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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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44
Per
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r
esil
ien
ce
co
m
p
o
n
en
ts
with
in
th
is
d
em
o
g
r
a
p
h
y
.
T
h
is
p
ap
er
aim
s
to
h
ig
h
lig
h
t
th
e
s
ig
n
if
ican
ce
o
f
id
en
tify
in
g
tech
n
o
lo
g
y
-
b
ased
ef
f
ec
tiv
e
in
t
er
v
en
tio
n
s
f
o
r
p
r
ev
e
n
tin
g
m
en
tal
h
ea
lth
is
s
u
es
ad
o
lescen
ts
am
o
n
g
.
R
is
e
with
in
m
en
tal
h
ea
lth
c
o
n
ce
r
n
s
a
m
o
n
g
th
is
p
o
p
u
latio
n
,
in
n
o
v
ativ
e
tech
n
o
lo
g
ical
s
o
lu
tio
n
s
p
o
ten
tial
t
o
p
r
o
v
id
e
ac
ce
s
s
ib
le
an
d
tailo
r
ed
s
u
p
p
o
r
t.
T
h
is
r
esear
ch
ex
p
lo
r
es
v
ar
io
u
s
tech
n
o
lo
g
ical
to
o
ls
m
o
b
ile
s
u
ch
as
ap
p
licatio
n
s
,
o
n
lin
e
p
latf
o
r
m
s
,
an
d
wea
r
ab
le
d
ev
ices
,
th
at
o
f
f
er
v
alu
a
b
le
r
eso
u
r
ce
s
f
o
r
ea
r
ly
i
n
ter
v
e
n
tio
n
an
d
o
n
g
o
in
g
m
en
tal
h
ea
lth
m
an
ag
e
m
en
t.
E
x
am
in
in
g
b
y
ef
f
ec
t
a
n
d
f
ea
s
ib
ilit
y
o
f
s
o
lu
tio
n
s
th
ese,
in
s
ig
h
ts
g
ain
h
o
w
tech
n
o
lo
g
y
lev
er
ag
ed
ca
n
e
n
h
an
ce
m
en
tal
well
-
b
ein
g
an
d
p
r
e
v
en
t
th
e
o
n
s
et
o
f
p
s
y
ch
o
lo
g
ical
d
is
o
r
d
er
s
in
ad
o
lescen
ts
.
A
th
o
r
o
u
g
h
an
aly
s
is
o
f
ex
is
tin
g
s
tu
d
ies
,
tr
en
d
s
tech
n
o
lo
g
y
in
n
o
v
atio
n
,
r
esear
ch
s
ee
k
s
to
co
n
tr
ib
u
te
v
alu
e
to
th
e
f
ield
o
f
m
en
tal
h
ea
lth
p
r
o
m
o
tio
n
an
d
p
r
ev
en
tio
n
.
Ad
d
itio
n
ally
,
p
er
s
p
ec
tiv
es
ex
p
l
o
r
e
b
o
th
ad
o
lescen
ts
’
m
en
tal
h
ea
lth
p
r
o
f
ess
io
n
als,
co
m
p
r
eh
e
n
s
iv
e
g
ain
im
p
ac
t p
o
ten
tial
o
f
th
ese
tech
n
o
l
o
g
ical
i
n
ter
v
en
tio
n
s
,
u
n
d
e
r
s
tan
d
in
g
[
3
]
.
I
n
th
e
in
q
u
ir
y
in
to
th
e
tech
in
n
o
v
atio
n
to
h
alt
m
en
tal
s
tr
u
g
g
le
co
n
ce
r
n
s
in
teen
s
,
th
e
f
u
s
io
n
o
f
th
er
ap
y
m
eth
o
d
s
h
as
o
f
f
er
e
d
e
n
co
u
r
a
g
in
g
o
u
tco
m
es
in
cu
ttin
g
d
o
wn
an
x
iety
,
ch
ief
ly
th
r
o
u
g
h
c
o
g
n
itiv
e
b
eh
av
io
u
r
al
th
er
ap
y
p
air
e
d
with
tech
n
o
l
o
g
y
[
4
]
.
Yet,
th
e
ex
tan
t
s
tu
d
ies
ca
ll
f
o
r
in
co
m
in
g
ad
v
an
ce
m
en
ts
to
r
ec
tify
u
n
s
o
lv
ed
r
e
q
u
ir
em
e
n
ts
an
d
h
u
r
d
les
in
th
is
f
ield
.
W
ith
f
o
cu
s
in
g
o
n
p
r
e
v
en
tio
n
s
tar
tin
g
f
r
o
m
y
o
u
n
g
a
g
es
an
d
in
v
o
lv
in
g
s
elf
-
h
elp
s
tr
u
ct
u
r
es
an
d
p
e
r
s
o
n
al
tailo
r
in
g
f
o
r
b
r
o
a
d
s
p
r
ea
d
,
t
h
er
e
lies
a
clam
o
u
r
f
o
r
au
t
o
m
ated
d
ata
h
ar
v
esti
n
g
to
m
ea
s
u
r
e
p
r
o
g
r
a
m
s
u
cc
ess
.
T
h
e
d
elib
er
ate
wea
v
in
g
o
f
m
o
tiv
atio
n
-
b
o
o
s
tin
g
ta
ctics
an
d
p
r
o
tr
ac
ted
ass
es
s
m
en
t
o
f
tech
-
b
ased
r
em
ed
ies
s
tan
d
s
p
iv
o
tal
in
co
n
f
ir
m
in
g
co
n
s
tan
t
p
ar
ticip
atio
n
a
n
d
its
ef
f
ec
t
o
n
teen
m
en
tal
well
-
b
ein
g
.
C
o
n
s
eq
u
en
tly
,
a
b
r
o
ad
-
b
ased
ap
p
r
o
a
ch
to
tech
i
n
ter
v
en
tio
n
s
m
u
s
t
p
u
t
f
ir
s
t
u
s
er
-
f
r
ien
d
lin
ess
,
r
esu
lt
-
g
ettin
g
,
an
d
last
in
g
n
ess
to
tack
le
th
e
m
e
n
tal
well
-
b
ein
g
ch
allen
g
es
o
f
teen
s
s
u
itab
ly
.
T
h
is
s
tu
d
y
s
ee
k
s
to
f
i
n
d
o
u
t
h
o
w
te
ch
n
o
lo
g
y
p
lay
s
a
r
o
le
in
m
en
t
al
well
-
b
ein
g
p
r
o
b
le
m
s
,
esp
ec
ially
in
ad
o
lescen
ts
with
a
f
o
cu
s
o
n
th
e
p
o
ten
tial o
f
d
ig
ital d
ev
ices to
p
r
o
v
i
d
e
ac
ce
s
s
ib
le
an
d
ef
f
ec
tiv
e
s
u
p
p
o
r
t.
2.
M
E
T
H
O
D
T
h
is
p
ap
er
is
b
ased
o
n
a
liter
a
tu
r
e
r
ev
iew
u
s
in
g
t
h
e
p
r
e
f
er
r
e
d
r
ep
o
r
tin
g
item
s
f
o
r
s
y
s
tem
atic
r
ev
iews
m
eta
-
an
aly
s
es
(
PR
I
SMA)
m
et
h
o
d
,
as
s
h
o
wn
in
Fig
u
r
e
1
.
