Grant: Catalyst Grant: eHealth Innovations

Major depressive disorder (MDD) costs the Canadian economy over $6 billion annually. This cost results from the combination of MDD's prevalence, duration, and chronicity: it affects roughly one in ten people during their lives, with individual episodes typically lasting 6-12 months; roughly 50% of cases will relapse at least once, and 15% will be chronically ill. Mood journaling is a cornerstone of self-management in depression, tracking symptom severity, medication adherence, and life events. Research over the last decade has shown that electronic journals are superior to paper ones. One *potential* advantage of mental health telemetry (MHT), where real-time mood journal data is collected using cell phones, is that individuals' electronic journal data can easily be converted into graphical records, allowing people living with depression to readily spot trends, correlations, or patterns in ways that would be quite challenging using paper diaries. This information should make it easier to recognize and evaluate changes in mental health status -- the first two steps in the process of self-management. The proposed project will build on our existing system for MHT, adding the ability for patients to visualize their own mood journal data on the same cell phones which they record their journals. (While other software 'apps' for visualizing mood-over-time exist, none to our knowledge combine platform independence, PHIPA compliance, the able to securely share mood data with patients' clinicians for use in routine clinical care, and approval for use in a teaching hospital setting.) We will then test our hypotheses that MHT will enable patients living with MDD to experience (i) improvement in their ability to self-manage MDD and(ii) enhanced quality-of-life; we also hypothesize that (iii) they will be willing to continue using it if given a choice after an initial trial. If successful, we will act to make MHT more broadly available for people with MDD.