Bowie-DaBreo, Dionne and Sunram-Lea, Sandra and Sas, Corina and Iles-Smith, Heather (2024) A transdisciplinary framework for ethical mobile mental health. PhD thesis, Lancaster University.
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Abstract
Mobile mental health has been touted as a means of increasing access to mental health care. But there are significant challenges to the implementation of mobile mental health, such as limited evidence of effects and concerns with privacy and security. These challenges pose notable ethical concerns that must be addressed in order to ensure good and fair delivery of mental health care. Adding to this complexity is the multidisciplinary nature of the field and the need to involve all stakeholders to ensure ethical development and use of these technologies. In this thesis, I explore multidisciplinary perspectives and ethical experiences in mobile mental health with the aim of developing a transdisciplinary framework. This thesis makes five original contributions. First, it presents a comprehensive cross-disciplinary review of the ethics of mobile mental health (Chapter 3) including an in-depth evaluation of ethical issues in the wild (Chapter 4). These studies found ethical issues and considerations not conveyed in the literature and proposed elements of ethically designed apps for depression. Second, I present similarities and differences in the discussion and prioritisation of ethics across disciplines (Chapters 3) which supported the thesis aims and the importance of multidisciplinarity. Third, I used these findings to develop ethical design cards for digital mental health and show support for their use as a toolkit to help multidisciplinary teams to consider ethical issues when designing and developing digital mental health interventions (Chapter 5). Fourth, I present original research exploring how multidisciplinary stakeholders conceptualise ethical digital mental health (Chapter 5). I found that this was largely grounded in the adage of doing no harm, which was impacted by the values underlying the design and use of the technologies. Finally, I conclude the thesis by amalgamating these findings into a transdisciplinary framework that advances understanding and provides practical guidance on developing and using ethical mobile mental health (Chapter 6).