T
h
e
au
th
o
r
s
s
ea
r
ch
e
d
o
n
lin
e
in
s
ev
er
al
d
atab
ases
,
s
u
ch
as
Scien
ce
Dir
ec
t,
Sco
p
u
s
,
an
d
Go
o
g
le
Sch
o
lar
.
T
h
e
s
ea
r
ch
s
tr
ateg
y
in
clu
d
es
th
e
f
o
llo
win
g
k
ey
wo
r
d
s
:
tech
n
o
lo
g
y
,
i
n
n
o
v
atio
n
,
m
en
tal
h
ea
lth
,
a
n
d
a
d
o
lescen
ts
.
T
h
e
s
ea
r
ch
is
co
n
d
u
cted
i
n
E
n
g
lis
h
,
with
n
o
r
estrictio
n
s
o
n
th
e
y
ea
r
o
f
p
u
b
licatio
n
.
T
h
e
in
itial
s
ea
r
ch
f
o
u
n
d
4
9
6
,
0
0
0
a
r
ticles
r
elate
d
to
th
o
s
e
k
ey
wo
r
d
s
.
T
h
er
ef
o
r
e,
at
th
e
f
in
al
s
tag
e,
o
n
ly
5
6
r
ef
er
e
n
ce
s
wer
e
s
elec
te
d
f
o
r
th
is
p
ap
er
with
a
p
u
b
licatio
n
tim
e
b
etwe
en
2001
-
2
0
2
4
.
Fig
u
r
e
1
.
PR
I
SMA
fl
o
wch
ar
t
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Tech
n
o
lo
g
y
t
o
s
u
p
p
o
r
t m
en
ta
l h
ea
lth
a
d
o
lescen
ts
:
a
liter
a
tu
r
e
r
ev
iew
(
Lin
a
Ha
n
d
a
ya
n
i
)
45
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Curre
nt
m
ent
a
l hea
lt
h
cha
lleng
es a
m
o
ng
a
do
lescent
s
3
.
1
.
1
.
P
re
v
a
lence
o
f
m
ent
a
l hea
lt
h pro
blem
s
I
n
r
ec
en
t
y
ea
r
s
,
th
e
r
e
h
as
b
e
en
an
alar
m
in
g
i
n
cr
ea
s
e
in
a
d
o
lescen
ts
s
u
f
f
er
in
g
f
r
o
m
m
e
n
tal
h
ea
lth
p
r
o
b
lem
s
.
Sev
e
r
al
f
ac
to
r
s
,
s
u
c
h
as
ac
ad
em
ic
p
r
ess
u
r
e,
s
o
cial
m
ed
ia
u
s
ag
e,
an
d
f
am
ily
d
y
n
am
ics
,
s
ig
n
if
ican
tly
co
n
tr
ib
u
te
to
t
h
e
r
is
e
i
n
m
e
n
ta
l
h
ea
lth
is
s
u
es
in
th
is
ag
e
g
r
o
u
p
.
Fu
r
th
e
r
m
o
r
e
,
th
e
s
tu
d
y
in
[
5
]
u
n
d
er
s
co
r
es
th
at
s
tig
m
a
o
f
m
en
tal
h
ea
lt
h
s
u
r
r
o
u
n
d
in
g
m
an
y
a
d
o
lescen
ts
h
esit
ate
to
h
elp
with
th
eir
p
r
o
b
lem
t
h
e
ex
ac
er
b
ati
n
g
.
I
t
is
cr
u
cial
f
o
r
tech
n
o
lo
g
ical
in
n
o
v
atio
n
s
to
h
ar
n
ess
th
ese
ch
allen
g
es
,
ad
d
r
ess
ad
o
lescen
ts
,
an
d
p
r
o
v
id
e
to
o
ls
ac
ce
s
s
ib
le
ef
f
ec
tiv
ely
to
p
r
ev
en
t,
m
an
ag
e
,
an
d
tr
ea
t
m
en
tal
h
ea
lth
p
r
o
b
lem
s
.
B
y
tech
n
o
lo
g
y
i
n
teg
r
atin
g
in
ter
v
en
tio
n
s
o
f
m
en
tal
h
ea
lt
h
,
th
e
b
r
o
ad
e
r
p
o
p
u
latio
n
ca
n
b
e
r
ea
ch
ed
an
d
allev
iate
p
o
t
en
tially
th
e
m
en
tal
b
u
r
d
e
n
o
f
h
ea
lth
is
s
u
es a
m
o
n
g
ad
o
lescen
ts
.
UNI
C
E
F
in
2
0
2
1
r
ep
o
r
ted
th
at
th
e
esti
m
ated
m
en
tal
d
is
o
r
d
er
s
in
ad
o
lescen
ts
in
th
e
wo
r
ld
r
ea
ch
ed
m
o
r
e
th
an
1
3
%,
o
f
wh
ich
4
0
%
wer
e
au
tis
m
an
d
d
ep
r
ess
io
n
.
B
ased
o
n
g
en
d
er
,
d
e
p
r
ess
io
n
,
an
d
d
y
s
p
h
o
r
ia
ar
e
m
o
r
e
co
m
m
o
n
in
wo
m
en
,
wh
i
le
atten
tio
n
d
ef
icit
h
y
p
er
ac
tiv
i
ty
d
is
o
r
d
er
(
ADHD
)
an
d
b
eh
a
v
io
r
al
d
is
o
r
d
er
s
ar
e
m
o
r
e
co
m
m
o
n
am
o
n
g
m
en
.
T
h
is
p
r
ev
alen
ce
s
h
o
ws
f
air
ly
co
n
s
is
ten
t
v
ar
iatio
n
[
6
]
.
Fro
m
2
0
0
9
-
2
0
1
9
,
th
e
in
cr
ea
s
e
in
ca
s
es
o
f
s
ad
n
ess
a
n
d
d
esp
air
am
o
n
g
h
ig
h
s
ch
o
o
l
s
tu
d
en
ts
r
ea
ch
ed
3
6
.
7
%
f
r
o
m
2
6
.
1
%
o
r
ig
in
ally
.
T
h
is
in
cr
ea
s
e
is
f
o
llo
wed
b
y
s
u
icid
e
p
lan
n
in
g
an
d
attem
p
t
s
[
7
]
.
A
m
eta
-
an
al
y
s
is
o
f
1
9
1
s
tu
d
ies
in
v
o
lv
in
g
1
,
3
8
9
,
4
4
7
p
ar
ticip
an
ts
also
f
o
u
n
d
th
e
p
r
e
v
alen
ce
o
f
m
e
n
tal
p
r
o
b
lem
s
in
ch
ild
r
en
a
n
d
ad
o
lescen
ts
u
n
d
er
th
e
ag
e
o
f
1
8
.
T
h
e
co
m
b
in
ed
s
y
m
p
to
m
s
o
f
d
e
p
r
ess
io
n
,
an
x
iety
s
y
m
p
to
m
s
,
an
d
s
leep
d
is
o
r
d
er
s
wer
e
3
1
%,
3
1
%,
an
d
4
2
%,
r
esp
ec
tiv
ely
,
d
u
r
in
g
th
e
C
OVI
D
-
1
9
p
an
d
em
ic.
