Dr. Edward Kaftarian on the Age of Cyberpsychiatry

Psych Congress Steering Committee member Edward Kaftarian, MD, is throwing down the gauntlet. He’s calling on psychiatry training and research programs nationwide to prioritize cyberpsychiatry, the study of our relationship with technology and its effect on our mental health.

 “We need mental health providers to be at the policy table to make sure technology is faithfully serving a mission to better mankind,” said Dr. Kaftarian, chief executive officer of Orbit Health Telepsychiatry, Encino, California, and cochair of Psych Congress Elevate. “In order to get there, we need to drive efforts to obtain information about how technology affects our mental and behavioral health.”

Dr. Kaftarian, who has made telepsychiatry the centerpiece of his practice, considers technology an inevitable part of humanity’s evolution. He spoke about cyberpsychiatry at the virtual 2020 Psych Congress Elevate conference, and recently shared some additional insight into the growing role of technology in mental health care.

Q: How long has the field of cyberpsychiatry been around? How did you get interested in it, and how would you explain it to someone unfamiliar with the term?

A: When the iPhone came out in 2007, I was in awe of its power to shape the way we think and behave. With my involvement in telemedicine, I continued to develop my appreciation for how technology was transforming mental health care. I realized that psychiatry training programs have been deficient in preparing us to deal with both the opportunities and threats of technology. I felt that this subject deserved further study, attention, and a name, so I coined the term cyberpsychiatry. I define cyberpsychiatry as the study of our relationship to technology and the way it can affect our mental health, both good and bad.

Q: How do you view the influence of technology? Is it a blessing or a curse?

A: Rather than taking a binary view of technology as a blessing or a curse, I choose to see it as an inevitable part of the evolution of humanity. Regardless of its benefits and drawbacks, we need to gain a scientific understanding of how it can influence our society. That way, we can steer it in a direction that best serves people. The measure of our success will be if the technology serves humans more than humans serving the technology.

Q: Is cyberpsychiatry currently being used in the treatment of patients with mental health issues? How so, and how commonly?

A: Cyberpsychiatry takes on many forms in the service of mental disorders. Virtual reality, telepsychiatry, transcranial magnetic stimulation, and chatbot therapists are some of the many examples of how technology's role in the world of psychiatry is growing.

Q: Is there a danger of cyberpsychiatry distancing mental health providers from their patients? If a patient is not in the room with a provider, for instance, couldn’t certain aspects of care be overlooked?

A: There is always a risk of taking the humanity out of medicine by relying too heavily on technology. However, I think some people place too much importance on the doctor and patient being in the same room. Even more important than geographic distance is the clinical distance we often see between the doctor and patient. In my experience with thousands of telemedicine encounters, I have been able to establish communication and trust with my patients that transcends geographic distances. If properly cultivated and supported by high quality technology, a great doctor-patient relationship can be enhanced, not necessarily detracted, by cyberpsychiatry.

Q: What are the drawbacks in treating patients via cyberpsychiatry? What are the main advantages? 

A: Technology is growing at a pace that is hard to manage. We do not have a full grasp of all of the unintended consequences. For example, artificial intelligence is only as good as how it is programmed. All human beings have some degree of bias that often escapes awareness. If chatbot therapist software allows bias to permeate the program, it could harm the quality of the assessment and treatment. Ironically, one of the biggest drawbacks to technology is that it relies on input from humans who are naturally imperfect organisms.

Q: What role do you think cyberpsychiatry will assume in patient care in the future? Do you see this affecting all mental health providers, or mainly those who have an interest in technology? 

A: In the past decade, technology has grown into our daily life with an unprecedented intensity. Cyberpsychiatry is becoming central to how we understand and treat the mental condition of our patients. As mental health providers, we need to evolve with the times and develop a more scientific understanding of how technology impacts the way our patients think and behave.

Q: Is there anything else you’d like to add?

A: We need mental health providers to be at the policy table to make sure technology is faithfully serving a mission to better mankind. In order to get there, we need to drive efforts to obtain information about how technology affects our mental and behavioral health. I am calling on all departments of psychiatry and residency programs in America to prioritize the study and research of cyberpsychiatry.  

— Jolynn Tumolo