Patient safety: technologies can help, but also hinder
Technological innovations in mental health are in line with NHS plans, but service users and nurses need input on key issues such as privacy and effectiveness
Potential benefits and threats from ever-more complex use of technology are the stuff of day-to-day conversations and national reporting around the world. While in the NHS Long Term Plan there are plans for significantly more use of technology to support clinical practice.
The field of mental health has itself seen a recent, but rapid, increase in technological innovation. Mental health apps have become commonplace, although variable in quality. Inpatient services are increasingly adopting a range of approaches, including body-worn cameras, fixed infrared camera systems identifying movement, position and measuring heart and breathing rates, pressure alarms on door frames, and alarms triggered by service users getting out of bed.
The aim of all these technologies has been, in different ways, to improve safety. However, the research evidence about their acceptability and effectiveness in practice is not strong. The context for these developments taking place include concerns about increasing patient safety incidents, ongoing challenges reaching desired staffing levels and, simply, an understandable desire to seek new ways of tackling serious problems, such as levels of self-harm and falls.
Service users and staff need to be in discussions about proposed new technologies
Technology offers much to the field of mental health, but meaningful decisions about its use requires clear aims, evidence and communication. Without realistic and explicitly measurable aims, it will be impossible to judge whether a system is delivering what was desired.
Research evidence needs to inform us of the potential for good and ill of any new technology, as all new clinical interventions can benefit one problem, but create another.
Communication requires meaningful advance engagement with service users and staff, together discussing potential advantages and disadvantages of any proposed new system.
In trying to aid patient safety, our challenge is to do what is acceptable and effective, balancing observation and privacy, and being clear where human presence is irreplaceable.
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