Alth
o
u
g
h
s
ig
n
s
o
f
r
ec
o
v
e
r
y
a
n
d
s
tab
ilizatio
n
ar
e
v
is
ib
le,
th
e
p
r
ev
ale
n
ce
o
f
m
en
tal
h
ea
lth
p
r
o
b
lem
s
is
also
in
cr
ea
s
in
g
[
8
]
.
T
h
e
W
HO
esti
m
ate
s
th
at
o
n
e
in
s
ev
en
ch
ild
r
e
n
ag
ed
1
0
-
1
9
y
ea
r
s
is
m
en
tally
d
is
tu
r
b
ed
,
wh
ich
alr
ea
d
y
ac
co
u
n
ts
f
o
r
1
5
%
o
f
t
h
e
g
lo
b
al
d
is
ea
s
e
b
u
r
d
en
.
A
n
x
iety
,
d
ep
r
ess
io
n
,
an
d
b
eh
a
v
io
r
al
d
is
o
r
d
er
s
ar
e
th
e
m
ain
ca
u
s
es o
f
d
is
ea
s
es a
n
d
d
i
s
ab
ilit
ies in
ad
o
lescen
ts
.
Me
an
wh
ile,
am
o
n
g
t
h
o
s
e
ag
ed
1
5
-
2
9
,
th
e
th
ir
d
h
ig
h
est
ca
u
s
e
o
f
d
ea
th
is
s
u
icid
e.
Failed
tr
ea
tm
en
t
o
f
m
en
tal
h
ea
lth
co
n
d
itio
n
s
ca
n
co
n
tin
u
e
i
n
to
a
d
u
lth
o
o
d
s
o
it
r
is
k
s
in
ter
f
er
in
g
with
h
ea
lth
a
n
d
e
v
en
lim
itin
g
th
e
a
b
ilit
y
to
liv
e
life
as
it
s
h
o
u
l
d
.
So
m
e
ad
o
lescen
ts
ar
e
at
h
ig
h
e
r
r
is
k
o
f
e
x
p
er
ien
ci
n
g
m
en
ta
l
d
is
o
r
d
er
s
d
u
e
to
s
ev
er
al
th
in
g
s
,
s
u
ch
as
h
o
u
s
in
g
co
n
d
itio
n
s
,
s
tig
m
a,
d
is
cr
im
in
atio
n
,
an
d
lack
o
f
a
cc
ess
to
q
u
ality
h
ea
lth
s
er
v
ic
es.
I
n
ad
d
itio
n
,
p
h
y
s
ical,
em
o
tio
n
al,
an
d
s
o
cial
ch
an
g
es a
ls
o
co
n
tr
i
b
u
te
to
m
e
n
tal
h
ea
lth
p
r
o
b
lem
s
,
am
o
n
g
t
h
em
[
9
]
.
3
.
1
.
2
.
F
a
ct
o
rs
co
ntr
ibu
t
ing
t
o
m
ent
a
l hea
lt
h is
s
ues
A
p
leth
o
r
a
o
f
d
eter
m
in
a
n
ts
co
n
tr
ib
u
te
to
th
e
em
er
g
en
ce
o
f
p
s
y
ch
o
lo
g
ical
h
ea
lth
co
m
p
licatio
n
s
am
o
n
g
ad
o
lescen
ts
co
n
tem
p
o
r
ar
ily
.
A
p
r
in
cip
al
co
n
s
titu
en
t
is
th
e
am
p
lifie
d
u
b
iq
u
ity
o
f
s
o
cial
m
ed
ia
an
d
tech
n
o
lo
g
y
in
th
eir
q
u
o
tid
ia
n
ex
is
ten
ce
.
T
h
e
r
elen
tles
s
ex
p
o
s
u
r
e
to
m
eticu
lo
u
s
ly
cu
r
ated
d
ep
ictio
n
s
o
f
f
lawless
n
es
s
an
d
th
e
in
ce
s
s
an
t
im
p
etu
s
to
ju
x
tap
o
s
e
th
e
m
s
elv
es
with
o
th
er
s
ca
n
en
g
en
d
er
s
en
s
atio
n
s
o
f
in
ad
eq
u
ac
y
an
d
d
im
in
is
h
ed
s
elf
-
wo
r
th
.
C
o
n
co
m
itan
tly
,
cy
b
er
b
u
lly
in
g
h
as
ascen
d
ed
as
a
p
r
o
n
o
u
n
ce
d
p
r
ed
icam
en
t,
with
ad
o
lescen
t
s
u
n
d
er
g
o
in
g
o
n
lin
e
h
a
r
ass
m
en
t
th
at
p
o
s
s
ess
e
s
s
ev
er
e
r
a
m
if
icatio
n
s
f
o
r
th
eir
p
s
y
ch
o
lo
g
ical
well
-
b
ei
n
g
.
T
h
e
d
ef
icien
cy
o
f
d
ir
ec
t
in
ter
p
er
s
o
n
al
in
ter
ac
tio
n
s
an
d
s
u
b
s
tan
tial
co
n
n
ec
tio
n
s
with
in
a
d
ig
ital
m
ilieu
ca
n
f
u
r
th
er
ex
ac
er
b
ate
s
en
s
atio
n
s
o
f
s
ec
lu
s
io
n
an
d
d
eso
latio
n
.
Mo
r
e
o
v
er
,
th
e
p
er
p
et
u
al
s
tim
u
latio
n
an
d
s
u
r
f
eit
o
f
in
f
o
r
m
atio
n
attr
ib
u
ted
t
o
tech
n
o
lo
g
y
ca
n
cu
lm
i
n
ate
in
h
ei
g
h
ten
ed
s
tr
ess
an
d
an
x
iety
,
a
d
v
er
s
ely
in
f
lu
en
cin
g
th
e
g
e
n
er
al
m
e
n
tal
h
ea
lth
o
f
ad
o
lescen
ts
.
Ad
d
r
ess
in
g
th
ese
d
eter
m
in
a
n
ts
an
d
d
ev
is
in
g
am
elio
r
ativ
e
s
tr
ate
g
ies
to
ab
ate
th
eir
d
etr
im
e
n
tal
r
ep
er
cu
s
s
io
n
s
is
im
p
er
ativ
e
in
f
o
s
ter
in
g
p
s
y
ch
o
lo
g
ical
well
-
b
ei
n
g
am
o
n
g
th
e
y
o
u
th
.
B
asically
,
m
en
tal
h
ea
lth
d
is
o
r
d
er
s
ca
n
af
f
ec
t
an
y
o
n
e
e
v
en
at
all
s
tag
es
o
f
th
e
life
cy
cle.
H
o
wev
er
,
in
th
o
s
e
wh
o
ex
p
er
ien
ce
it
in
ch
i
ld
h
o
o
d
,
th
er
e
is
a
s
en
s
itiv
e
d
e
v
elo
p
m
en
t.
I
n
ap
p
r
o
p
r
iate
p
ar
e
n
tin
g
an
d
p
h
y
s
ical
p
u
n
is
h
m
en
t
ca
n
t
h
r
ea
ten
ch
il
d
r
en
'
s
h
ea
lth
,
wh
ile
b
u
lly
in
g
is
th
e
m
ain
r
is
k
o
f
m
en
tal
h
e
alth
d
is
o
r
d
er
s
.
