JMIR Mental Health Internet interventions, technologies and digital innovations for mental health and behaviour change Volume 7 (2020), Issue 4 ISSN: 2368-7959 Editor in Chief: John Torous, MD Contents Editorial Advancing E-Mental Health in Canada: Report From a Multistakeholder Meeting (e19360) Gillian Strudwick, Danielle Impey, John Torous, Reinhard Krausz, David Wiljer. 3 Original Papers A Web- and Mobile-Based Intervention for Comorbid, Recurrent Depression in Patients With Chronic Back Pain on Sick Leave (Get.Back): Pilot Randomized Controlled Trial on Feasibility, User Satisfaction, and Effectiveness (e16398) Sandra Schlicker, Harald Baumeister, Claudia Buntrock, Lasse Sander, Sarah Paganini, Jiaxi Lin, Matthias Berking, Dirk Lehr, David Ebert. 6 Temporal Associations of Daily Changes in Sleep and Depression Core Symptoms in Patients Suffering From Major Depressive Disorder: Idiographic Time-Series Analysis (e17071) Noah Lorenz, Christian Sander, Galina Ivanova, Ulrich Hegerl. 27 A Web-Based Adaptation of the Quality of Life in Bipolar Disorder Questionnaire: Psychometric Evaluation Study (e17497) Emma Morton, Sharon Hou, Oonagh Fogarty, Greg Murray, Steven Barnes, Colin Depp, CREST.BD, Erin Michalak. 38 Digital Peer Support Mental Health Interventions for People With a Lived Experience of a Serious Mental Illness: Systematic Review (e16460) Karen Fortuna, John Naslund, Jessica LaCroix, Cynthia Bianco, Jessica Brooks, Yaara Zisman-Ilani, Anjana Muralidharan, Patricia Deegan. 65 The Performance of Emotion Classifiers for Children With Parent-Reported Autism: Quantitative Feasibility Study (e13174) Haik Kalantarian, Khaled Jedoui, Kaitlyn Dunlap, Jessey Schwartz, Peter Washington, Arman Husic, Qandeel Tariq, Michael Ning, Aaron Kline, Dennis Wall. 76 Long-Term Effectiveness and Cost-Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder, Panic Disorder, and Social Anxiety Disorder in Japan: One-Year Follow-Up of a Single-Arm Trial (e17157) Kazuki Matsumoto, Sayo Hamatani, Kazue Nagai, Chihiro Sutoh, Akiko Nakagawa, Eiji Shimizu. 90 How Contextual Constraints Shape Midcareer High School Teachers© Stress Management and Use of Digital Support Tools: Qualitative Study (e15416) Julia Manning, Ann Blandford, Julian Edbrooke-Childs, Paul Marshall. 104 JMIR Mental Health 2020 | vol. 7 | iss. 4 | p.1 XSL·FO RenderX Analyzing Trends of Loneliness Through Large-Scale Analysis of Social Media Postings: Observational Study (e17188) Keren Mazuz, Elad Yom-Tov. 116 Portuguese Psychologists© Attitudes Toward Internet Interventions: Exploratory Cross-Sectional Study (e16817) Cristina Mendes-Santos, Elisabete Weiderpass, Rui Santana, Gerhard Andersson. 126 Review The Use of Text Messaging to Improve Clinical Engagement for Individuals With Psychosis: Systematic Review (e16993) Jessica D©Arcey, Joanna Collaton, Nicole Kozloff, Aristotle Voineskos, Sean Kidd, George Foussias. 50 Letter to the Editor Comment on ªDigital Mental Health and COVID-19: Using Technology Today to Accelerate the Curve on Access and Quality Tomorrowº: A UK Perspective (e19547) Pauline Whelan, Charlotte Stockton-Powdrell, Jenni Jardine, John Sainsbury. 143 JMIR Mental Health 2020 | vol. 7 | iss. 4 | p.2 XSL·FO RenderX JMIR MENTAL HEALTH Strudwick et al Editorial Advancing E-Mental Health in Canada: Report From a Multistakeholder Meeting Gillian Strudwick1, RN, PhD; Danielle Impey2, PhD; John Torous3, MD, MBI; Reinhard Michael Krausz4, MD, PhD; David Wiljer5, PhD 1Centre for Addiction and Mental Health, Toronto, ON, Canada 2Mental Health Commission of Canada, Ottawa, ON, Canada 3Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States 4Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada 5University Health Network, Toronto, ON, Canada Corresponding Author: Gillian Strudwick, RN, PhD Centre for Addiction and Mental Health 1001 Queen St W Toronto, ON, M6J1H4 Canada Phone: 1 4165358501 Email: [email protected] Abstract The need for e-mental health (electronic mental health) services in Canada is significant. The current mental health care delivery models primarily require people to access services in person with a health professional. Given the large number of people requiring mental health care in Canada, this model of care delivery is not sufficient in its current form. E-mental health technologies may offer an important solution to the problem. This topic was discussed in greater depth at the 9th Annual Canadian E-Mental Health Conference held in Toronto, Canada. Themes that emerged from the discussions at the conference include (1) the importance of trust, transparency, human centeredness, and compassion in the development and delivery of digital mental health technologies; (2) an