From the Editor
March, 2014. These days, it seems apt to think of technology in the fast lane. New forms of social media and communication roll out daily, and new and better devices deliver messages, news, and entertainment at warp speed. “Dead zones” have virtually disappeared, and zones forbidding use, such as the cabin of an airliner in flight, are fast disappearing. Landlines are antiques, voicemail is antiquated, and routine texting is endangered by super-smartphones, whatsapp, augmented reality, Google Glass, and all of the other new devices we haven’t heard about yet. Or perhaps I should say that I haven’t heard about yet, since I am truly among the technologically unenlightened, put to shame by my 6-year-old grandson.
It would be naïve to argue that these amazing leaps of progress would bypass our clinical world, and a stroll down the teaching hallways of a microsurgery suite or through the medical school simulation lab is all it would take to squelch that idea. But in the field of psychiatry, are we keeping up? I think not, but I have hope, since I believe that high-tech communication between clinicians and patients is inevitable and is oozing under the door! How many of us exchange emails or texts with our own physicians regarding our own healthcare? I’d guess that a lot of us do. How many of us use Skype or other forms of videoconferencing to connect with our own patients when office visits are not possible—even to conduct psychotherapy sessions? You may recall the Clinical Case Discussion in this Journal some time ago by Debra Quackenbush, PhD, describing a course of “avatar therapy” that she conducted with a patient in the Middle East, carried out in “Second Life,” a virtual reality system.1 That type of work is probably too foreign for comfort for most of us, but this will change, and it probably should change, at least for some of us. I’m not ready to sacrifice the immediacy and impact of good old-fashioned in-person work, which captures the vitality of a relationship in ways that machines can’t. But we must be open to a changing world, and we can bring help to many who are suffering but lack resources or available clinicians. Part of our job, then, is to design and guide these new strategies into ethical and effective delivery systems that are validated and legitimate.
In this issue of the Journal, Carras and colleagues describe the growing use of mobile phones, email, the Internet, and other forms of telecommunication in a community psychiatry clinic. They conclude that the feasibility and impact of technology-based interventions are persuasive and offer new avenues to provide health information and treatment. Also in this issue of the Journal, Ahuja and colleagues present a case of a young man who posted content on Facebook that suggested suicidal risk, leading to swift and probably life-saving intervention. In their discussion, Draper and Womble suggest that social media, “when used effectively, can be a powerful tool in saving the lives of people who are considering suicide.” They describe a number of Facebook strategies that “harness the power of chat as an intervention tool”—a set of laudable and responsible services that will surely be emulated by other social media systems.
John Oldham, MD
1. Quackenbush DM, Krasner A..Avatar therapy: Where technology, symbols, culture, and connection collide.J Psychiatr Pract.2012;18:451–9.