No
t
o
n
ly
th
at,
em
o
tio
n
al
s
k
ills
,
d
r
u
g
u
s
e,
g
e
n
etics,
p
o
v
er
ty
,
in
eq
u
ality
,
en
v
ir
o
n
m
en
tal
d
ep
r
iv
atio
n
,
an
d
o
th
e
r
s
o
cial
cir
cu
m
s
tan
ce
s
ar
e
also
f
ac
to
r
s
th
at
c
o
n
tr
ib
u
te
to
it.
T
h
e
co
m
p
lex
in
te
r
ac
tio
n
b
etwe
en
s
tr
ess
,
in
d
iv
id
u
a
l
v
u
ln
er
ab
ilit
y
,
a
n
d
s
o
cial
an
d
s
tr
u
ctu
r
al
co
n
d
itio
n
s
d
eter
m
in
es a
p
er
s
o
n
'
s
m
en
tal
h
ea
lth
s
tatu
s
[
1
0
]
.
A
cr
o
s
s
-
s
ec
tio
n
al
s
tu
d
y
o
f
2
9
5
h
ig
h
s
ch
o
o
l
s
tu
d
e
n
ts
ag
ed
1
6
-
1
8
in
Han
o
i
r
ev
ea
led
t
h
at
m
en
tal
h
ea
lth
p
r
o
b
lem
s
am
o
n
g
th
em
wer
e
i
n
f
lu
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d
b
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ce
r
tain
in
ter
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f
ac
to
r
s
,
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u
ch
as
lo
w
s
elf
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este
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,
wo
r
r
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ab
o
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p
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ical
ap
p
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,
r
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r
ain
i
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g
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ticip
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cisi
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I
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n
m
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t,
m
en
tal
h
ea
lth
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a
s
s
o
ciate
d
with
p
ee
r
in
f
lu
en
ce
,
p
u
b
lic
p
u
n
is
h
m
en
t,
an
d
teac
h
er
r
ep
r
im
an
d
s
[
1
1
]
.
A
n
o
th
er
s
tu
d
y
s
tates
th
at
m
e
n
tal
h
ea
lth
d
is
o
r
d
er
s
d
u
r
in
g
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o
lescen
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ca
n
i
n
ter
f
er
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with
em
o
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c
o
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itiv
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an
d
b
e
h
av
io
r
al
f
u
n
ctio
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s
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wh
ich
h
av
e
an
im
p
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t
o
n
d
ec
r
ea
s
in
g
s
o
c
ial
in
ter
ac
tio
n
a
n
d
ac
ad
em
ic
ac
h
iev
em
e
n
t.
T
h
e
o
n
s
et
o
f
p
s
y
c
h
o
lo
g
ical
d
is
o
r
d
er
s
,
d
ep
r
ess
io
n
,
an
d
a
n
x
iety
is
also
in
s
ep
ar
ab
le
f
r
o
m
t
h
e
lev
el
o
f
s
tr
ess
an
d
t
h
e
s
tr
ess
r
ea
ctio
n
p
atter
n
its
elf
.
Su
ch
co
n
d
itio
n
s
ca
n
i
n
ter
f
e
r
e
with
th
eir
well
-
b
ein
g
in
a
d
u
lth
o
o
d
[
1
2
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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3
.
1
.
3
.
I
m
pa
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f
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t
re
a
t
ed
menta
l hea
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h pro
blem
s
T
h
e
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b
al
p
an
d
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as
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f
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er
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if
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,
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n
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er
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h
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n
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ity
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o
r
i
n
v
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tiv
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h
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tech
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tio
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s
t
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tar
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s
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d
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ce
s
s
ib
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n
v
en
tio
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al
h
ea
lth
ca
r
e
[
1
3
]
.
A
n
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ta
b
le
elem
en
t
o
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h
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lth
tec
h
n
o
lo
g
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p
r
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g
r
ess
io
n
is
th
e
d
ep
lo
y
m
e
n
t
o
f
s
o
cially
ass
is
ti
v
e
r
o
b
o
ts
to
aid
o
ld
er
ad
u
lts
,
wh
ich
in
d
icate
s
f
av
o
r
ab
le
o
u
t
co
m
es
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f
ac
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g
s
o
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en
g
ag
em
en
ts
an
d
b
o
ls
ter
in
g
h
ea
lth
y
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g
in
g
wh
ile
s
tay
in
g
in
o
n
e'
s
o
wn
h
o
m
e
[
1
3
]
.
Fu
r
th
er
m
o
r
e,
th
e
am
alg
am
atio
n
o
f
tech
n
o
lo
g
y
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n
o
tab
ly
v
id
e
o
g
am
es,
h
o
l
d
s
s
ig
n
if
ican
t
p
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tial
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ter
in
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m
an
izatio
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o
f
h
o
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en
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o
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m
en
ts
,
p
ar
ticu
lar
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o
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p
ae
d
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ic
an
d
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escen
t
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o
p
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latio
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s
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n
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g
h
o
s
p
italizatio
n
.
B
y
ca
p
italizin
g
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tech
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lo
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ical
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v
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ce
m
en
ts
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en
co
m
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a
s
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g
m
o
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lth
ap
p
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s
an
d
d
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er
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p
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tic
f
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ewo
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itiativ
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e
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ated
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en
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m
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allen
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ad
o
lescen
ts
,
th
er
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y
en
h
an
cin
g
p
atien
t
r
esu
l
ts
an
d
o
v
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all
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r
e
q
u
ality
.
A
s
tu
d
y
r
ev
ea
led
th
at
n
e
g
a
tiv
e
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tig
m
a
ag
ain
s
t
m
en
tal
h
ea
lth
s
er
v
ices
an
d
tr
ea
tm
e
n
t
is
s
til
l
wid
esp
r
ea
d
.
As
a
r
esu
lt,
th
e
r
is
k
o
f
s
u
icid
e
in
cr
ea
s
ed
b
y
4
.
1
9
tim
es
in
ca
s
es
o
f
u
n
t
r
e
ated
d
ep
r
ess
io
n
in
ad
o
lescen
ce
.
Ad
o
lescen
ts
wh
o
ex
p
e
r
ien
ce
d
e
p
r
ess
io
n
will
b
e
m
o
r
e
ir
r
itab
le,
m
o
o
d
s
win
g
s
,
an
x
iety
,
h
av
e
d
ec
r
ea
s
ed
ap
p
etite,
a
n
d
h
av
e
d
ec
r
ea
s
ed
ac
ad
em
ic
ac
h
iev
em
en
t.
An
o
th
er
s
tu
d
y
also
s
tated
th
at
th
e
f
o
llo
w
-
u
p
r
esu
lts
o
f
1
,
2
3
8
1
4
-
y
ea
r
-
o
ld
ad
o
lescen
ts
wh
o
ex
p
er
ien
ce
d
clin
ical
d
ep
r
ess
io
n
i
n
th
o
s
e
wh
o
d
id
n
o
t
ac
ce
s
s
m
en
tal
h
ea
lth
s
er
v
ices
wer
e
7
.
3
8
tim
es
m
o
r
e
lik
ely
to
co
m
m
it
s
u
icid
e.
T
h
e
lack
o
f
tr
ea
tm
en
t
is
m
o
tiv
ated
b
y
th
e
f
ac
t
t
h
at
th
e
r
e
ar
e
s
till
m
an
y
n
eg
ativ
e
s
tig
m
as
o
n
ac
ce
s
s
to
m
en
tal
h
ea
lth
s
er
v
ices
i
n
th
e
co
m
m
u
n
ity
,
r
ejec
tio
n
f
r
o
m
p
ar
e
n
ts
,
an
d
s
o
cial
p
r
eju
d
ice
[
1
4
]
.
