title: Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record.
abstract: BACKGROUND
  Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this end, a qualitative analysis of focus group discussions regarding the Mental Health Engagement Network, a web-based personal health record and smartphone intervention, is presented here.
  
  
  METHODS
  Individuals living in the community with a mood or psychotic disorder (n = 394) were provided with a smartphone and access to an electronic personal health record, the Lawson SMART Record, for 12 to 18 months to manage their mental health. This study employed a delayed-implementation design and obtained both quantitative and qualitative data through individual interviews and focus group sessions. Participants had the opportunity to participate in voluntary focus group sessions at three points throughout the study to discuss their perceptions of the technologies. Qualitative data from 95 focus group participants were analysed using a thematic analysis.
  
  
  RESULTS
  Four overarching themes emerged from focus group discussions: 1) Versatile functionality of the Lawson SMART Record and smartphone facilitated use; 2) Aspects of the technologies as barriers to use; 3) Use of the Mental health Engagement Network technologies resulted in perceived positive outcomes; 4) Future enhancement of the Lawson SMART Record and intervention is recommended.
  
  
  CONCLUSIONS
  These qualitative data provide a valuable contribution to the understanding of how smarttechnologies can be integrated into usual mental health care. Smartphones are extremely portable andcommonplace in society. Therefore, clients can use these devices to manage and track mental health issuesin any place at almost any time without feeling stigmatized.
  
  
  CONCLUSIONS
  Assessing clients' perspectives regarding the use of smart technologies in mental health care provides an invaluable addition to the current literature. Qualitative findings support the feasibility of implementing a smartphone and electronic personal health record intervention with individuals who are living in the community and experiencing a mental illness, and provide considerations for future development and implementation.
authors.affiliation: Lawson Health Research Institute, 750 Baseline Road East, London, ON, Canada. cforchuk@uwo.ca.|Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, ON, Canada. cforchuk@uwo.ca.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Forchuk
authors.affiliation: Lawson Health Research Institute, 750 Baseline Road East, London, ON, Canada. Jeffrey.Reiss@lhsc.on.ca.|Department of Psychiatry, Schulich School of Medicine and Dentistry Western University, London, ON, Canada. Jeffrey.Reiss@lhsc.on.ca.|Mental Healthcare Program, London Health Sciences Centre, London, ON, Canada. Jeffrey.Reiss@lhsc.on.ca.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Reiss
authors.affiliation: Lawson Health Research Institute, 750 Baseline Road East, London, ON, Canada. Tony.Oregan@lhsc.on.ca.
authors.forename: Tony
authors.initials: T
authors.lastname: O'Regan
authors.affiliation: Lawson Health Research Institute, 750 Baseline Road East, London, ON, Canada. Paige.Ethridge@lhsc.on.ca.
authors.forename: Paige
authors.initials: P
authors.lastname: Ethridge
authors.affiliation: Lawson Health Research Institute, 750 Baseline Road East, London, ON, Canada. ldonelle@uwo.ca.|Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, ON, Canada. ldonelle@uwo.ca.|School of Health Studies, Faculty of Science, Western University, London, ON, Canada. ldonelle@uwo.ca.
authors.forename: Lorie
authors.initials: L
authors.lastname: Donelle
authors.affiliation: Lawson Health Research Institute, 750 Baseline Road East, London, ON, Canada. harudnick@hotmail.com.|Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. harudnick@hotmail.com.|Mental Health and Substance Use Services, Vancouver Island Health Authority, Victoria, BC, Canada. harudnick@hotmail.com.
authors.forename: Abraham
authors.initials: A
authors.lastname: Rudnick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057286:Electronic Health Records; D005260:Female; D017144:Focus Groups; D055991:Health Records, Personal; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D063731:Mobile Applications; D019964:Mood Disorders / Q000523:psychology; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D011618:Psychotic Disorders / Q000523:psychology; D036301:Qualitative Research; D000068997:Smartphone; D012944:Social Support; D055815:Young Adult