furthermore, some participants said they struggled cognitively or emotionally when engaging in complex therapeutic tasks, and some lost motivation to continue with the program due to these overwhelming or frustrating emotions.

In terms of relationships fostered through technology, DHMI appeared to strengthen already established relationships by encouraging patients to interact with others and talk about mental health issues. Additionally, relationships between therapists/support workers and virtual characters emerged due to DHMI. Most participants reported feeling a sense of encouragement and support when interacting with a therapist/support worker. Additionally, participants tended to personify game characters as real individuals, perceiving the characters to be supportive, collaborative, and empathetic.

Lastly, participants reported feeling a sense of independence and accomplishment associated with completion of DHMI programs. Across all studies, most participants relayed DHMI as an opportunity to learn new skills related to mental health management. However, not all participants achieved a total understanding of the skills provided to them.

While the authors believe future research is needed to better understand how to best implement digital programs to people with intellectual disabilities, the results of this review show that people with intellectual disabilities have varied and diverse needs, but many may benefit from individualized DHMI to better manage mental health skills. Furthermore, DHMI appeared to provide these patients with a feeling of “digital empowerment,” a step in the right direction to bridging the digital gap in mental health care.

“DMHI has the potential to benefit people with intellectual disabilities as a complement to therapy, but not as a replacement for face-to-face services as the perceived value of in-person support for a therapist came through the responses,” wrote the authors. “Careful consideration should be given to ways of integrating DMHI into conventional service delivery.”

Reference

MacHale R, Ffrench C, McGuire B. The experiences and views of adults with intellectual disabilities accessing digital mental health interventions: a qualitative systematic review and thematic synthesis. J Appl Res Intellect Disabil. Published online February 13, 2023. doi:10.1111/jar.13082