I
n
C
h
in
a,
p
e
o
p
le
with
s
ch
izo
p
h
r
en
ia
o
n
ly
g
et
tr
ea
tm
e
n
t
af
te
r
a
4
-
y
ea
r
d
elay
.
Af
ter
b
ein
g
t
r
ac
ed
,
th
e
r
e
s
u
l
ts
s
h
o
w
e
d
t
h
at
t
h
e
d
e
l
a
y
ca
u
s
e
d
t
h
e
m
t
o
b
e
o
v
e
r
w
e
i
g
h
t
an
d
l
o
w
e
r
s
u
i
c
i
d
al
i
d
e
a
ti
o
n
.
A
l
th
o
u
g
h
t
h
e
p
o
t
e
n
t
i
a
l
f
o
r
s
u
i
c
i
d
e
i
s
l
o
w
,
t
h
e
n
e
g
a
t
iv
e
s
y
n
d
r
o
m
e
s
c
a
l
e
s
c
o
r
e
(
P
AS
S
N
)
s
c
o
r
e
i
s
h
i
g
h
e
r
.
I
n
o
t
h
e
r
w
o
r
d
s
,
n
e
g
a
t
i
v
e
s
y
m
p
to
m
s
ca
n
ap
p
ea
r
if
y
o
u
d
o
n
'
t
g
et
tr
ea
tm
en
t
r
ig
h
t
awa
y
.
T
h
e
s
y
m
p
to
m
s
in
q
u
esti
o
n
in
clu
d
e
em
o
tio
n
al
ap
ath
y
,
d
u
ll
af
f
ec
tio
n
,
wilf
u
l
ac
tiv
ity
,
s
p
atial
d
is
o
r
d
er
s
,
a
n
d
d
ee
p
w
o
r
k
,
to
m
e
n
tal
d
is
ab
ilit
y
[
1
5
]
.
L
o
o
k
in
g
at
lim
ited
ac
ce
s
s
to
h
ea
lth
ca
r
e
in
r
u
r
al
ar
ea
s
,
a
2
0
2
2
Oh
io
s
tu
d
y
r
ev
ea
led
th
at
l
o
w
g
r
ad
u
atio
n
r
ates
am
o
n
g
m
id
d
le
s
ch
o
o
l stu
d
e
n
ts
ar
e
u
n
d
er
lin
ed
as a
lo
n
g
-
ter
m
im
p
lic
atio
n
o
f
u
n
tr
ea
ted
m
en
tal
h
ea
lt
h
p
r
o
b
lem
s
[
1
6
]
.
3
.
1
.
4
.
B
a
rr
iers t
o
s
ee
k
ing
help
R
eg
ar
d
less
o
f
tech
n
o
lo
g
ical
s
o
lu
tio
n
s
av
ailab
le
co
n
ce
r
n
in
g
m
en
tal
h
ea
lth
is
s
u
es
am
o
n
g
a
d
o
lescen
ts
,
b
ar
r
ier
s
h
i
n
d
er
y
o
u
th
f
r
o
m
s
ee
k
in
g
ass
is
tan
ce
.
A
p
r
ev
ale
n
t
b
ar
r
ier
in
v
o
lv
es
s
tig
m
a
s
u
r
r
o
u
n
d
in
g
m
en
tal
h
ea
lth
co
n
d
itio
n
s
,
r
esu
ltin
g
in
em
b
a
r
r
ass
m
en
t
o
r
ash
am
ed
f
ee
lin
g
s
r
eg
ar
d
in
g
s
tr
u
g
g
les,
p
r
ec
ip
it
atin
g
r
elu
ctan
ce
t
o
ac
q
u
ir
e
s
u
p
p
o
r
t.
C
o
n
c
u
r
r
e
n
tly
,
k
n
o
wled
g
e
s
ca
r
city
ass
o
c
iated
with
r
eso
u
r
ce
s
an
d
a
m
b
ig
u
ity
r
eg
ar
d
i
n
g
ac
ce
s
s
ib
ilit
y
p
o
ten
tially
p
r
ev
en
ts
ad
o
lescen
ts
f
r
o
m
s
ee
k
in
g
ass
is
tan
ce
.
Mo
r
eo
v
er
,
p
r
iv
ac
y
ap
p
r
eh
e
n
s
io
n
s
co
n
n
ec
ted
to
tech
n
o
lo
g
y
u
tili
za
tio
n
m
en
tal
h
ea
lth
s
u
p
p
o
r
t
m
ig
h
t
lik
ewise
f
u
n
ctio
n
as
o
b
s
tr
u
ctiv
e
elem
en
ts
;
ad
o
lescen
ts
ex
h
ib
it
tr
ep
id
atio
n
to
war
d
p
e
r
s
o
n
al
in
f
o
r
m
at
io
n
ex
p
o
s
u
r
e
o
r
m
is
u
s
e
[
1
7
]
.
R
eso
lv
in
g
th
ese
im
p
ed
im
en
ts
n
ec
ess
itates
a
war
en
ess
elev
atio
n
r
eg
ar
d
in
g
m
en
tal
h
ea
lth
s
er
v
ices,
s
t
ig
m
a
r
ed
u
ctio
n
v
ia
ed
u
ca
tio
n
an
d
ad
v
o
ca
cy
,
i
n
ad
d
itio
n
to
em
p
h
asizin
g
co
n
f
id
en
tiality
alo
n
g
s
id
e
d
at
a
s
ec
u
r
ity
with
in
tech
n
o
lo
g
ical
in
n
o
v
atio
n
s
tailo
r
ed
to
a
d
o
lescen
t m
en
tal
well
-
b
ein
g
s
u
p
p
o
r
t.
I
n
th
e
Ph
ilip
p
in
es,
b
a
r
r
ier
s
to
m
en
tal
h
ea
lth
h
elp
ar
e
ca
u
s
ed
b
y
ec
o
n
o
m
ic
co
n
d
itio
n
s
a
n
d
lack
o
f
ac
ce
s
s
to
s
er
v
ices.
Fo
r
th
o
s
e
liv
in
g
o
u
ts
id
e
th
e
co
u
n
tr
y
,
im
m
ig
r
atio
n
s
tatu
s
,
lack
o
f
h
ea
lth
in
s
u
r
an
ce
,
d
is
cr
im
in
atio
n
,
an
d
lack
o
f
ac
cu
ltu
r
atio
n
o
f
h
o
s
t
cu
ltu
r
e
ar
e
o
b
s
tacle
s
f
o
r
th
o
s
e
with
m
en
tal
d
is
o
r
d
er
s
.
T
h
ese
two
g
r
o
u
p
s
ar
e
also
h
i
n
d
er
e
d
b
y
th
e
s
o
cial
s
tig
m
a
th
at
ci
r
c
u
lates
b
ec
au
s
e
th
ey
ar
e
co
n
s
i
d
er
ed
in
c
o
m
p
atib
le
with
Asi
an
v
alu
es
th
at
ar
e
in
ce
r
tain
n
o
r
m
s
s
o
th
at
m
e
n
tal
i
lln
ess
is
u
n
ac
ce
p
tab
le
[
1
8
]
.
