The WHO Department of Mental Health and Substance Abuse has been conducting internet-based research to inform the development of the ICD-11 since 2010, and established the Global Clinical Practice Network during the same year. To date, GCP.Nework’s more than 12 600 members from 150 countries spanning all WHO global regions have contributed to the ICD-11 by participating in more than a dozen multilingual studies related to the ICD-11 classification of Mental and Behavioural Disorders. GCP.Network has clearly established that conducting global, internet-based research among clinicians providing mental health services, with strong participation from professionals in low- and middle-income countries, is viable. GCP.Network clinicians have provided over 30 000 responses, with study results increasingly represented in the peer-reviewed literature.
To gain further information about how to enhance GCP.Network’s capacity and interest in using the internet to develop and implement the ICD-11 and to meet other clinical and professional needs, as well as examine the barriers and facilitators to internet access across the network, we conducted a survey on technology use in clinical practice during 2015. Below we summarize the major findings.
At the time of the study 10 070 GCPN members qualified to participate in the study in one of the five available languages. 2 561 GCP.Network members completed the study: 908 in English (35.5%), 389 in in Spanish (15.2%), 360 in Chinese (14.1%), 342 in French (13.4%), 300 in Russian (11.7%), and 262 in Japanese (10.2%).
Mean age: 45.78 yrs (SD~11.4 yrs)
Mean professional experience: 15.88 yrs (SD~10.38 yrs)
Male: female ratio: 58.2%: 41.8%
Forty-five percent of respondents from the AFRO region reported that the cost of internet limited their use of it at home, compared to 28.6% in the SEARO region, and 6% in the AMRO-North region.
Considerations in developing ICD-11 internet-based studies or web-based materials should be given to GCPN members living in regions where internet connections are slow or unreliable and cost is a barrier to use. This could include special attention to the length of surveys (where shorter may be more manageable for areas with slower and less reliable connections), as well as the file sizes for any sharable and downloadable content (e.g., pictures, pdf, and video files). Finally, survey platforms should be able to handle intermittent internet connections, such that if members start a survey and lose internet connection, they will be able to pick up where they left off once their connection is restored.
Laptop and desktop computers were the most commonly used devices to access the internet, however, the majority of respondents also reported accessing the internet using a smartphone, tablet, or other mobile device. It may be useful to consider formatting future surveys and any web content for mobile devices, such as tablets and smartphones running iOS and Android.
Most GCPN members are already accessing the internet in many ways for their clinical practice, and those who are not are interested in doing so. Most members are interested in using tablet and smartphone apps to access the ICD-11 once completed, even if they do not currently own or have access to a mobile device. Only about 15% of the members have suggested that their patients use mobile health applications (mHealth apps). Among the suggested mhealth apps for patients were apps for mindfulness, sleep cycle, relaxation, cognitive training, and CBT. While smartphone and tablet are increasing globally, making these increasingly viable adjuncts to the work of health professionals, apps for patient use must be rigorously evaluated.