Quality of »Mental health internet sites« evaluated with the DISCERN instrument. Nada Tržan-Herman*, Psychiatric hospital Vojnik, Slovenia Introduction The term »mental health« consists in general of the following categories: Adjustment Disorders; Alcohol-Related Disorders; Anxiety Disorders; Drug-Related Disorders; Eating Disorders; Infancy, Childhood and Adolescence Disorders; Mood Disorders; Personality Disorders, and Psychotic Disorders. Good mental health is a vital element of each society. Nowadays mental illnesses are increasing and it is a worldwide problem. A recent World Health Organization report predicts that www.hsphsun2.harvard.edu/ organizations/bdu/vol1.html”depression (suicide) will be the leading cause of disability and premature death in the industrial world in the next 25 years. (1, 2). A severe obstacle is patients’ non-compliance with pharmacotherapy. In this paper I present an evaluation of internet sites for patients who search for help when they have mental health problems. They try to get an answer on the following questions: how can I stay healthy and reduce my risk of contracting a disease? Should I see my doctor? Am I getting the right type of care and treatment for my health problems? Quality of information is an important issue for these sensitive patients. Evaluations of corresponding internet sites are made with the DISCERN instrument (3) – not only for internet sites in English, but also in Spanish and Slovenian language. It is important for patients’ decisions to get good quality information in their native languages. Objectives 1. To find good quality internet sites which can help in bringing a decision on the best treatment choice for an individual person who search for advice on »mental health« - specially in the prodromal phase (4) The evaluations are based with the DISCERN instrument. 2. To prove that it would be valuable to include the DISCERN instrument as a part of standardised procedure for evaluation of good quality internet sites which provide information on treatment choices. Method 1. Simple search strategy was used via Google because people usually do not know specific professional medical terms: - in English »mental health« - in Spanish: »salud mental« - in Slovenian: »duševno zdravje« 2. Search results (the first page after the above search strategy) are evaluated with the DISCERN instrument (www.discern.org.uk) There are the following criteria for evaluations of documents: Are the aims clear? Does it achieve its aims? Is it relevant? Is it clear what sources of information were used to compile the publication (other than the author or producer)? Is it clear when the information used or reported in the publication was produced? Is it balanced and unbiased? Does it provide details of additional sources of support and information? Does it refer to areas of uncertainty? Does it describe how each treatment works? Does it describe the benefits of each treatment? Does it describe the risks of each treatment? Does it describe what would happen if no treatment is used? Does it describe how the treatment choices affect overall quality of life? Is it clear that there may be more than one possible treatment choice? Does it provide support for shared decision-making? Each criteria has scores from 1 to 5 (5 is the best). Based on the answers to all of the above questions, finally the overall quality of the publication as a source of information about treatment choices is rated and another mark from 1 to 5 is given. The best result of the evaluation that can be possibly achieved is 16x5, which means 80 scores. Internet sites Country DISCERN / Scores 01 www.mentalhealth.com Canada 74 02 www.nlm.nih.gov/medlineplus/mentalhealth.html NIH-USA 73 03 www.who.int/mental_health/en WHO 64 04 www.mentalhealth.about.com/home USA 70 05 www.nimh.nih.gov/index.shtml NIH-Mental health-USA 73 06 www.mentalhealth.org.uk/about-us UK 70 07 www.nmha.org USA 70 08 www.camh.net/education/International_health_programs/index. Canada 62 09 www.counsellingresource.com/quizzes/prime/index.html UK 62 10 www.eutimia.com/index2.html OPS, Argentina 65 Table 1: Good quality internet sites on “mental health” evaluated with DISCERN instrument Discussion People should find good quality information on health problems in their own language. - Most good quality internet sites which are discovered and listed in Table 1 are in English.; only one in Spanish language. It would be excellent to translate (by permission) these sites into various national languages – referring to the needs of a specific country. I see that internet sites which I have evaluated are weak in giving the answer to the following question: »what would happen if no treatment is used?