Understanding appropriation of digital self-monitoring tools in mental health care – an implementation pilot

INTRODUCTION: Digital self-monitoring tools, such as the Experience Sampling Method (ESM), enable individuals to collect detailed information about their mental health and daily life context and may help guide and support person-centered mental health care. However, like many digital interventions, ESM struggles to move from research to clinical integration. To guide the implementation of self-monitoring tools in mental health care, it is important to understand how people appropriate them in everyday life. Therefore, this study examined how clinicians and their clients adopted, adapted, and incorporated an ESM-based self-monitoring tool into therapeutic practices. METHODS: We piloted an ESM tool within a psychiatric hospital setting. After utilizing the tool, seven clinicians and 11 clients participated in semi-structured interviews. A thematic framework analysis was performed focusing on participants’ (1) prior knowledge and expectations, (2) actual use in practice, and (3) potential future use of ESM tools.RESULTS: Only one clinician had experience using digital self-monitoring tools. Although many participants experienced benefits they also encountered challenges in using the ESM tool. Clinicians experienced mismatches between system usability and their technical competencies, clients found it difficult to comply with the self-assessments, and interpreting self-monitoring data was challenging for both groups. DISCUSSION: This study shows that clinicians' and clients’ choice to adopt and integrate self-monitoring tools into clinical practice is influenced by the balance between perceived added benefits and the effort required to achieve them. Future research should address the identified potential barriers to clinical implementation of digital self-monitoring tools and further explore non-adopters' views.