emphasis on equity, diversity, inclusion, and access when implementing e-mental health services; (3) the need to ensure that the mental health workforce is able to engage in a digital way of working; and (4) co-production of e-mental health services among a diverse stakeholder group becoming the standard way of working. (JMIR Ment Health 2020;7(4):e19360) doi:10.2196/19360 KEYWORDS mental health; psychiatry; medical informatics; digital health; nursing informatics Just before North American travel and face-to-face contact was British Columbia Department of Psychiatry, University Health reduced or eliminated by coronavirus disease (COVID-19), Network, and the Centre for Addiction and Mental Health. In more than 250 people gathered in Toronto, Canada, for the 9th an effort to ensure the relevancy, timeliness, and potential impact Annual Canadian E-Mental Health Conference [1]. In any given of the topics discussed, the audience was made up of a diverse year, 20% of Canadians will have experienced a mental health group of stakeholders such as people with lived experience of or addiction related issue [2], and by the age of 40 years, mental illness, health providers (including peer support workers, approximately half of Canadians have or will have had a mental caregivers, and health professionals), researchers, students, illness [3]. With a large number of people requiring access to administrators, system leaders, vendors/technology developers, mental health care and the lack of current face-to-face services and policy makers. in Canada to meet this need, the conference was held to share Although there is an abundance of digital technologies used in ideas, leading research and best practices for the use of e-mental non±mental health contexts, there are only a limited (but health (electronic mental health) technologies to improve care. growing) number of examples of meaningful digital technology The conference was founded by the University of British use among mental health populations in the country [4]. The Columbia Department of Psychiatry and coproduced this year need to quicken the pace of the adoption of digital technologies by the Mental Health Commission of Canada, University of within mental health service delivery contexts was discussed. http://mental.jmir.org/2020/4/e19360/ JMIR Ment Health 2020 | vol. 7 | iss. 4 | e19360 | p.3 (page number not for citation purposes) XSL·FO RenderX JMIR MENTAL HEALTH Strudwick et al Many strategies were shared. Common themes through all, evidence, and cultural humility to build and adopt smarter regardless of technology or tool, were trust, equity, and training. approaches to mental health care. Diversity, inclusion, equity, Interestingly, on the heels of the conference, COVID-19 has and access are the fundamental starting points for expanding acted as an unfortunate but much needed accelerator for the reach and broadening perspectives. scaling and spread of e-mental health technologies [5] such as A third theme was that the current mental health workforce is increasing access to virtual assessments by a physician in likely not ready at this moment to fully engage in a digital way Ontario paid for by a temporary billing code of the provincial of working. While it will be important that future mental health insurance plan (Ontario Health Insurance Plan) [6]. Watching professionals like psychiatrists, nurses, and social workers have many of the strategies discussed just weeks before now being developed digital health competencies in their entry-to-practice adopted locally and worldwide underscores the potential of level educational programs, there is a large workforce currently focusing on trust, equity, and training. practicing that likely do not possess these competencies. One central theme of numerous discussions was the close Creative ways to support the development of these competencies attention that needs to be paid to trust, transparency, human is certainly needed, as these mental health professionals are centeredness, and compassion in the development and delivery currently practicing within the system and have limited time to of digital mental health technologies [7]. These concepts are engage in formal education. As care is increasingly delivered central to the ªsuccessfulº uptake of these technologies by virtually and uses differing care models than that used today, people with mental illness, especially given the sensitivity of it is also possible that there are roles that do not exist today (eg, the mental health clinical area. Trust, transparency, human digital specialist or navigator) that may be needed to maximize centeredness, and compassion can be understood in several the potential