«. This question is important for various mental diseases, because relapses are to be avoided as they may have a permanent negative effect on the brain. It is worth to pay attention on the proper domain names registrations because good quality internet sites should come out as much as possible on the first page when people search for “mental health”. The DISCERN instrument is an effective instrument for evaluation of internet sites but it would be useful to add another criteria for evaluation and this is: awards; e.g. when an internet site has an HON sign (“Medical information you can trust”) it is a good element of trust (www.hon.ch) I suggest introducing a »DISCERN sign« as an “internet sites award”. It would be a good proof that a specific internet site gives good-quality information on treatment choices. In my opinion evaluations of internet sites with the DISCERN instrument require basic professional knowledge of medicine. Literature 1. www.who.int/mental_health/en/, May 2008 2. Prince M. et al No health without mental health, Lancet (series-Global Mental Health), 8 Sept 2007, vol. 370, No 9590, pp.859-877 3. Deborah Charnock, The DISCERN Handbook (Quality Criteria for consumer health information on treatment choices, compiled by D. Charnock), Redcliffe Medical Press, 1998 4. De Hert M. et al The Secret of the Brain Chip - A self help guide for people experiencing psychosis, EPO, Belgium, 2000 * Author’s address details: Nada Tržan-Herman, MSc E1: [email protected] E2: [email protected] Psychiatric hospital Vojnik Celjska cesta 37, 3212 Vojnik, Slovenia www.pb-vojnik.si 11th EUROPEAN CONFERENCE OF MEDICAL AND HEALTH LIBRARIES Helsinki, Finland, 2008, June 23-28 Results There are forty internet sites which come out as search results; the method is previously described and the full text is on the enclosed handouts. Only ten of them have met the following basic criteria: Are the aims clear? Does it achieve its aims? Is it relevant? These ten internet sites were evaluated with DSCERN instrument and the results – good quality internet sites - are presented in Table 1. www.cyp2c9.com Art work - painetd by a woman with schizophrenia; this picture is a result of a “Creative Therapy” which is a part of therapy in the Psychiatric hospital Vojnik. Psychiatric hospital Vojnik, Slovenia The psychiatric hospital Vojnik has about 180 beds. In 2006 it was ranked in first place among six Slovenian psychiatric hospitals regarding patients’ satisfaction. In this survey it is exposed that patients in this hospital are very well informed about therapy - including pharmacotherapy.
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Quality of »Mental health internet sites«evaluated with the DISCERN instrument.Nada Tržan-Herman*, Psychiatric hospital Vojnik, Slovenia
IntroductionThe term »mental health« consists in general of the following categories: AdjustmentDisorders; Alcohol-Related Disorders; Anxiety Disorders; Drug-Related Disorders; Eating Disorders; Infancy, Childhood and Adolescence Disorders; Mood Disorders; Personality Disorders, and Psychotic Disorders.
Good mental health is a vital element of each society. Nowadays mental illnesses areincreasing and it is a worldwide problem.A recent World Health Organization report predicts that www.hsphsun2.harvard.edu/organizations/bdu/vol1.html”depression (suicide) will be the leading cause of disability and premature death in the industrial world in the next 25 years. (1, 2).
A severe obstacle is patients’ non-compliance with pharmacotherapy. In this paper Ipresent an evaluation of internet sites for patients who search for help when they have mental health problems. They try to get an answer on the following questions: how canI stay healthy and reduce my risk of contracting a disease? Should I see my doctor? Am Igetting the right type of care and treatment for my health problems? Quality of information is an important issue for these sensitive patients.
Evaluations of corresponding internet sites are made with the DISCERN instrument (3) – not only for internet sites in English, but also in Spanish and Slovenian language. It isimportant for patients’ decisions to get good quality information in their native languages.
Objectives1. To find good quality internet sites which can help in bringing a decision on the best treatment choice for an individual person who search for advice on »mental health« - specially in the prodromal phase (4) The evaluations are based with the DISCERN instrument.2. To prove that it would be valuable to include the DISCERN instrument as a part of standardised procedure for evaluation of good quality internet sites which provide information on treatment choices.