F
r
o
m
t
h
e
5
3
s
tu
d
ies
id
en
tifie
d
,
f
o
u
r
th
em
es
o
f
o
b
s
tacle
s
ex
p
er
ien
ce
d
b
y
ad
o
lescen
ts
em
er
g
ed
.
I
n
ter
n
al
(
in
d
iv
id
u
al)
f
ac
to
r
s
s
u
ch
a
s
lack
o
f
m
en
tal
h
ea
lth
k
n
o
wled
g
e
an
d
lack
o
f
p
er
ce
p
tio
n
o
f
s
ee
k
in
g
h
elp
b
ec
am
e
t
h
e
f
ir
s
t
th
em
e.
So
cial
f
ac
to
r
s
,
n
am
ely
n
eg
ativ
e
s
tig
m
a
an
d
f
ee
lin
g
s
o
f
p
ast,
ar
e
th
e
s
ec
o
n
d
th
em
e.
I
n
th
e
th
ir
d
th
em
e,
th
er
e
is
a
s
en
s
e
o
f
ad
o
lescen
ce
ab
o
u
t
th
e
m
o
s
t
im
p
o
r
tan
t
r
elatio
n
s
h
ip
with
p
r
o
f
ess
io
n
als,
in
clu
d
in
g
d
ata
co
n
f
id
en
tiality
,
m
ak
in
g
it
d
if
f
ic
u
lt
to
b
u
ild
tr
u
s
t
in
n
ew
p
eo
p
le
wh
o
wer
e
p
r
ev
io
u
s
ly
u
n
k
n
o
wn
.
T
h
e
last
th
em
e
m
en
tio
n
ed
th
at
s
y
s
tem
ic
an
d
s
tr
u
ctu
r
al
f
ac
ilit
ato
r
s
,
s
u
ch
as
f
in
an
cial
lim
itatio
n
s
,
lo
g
is
tical
lim
itatio
n
s
,
an
d
th
e
av
ailab
ilit
y
o
f
p
r
o
f
ess
io
n
al
ass
is
tan
ce
ar
e
o
b
s
tacle
s
f
o
r
ad
o
lescen
ts
to
s
ee
k
h
elp
r
elate
d
to
t
h
eir
m
en
tal
h
e
alth
d
is
o
r
d
er
s
[
1
9
]
.
A
s
tu
d
y
in
Af
r
ica
(
2
0
2
3
)
o
f
s
e
v
er
al
ca
s
es
f
o
u
n
d
th
at
ad
o
lescen
ts
'
b
ar
r
ier
s
to
ac
ce
s
s
in
g
m
en
tal
h
ea
lth
s
er
v
ices v
ar
ied
co
n
s
id
er
ab
ly
.
T
h
e
p
r
ef
er
e
n
ce
f
o
r
alter
n
ativ
e
an
d
co
m
p
lem
e
n
tar
y
m
ed
icin
e
th
r
o
u
g
h
th
e
ch
u
r
c
h
,
r
u
k
y
a
h
,
a
n
d
s
o
o
n
o
f
ten
lea
d
s
to
m
is
u
n
d
er
s
tan
d
in
g
s
ab
o
u
t
th
e
ca
u
s
es
an
d
p
r
o
g
n
o
s
is
o
f
m
en
tal
h
ea
lth
co
n
d
itio
n
s
.
J
u
s
t
lik
e
o
th
er
s
tu
d
ies,
n
eg
ativ
e
s
tig
m
a
s
p
r
ea
d
in
s
o
ciety
,
lack
o
f
k
n
o
wled
g
e
r
elate
d
to
m
en
tal
h
ea
lth
(
b
o
t
h
in
p
atien
ts
an
d
p
a
r
en
ts
)
,
an
d
ec
o
n
o
m
ic
d
if
f
icu
lti
es
ar
e
also
v
alid
ated
as
o
b
s
tacle
s
.
R
ac
e,
a
h
is
to
r
y
o
f
s
u
icid
e
attem
p
ts
,
ex
p
ec
tatio
n
s
o
f
u
n
av
ailab
le
h
ea
lth
s
er
v
ic
es,
f
ea
r
o
f
tr
ea
tm
en
t,
r
u
r
al
h
o
u
s
in
g
,
an
d
p
ar
en
tal
d
en
ial
o
f
c
h
ild
r
en
'
s
m
en
tal
h
ea
lth
co
n
d
itio
n
s
co
n
tr
ib
u
te
t
o
ad
o
lescen
ts
'
in
h
ib
itio
n
o
f
ac
ce
s
s
to
s
er
v
ices
[
2
0
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
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lic
Hea
lth
Sci
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N:
2252
-
8
8
0
6
Tech
n
o
lo
g
y
t
o
s
u
p
p
o
r
t m
en
ta
l h
ea
lth
a
d
o
lescen
ts
:
a
liter
a
tu
r
e
r
ev
iew
(
Lin
a
Ha
n
d
a
ya
n
i
)
47
3
.
1
.
5
.
Nee
d f
o
r
inn
o
v
a
t
i
v
e
s
o
lutio
ns
I
n
th
e
ad
d
r
ess
in
g
o
f
t
h
e
d
ee
p
l
y
ess
en
tial
n
ee
d
in
ess
f
o
r
th
e
f
in
d
in
g
o
f
in
n
o
v
atio
n
-
ty
p
e
s
o
l
u
tio
n
s
o
n
to
th
e
p
r
ev
en
tio
n
o
f
p
r
o
b
lem
ati
c
m
en
tal
h
ea
lth
o
cc
u
r
r
en
ce
s
s
ee
n
am
o
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y
o
u
th
f
u
l
ad
o
lesc
en
ts
,
th
e
co
m
p
lex
in
v
o
lv
in
g
o
f
in
f
o
r
m
atio
n
an
d
co
m
m
u
n
icatio
n
tech
n
o
lo
g
ies
(
I
C
T
s
)
d
o
c
o
m
e
o
u
t
as
a
m
o
s
t
p
o
ten
tial
p
r
o
m
is
in
g
p
ath
[
2
1
]
.
Utilizin
g
th
e
d
er
iv
in
g
k
n
o
wled
g
e
f
r
o
m
s
o
u
r
ce
s
th
at
s
ig
n
if
y
in
g
ly
s
tr
ess
th
e
cr
it
icality
o
f
cu
ltu
r
ally
s
en
s
itiv
e
an
d
r
ea
ctio
n
ar
y
d
ig
it
al
m
en
tal
h
ea
lth
ass
i
s
tan
ce
s
p
ac
k
ag
es,
s
u
ch
as
AI
Mh
i
f
o
r
y
o
u
th
s
u
p
p
o
r
t,
th
er
e
is
p
o
s
s
ib
ilit
ie
s
f
o
r
cr
ea
tin
g
s
p
ec
if
ic
in
ter
v
en
tio
n
s
tar
g
etin
g
r
is
k
ier
elem
en
ts
ass
o
ciate
d
with
s
u
icid
alities
an
d
h
ea
lth
d
eg
r
ad
atio
n
s
in
v
u
ln
er
a
b
le
p
o
p
u
latio
n
s
[
2
1
]
.
