FoReTech: eHealth technology development in forensic mental health

FoReTech: eHealth technology development in forensic mental health eHealth is the use of technology to improve health, healthcare and wellbeing. Research and practice have identified multiple advantages and possibilities of the use of these eHealth technologies, such as apps, web-based interventions, wearables and virtual reality, for forensic mental health. However, use in practice is lagging behind: uptake of these technologies is slow and often there is no good fit between the technology and the context in which it is used. In order to bridge the gap between eHealth’s potential and its actual use, proper design, implementation and evaluation is pivotal. This presentation addresses the issues described above. First of all, an overview of the current state of eHealth is provided. Examples of technologies that are being used in Dutch forensic mental health are used to illustrate the possibilities and limitations. Second, an explanation of the relevance of good eHealth development for increasing the fit between technology, people and the forensic mental health context is provided. Attention will be paid to the why and how of design, implementation and evaluation. This is based on recent insights, research findings and development models such as the CeHRes Roadmap. Third, a case from practice will be used to illustrate the development process of eHealth for forensic mental health. In this case, a VR application for treatments in Dutch forensic mental health is developed in close cooperation with patients. This development process is guided by the CeHRes Roadmap. FoReTech: Monitoring and coaching of precursors of violence via technology In the treatment of forensic psychiatric outpatients, a therapist is (often) not present when a violent outburst occurs, and can only discuss undesired behaviour before or after it has happened. Technology, however, can be present 24/7. It has the ability to provide just-in-time feedback to prevent undesired behaviour by intervening before escalations actually occur. In order to know when to intervene, a technology needs to monitor specific precursors (or predictors) of violence. Examples of these precursors are physiological arousal, conflict between partners, and geographical location. These precursors can be monitored via technology, e.g. a smartwatch that measures heartrate variability and skin conductance, experience sampling via a smartphone, or the GPS function of a phone. In a subproject of FoReTech, a monitoring and coaching technology for reactive intimate partner violence (IPV) is being developed. The development process starts by studying the biopsychosocial precursors of reactive IPV via mental models of experts combined with scientific literature. After the behaviour and its precursors have been analysed, an interdisciplinary team will determine how to monitor the most important precursors via technology. In close cooperation with patients, their partners and therapists, a technology that uses the monitoring data to coach patients and their partners in reducing IPV will be created. This development process will be guided by principles and methods from different approaches, such as participatory development, behaviour change theories and persuasive technology. This presentation will discuss the development process and provide insight into the possibilities and challenges of monitoring & coaching technologies in forensic mental health.