Method1. Simple search strategy was used via Google because people usually do not know specific professional medical terms:- in English »mental health«- in Spanish: »salud mental«- in Slovenian: »duševno zdravje«
2. Search results (the first page after the above search strategy) are evaluated with the DISCERN instrument (www.discern.org.uk) There are the following criteria for evaluations of documents:
Are the aims clear? Does it achieve its aims? Is it relevant? Is it clear what sources ofinformation were used to compile the publication (other than the author or producer)?Is it clear when the information used or reported in the publication was produced? Is it balanced and unbiased? Does it provide details of additional sources of support andinformation? Does it refer to areas of uncertainty? Does it describe how each treatment works? Does it describe the benefits of each treatment? Does it describe the risks of each treatment? Does it describe what would happen if no treatment is used? Does it describe how the treatment choices affect overall quality of life? Is it clear that theremay be more than one possible treatment choice? Does it provide support for shared decision-making? Each criteria has scores from 1 to 5 (5 is the best).Based on the answers to all of the above questions, finally the overall quality of thepublication as a source of information about treatment choices is rated and another mark from 1 to 5 is given. The best result of the evaluation that can be possibly achieved is 16x5,which means 80 scores.
Internet sites Country DISCERN / Scores
01 www.mentalhealth.com Canada 74
02 www.nlm.nih.gov/medlineplus/mentalhealth.html NIH-USA 73 03 www.who.int/mental_health/en WHO 64
04 www.mentalhealth.about.com/home USA 70
05 www.nimh.nih.gov/index.shtml NIH-Mental health-USA 73
06 www.mentalhealth.org.uk/about-us UK 70
07 www.nmha.org USA 70
08 www.camh.net/education/International_health_programs/index. Canada 62
09 www.counsellingresource.com/quizzes/prime/index.html UK 62
10 www.eutimia.com/index2.html OPS, Argentina 65
Table 1: Good quality internet sites on “mental health” evaluated with DISCERN instrument
DiscussionPeople should find good quality information on health problems in their own language.- Most good quality internet sites which are discovered and listed in Table 1 are inEnglish.; only one in Spanish language. It would be excellent to translate (by permission) these sites into various national languages – referring to the needs of a specific country.
I see that internet sites which I have evaluated are weak in giving the answer to thefollowing question: »what would happen if no treatment is used?«. This question isimportant for various mental diseases, because relapses are to be avoided as they may have a permanent negative effect on the brain.
It is worth to pay attention on the proper domain names registrations because good quality internet sites should come out as much as possible on the first page when people search for “mental health”.
The DISCERN instrument is an effective instrument for evaluation of internet sites butit would be useful to add another criteria for evaluation and this is: awards; e.g. when an internet site has an HON sign (“Medical information you can trust”) it is a good element of trust (www.hon.ch)
I suggest introducing a »DISCERN sign« as an “internet sites award”. It would be a good proof that a specific internet site gives good-quality information on treatment choices.In my opinion evaluations of internet sites with the DISCERN instrument require basic professional knowledge of medicine.
Literature
1. www.who.int/mental_health/en/, May 2008
2. Prince M. et al No health without mental health, Lancet (series-Global Mental Health), 8 Sept 2007, vol. 370, No 9590, pp.859-877
3. Deborah Charnock, The DISCERN Handbook (Quality Criteria for consumer health information on treatment choices, compiled by
D. Charnock), Redcliffe Medical Press, 1998
4. De Hert M. et al The Secret of the Brain Chip - A self help guide for people experiencing psychosis, EPO, Belgium, 2000
* Author’s address details:Nada Tržan-Herman, MScE1: [email protected]: [email protected] hospital VojnikCeljska cesta 37, 3212 Vojnik, Sloveniawww.pb-vojnik.si
11th EUROPEAN CONFERENCE OF MEDICAL AND HEALTH LIBRARIESHelsinki, Finland, 2008, June 23-28
ResultsThere are forty internet sites which come out as search results; the method is previously described and the full text is on the enclosed handouts. Only ten of them have met the following basic criteria:Are the aims clear?Does it achieve its aims?Is it relevant?These ten internet sites were evaluated with DSCERN instrument and theresults – good quality internet sites - are presented in Table 1.
www.cyp2c9.com
Art work - painetd by a woman with schizophrenia; thispicture is a result of a “Creative Therapy” which is a partof therapy in the Psychiatric hospital Vojnik.
Psychiatric hospital Vojnik, Slovenia The psychiatric hospital Vojnik has about 180 beds. In 2006 it was ranked in first place among six Slovenian psychiatric hospitals regarding patients’ satisfaction. In this survey it is exposed that patients in this hospital are very well informed about therapy - including pharmacotherapy.
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