Ad
d
itio
n
ally
,
as
p
r
o
n
o
u
n
ce
d
in
an
o
th
er
s
o
u
r
ce
d
r
ef
er
en
ce
[
2
2
]
,
th
e
m
ix
tu
r
e
o
f
th
eo
r
etica
l c
o
n
ce
p
tio
n
s
an
d
p
r
ac
tical
m
o
d
els r
elatin
g
to
I
C
T
u
s
ag
e
w
it
h
in
th
e
Satir
f
am
ily
th
er
ap
y
p
e
r
s
p
ec
tiv
e
g
iv
es
g
r
o
u
n
d
wo
r
k
f
o
r
th
e
p
r
o
m
o
tin
g
o
f
tech
n
o
l
o
g
y
-
en
h
a
n
ce
d
s
u
p
p
o
r
ts
f
o
r
C
h
in
ese
ad
o
lescen
t
g
r
o
u
p
s
.
T
h
r
o
u
g
h
t
h
e
d
r
awin
g
o
f
tech
n
o
l
o
g
ical
p
o
ten
tials
aim
ed
at
th
e
p
r
o
v
i
s
io
n
o
f
ac
ce
s
s
ib
le
-
im
m
ed
iate
co
n
n
ec
tiv
es,
s
u
p
p
o
r
ts
,
an
d
ed
u
ca
tiv
e
to
o
ls
,
n
ew
-
a
g
e
s
o
lu
tio
n
s
m
ak
e
a
b
le
th
e
b
r
i
d
g
in
g
o
f
tr
ad
itio
n
al
m
en
tal
h
ea
lth
s
er
v
ice
g
ap
s
t
o
em
p
o
wer
s
aid
ad
o
lescen
ts
with
p
r
o
ac
tiv
e
well
-
b
ein
g
m
an
ag
em
en
ts
.
T
h
is
ap
p
r
o
ac
h
o
f
a
tr
an
s
f
o
r
m
ativ
e
n
atu
r
e
o
n
its
o
wn
h
ig
h
lig
h
t
s
th
e
v
alu
ab
ilit
y
o
f
em
b
r
ac
i
n
g
an
d
in
teg
r
ati
n
g
tech
n
o
lo
g
y
ad
v
an
ce
m
en
ts
f
o
r
b
etter
p
r
o
m
o
tio
n
a
n
d
h
ea
lth
f
o
r
tify
in
g
f
o
r
a
d
o
lescen
ts
.
Dig
ital
in
n
o
v
atio
n
i
n
m
e
n
tal
h
ea
lth
is
b
asically
a
g
r
ea
t
o
p
p
o
r
tu
n
ity
,
b
u
t
c
h
allen
g
es
a
r
e
s
till
f
o
u
n
d
wh
en
im
p
lem
en
tin
g
it.
T
h
r
o
u
g
h
th
e
c
o
n
s
en
s
u
s
d
ev
elo
p
m
en
t
p
an
el
ap
p
r
o
ac
h
,
th
e
ex
p
er
t
p
an
el,
in
ter
n
atio
n
al,
an
d
cr
o
s
s
-
d
is
cip
lin
ar
y
wo
r
k
to
g
eth
er
to
d
e
v
elo
p
a
f
r
am
e
wo
r
k
f
o
r
t
h
e
co
n
ce
p
t
o
f
d
ig
ital
m
en
tal
h
ea
lth
in
n
o
v
atio
n
.
Ho
wev
er
,
th
is
ap
p
r
o
ac
h
to
in
ter
v
en
tio
n
m
u
s
t
b
e
cr
ea
tiv
e
an
d
r
eq
u
i
r
e
ch
an
g
e
b
y
ex
p
an
d
in
g
th
e
r
o
le
o
f
tr
a
d
itio
n
al
d
iag
n
o
s
tic
s
y
s
tem
s
.
Acc
ess
ib
il
ity
an
d
co
-
d
esig
n
th
en
b
ec
o
m
e
ess
en
tial to
s
u
s
tain
in
n
o
v
atio
n
to
last
[
2
3
]
.
I
n
ad
d
itio
n
to
b
ein
g
tech
n
o
lo
g
y
-
b
ased
,
co
m
m
u
n
ity
/co
m
m
u
n
ity
em
p
o
wer
m
en
t
ca
n
a
ls
o
b
e
an
in
n
o
v
ativ
e
s
o
lu
tio
n
.
J
u
r
is
d
ictio
n
s
in
C
an
ad
a
,
th
r
o
u
g
h
th
e
ag
r
ee
m
en
t
o
n
th
e
co
m
m
o
n
p
r
i
n
cip
al
s
tatem
en
t
o
n
s
h
ar
ed
h
ea
lth
p
r
io
r
ities
,
p
r
o
m
o
te
co
m
m
u
n
ity
-
b
ased
m
en
t
al
h
ea
lth
p
r
o
m
o
tio
n
p
r
o
g
r
am
s
as
well
as
ea
r
ly
in
ter
v
en
tio
n
s
tar
g
etin
g
ch
ild
r
e
n
an
d
ad
o
lescen
ts
as
s
o
lu
tio
n
in
n
o
v
atio
n
s
.
B
ar
r
ier
s
r
elate
d
to
co
s
ts
,
lim
itatio
n
s
in
s
ee
k
in
g
h
elp
,
a
n
d
l
o
n
g
wait
tim
es
ar
e
o
v
e
r
co
m
e
with
th
e
ag
r
ee
m
en
t.
T
h
er
e
is
a
lo
t
o
f
e
v
id
en
ce
to
f
in
d
th
at
co
m
m
u
n
ity
-
b
ased
in
ter
v
en
tio
n
s
an
d
s
p
ec
if
ic
p
r
im
ar
y
ca
r
e
ar
e
ef
f
ec
tiv
e
a
n
d
e
v
en
c
o
s
t
-
ef
f
ec
tiv
e,
lead
in
g
t
o
in
cr
ea
s
ed
ac
ce
s
s
to
m
en
tal
h
ea
lth
s
er
v
ices
[
2
4
]
.
3
.
2
.
Ro
le
o
f
t
ec
hn
o
lo
g
y
in ment
a
l hea
lt
h pre
v
ent
io
n
T
h
e
am
alg
a
m
atio
n
o
f
av
an
t
-
g
ar
d
e
h
ea
lth
tec
h
n
o
lo
g
ies,
ep
ito
m
ized
b
y
m
o
b
ile
h
ea
lth
a
p
p
licatio
n
s
,
o
n
lin
e
in
ter
v
en
tio
n
s
,
a
n
d
s
o
c
ially
ass
is
t
iv
e
r
o
b
o
ts
,
e
n
g
en
d
er
s
a
m
u
ltit
u
d
e
o
f
b
en
ef
its
i
n
r
ec
tify
in
g
m
e
n
tal
h
ea
lth
d
ilem
m
as
am
o
n
g
ad
o
l
escen
ts
.
T
h
ese
n
o
v
elties
p
r
o
f
f
er
an
ar
r
ay
o
f
r
eso
lu
tio
n
s
to
en
d
o
r
s
e
s
alu
b
r
io
u
s
ag
in
g
an
d
th
war
t
m
en
tal
h
ea
lth
q
u
an
d
a
r
ies,
ef
f
icac
io
u
s
ly
b
r
id
g
in
g
lacu
n
ae
in
r
eso
u
r
ce
s
a
n
d
s
er
v
ices
f
o
r
th
e
eld
er
ly
p
o
p
u
latio
n
.
T
h
e
u
tili
za
tio
n
o
f
s
m
ar
tp
h
o
n
e
ap
p
licati
o
n
s
to
s
u
p
er
v
is
e
s
leep
p
atter
n
s
an
d
air
q
u
ality
,
as
d
elin
ea
ted
in
[
1
3
]
,
b
u
r
g
eo
n
s
well
-
b
ein
g
an
d
co
g
n
itiv
e
ac
u
ity
.
C
o
r
r
o
b
o
r
ativ
ely
,
d
ig
ital
th
er
ap
eu
tic
f
r
am
ewo
r
k
s
,
ex
em
p
lifie
d
b
y
th
e
ME
DSR
eM
©
s
y
s
tem
f
o
r
h
y
p
er
ten
s
io
n
ad
h
er
en
ce
d
escr
ib
ed
in
[
1
3
]
,
elu
cid
ate
th
e
au
g
m
e
n
tatio
n
o
f
m
e
d
icatio
n
ad
h
e
r
en
ce
a
n
d
s
alu
tar
y
r
esu
lts
.
Mo
r
eo
v
er
,
s
o
cially
ass
is
tiv
e
au
to
m
ato
n
s
,
as
r
ep
o
r
ted
in
[
1
3
]
ev
in
ce
th
e
p
o
te
n
tial
to
ten
d
er
co
g
n
itiv
e
r
ein
f
o
r
ce
m
en
t
an
d
am
elio
r
ate
in
d
o
o
r
air
q
u
ality
r
eg
u
latio
n
f
o
r
s
en
io
r
a
d
u
lts
g
r
ap
p
lin
g
with
c
h
r
o
n
ic
af
f
lictio
n
s
,
wh
ich
m
ig
h
t
ex
tr
ap
o
late
t
o
a
d
o
lescen
ts
'
ad
v
an
tag
es.
Har
n
ess
in
g
th
es
e
tech
n
o
l
o
g
ical
s
tr
id
es
a
n
d
d
ef
tly
en
g
ag
in
g
s
tak
eh
o
ld
er
s
p
r
o
p
itio
u
s
ly
,
th
e
d
o
m
ain
ca
n
escalate
in
a
v
er
ti
n
g
m
e
n
tal
h
ea
lth
p
e
r
tu
r
b
atio
n
s
am
o
n
g
th
e
y
o
u
th
,
th
er
eb
y
f
o
s
ter
in
g
h
o
lis
tic
well
-
b
ein
g
.
T
h
e
ex
ten
t
an
d
s
co
p
e
o
f
in
n
o
v
ativ
e
tech
n
o
lo
g
ical
ad
a
p
tatio
n
s
h
o
ld
a
p
iv
o
tal
in
f
l
u
en
ce
in
cu
r
b
i
n
g
m
en
tal
h
ea
lth
co
m
p
licatio
n
s
with
in
ad
o
lescen
t
d
em
o
g
r
ap
h
ics.
T
h
e
p
r
ev
ale
n
t
ass
im
ilati
o
n
o
f
s
m
ar
tp
h
o
n
es
alo
n
g
s
id
e
in
ter
n
et
ap
p
licatio
n
s
p
r
o
p
els
d
ig
ital
m
en
tal
h
ea
lt
h
in
itiativ
es
in
to
a
r
ea
lm
wh
e
r
e
th
ey
p
o
s
s
ess
th
e
p
r
o
p
e
n
s
ity
to
ca
ter
to
an
ex
p
an
s
iv
e
s
u
b
s
et
o
f
y
o
u
n
g
in
d
iv
i
d
u
als
wh
o
o
th
er
wis
e
lack
ac
c
ess
to
co
n
v
en
tio
n
al
m
en
tal
h
ea
lth
in
s
titu
tio
n
s
.
T
h
ese
p
io
n
ee
r
in
g
s
o
lu
tio
n
s
p
r
o
f
f
er
co
n
tin
u
o
u
s
s
u
p
p
o
r
t
an
d
r
eso
u
r
ce
av
ailab
ilit
y
in
d
is
cr
im
in
ately
o
f
tim
e
an
d
l
o
ca
tio
n
,
ef
f
ec
tiv
ely
s
u
r
m
o
u
n
ti
n
g
g
eo
g
r
ap
h
ical
co
n
s
tr
ain
ts
an
d
s
o
cial
p
r
eju
d
ices.
No
n
eth
eless
,
p
r
io
r
itizin
g
eq
u
i
tab
le
an
d
i
n
clu
s
iv
e
p
ar
a
d
ig
m
s
in
th
e
ad
v
en
t
an
d
o
p
er
atio
n
aliza
tio
n
o
f
s
u
ch
tech
n
o
lo
g
ies
is
p
ar
am
o
u
n
t
t
o
g
u
ar
a
n
tee
ad
v
an
tag
eo
u
s
u
tili
za
tio
n
b
y
ad
o
lescen
ts
am
id
s
t
d
iv
er
s
e
s
o
cio
-
ec
o
n
o
m
ic
tier
s
an
d
v
a
r
ied
b
ac
k
g
r
o
u
n
d
s
.
Pro
s
p
ec
tiv
e
in
v
esti
g
ativ
e
en
d
ea
v
o
r
s
s
h
o
u
ld
co
n
ce
n
tr
ate
o
n
m
eticu
lo
u
s
ly
ap
p
r
aisi
n
g
th
e
p
r
o
f
icien
c
y
o
f
th
ese
tech
n
o
lo
g
ical
in
ter
v
en
tio
n
s
in
h
eter
o
g
en
o
u
s
co
h
o
r
ts
an
d
co
n
tex
ts
to
en
h
an
ce
th
eir
s
alu
tar
y
ef
f
ec
ts
o
n
m
en
tal
h
ea
lth
p
ar
ad
ig
m
s
.
Fu
r
th
e
r
m
o
r
e,
s
y
n
er
g
is
tic
ef
f
o
r
ts
am
o
n
g
tech
n
o
lo
g
y
d
ev
el
o
p
er
s
,
clin
i
ca
l
m
en
tal
h
ea
lth
ex
p
e
r
ts
,
an
d
leg
is
lativ
e
au
th
o
r
ities
ar
e
in
d
is
p
en
s
ab
le
in
estab
lis
h
in
g
a
r
esil
ien
t
f
r
am
e
wo
r
k
t
h
at
au
g
m
en
ts
t
h
e
d
is
tr
ib
u
tio
n
an
d
ac
ce
s
s
ib
ilit
y
o
f
th
ese
av
a
n
t
-
g
ar
d
e
s
o
lu
tio
n
s
.
T
h
e
p
r
ac
ticab
ilit
y
alo
n
g
wit
h
ef
f
icien
cy
o
f
i
n
d
iv
id
u
alize
d
in
ter
f
er
en
ce
s
,
s
u
ch
as
th
e
SMS
tex
t
co
m
m
u
n
icatio
n
in
ter
v
en
tio
n
k
n
o
wn
as
Kir
ab
o
s
itu
ated
in
Ug
an
d
a,
ac
ce
n
t
u
ates
th
e
p
iv
o
tal
n
atu
r
e
o
f
m
o
d
if
y
in
g
s
tr
atag
em
s
to
ca
ter
to
th
e
d
is
tin
ct
n
ec
ess
ities
o
f
teen
ag
er
s
in
th
e
s
p
h
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-
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48
in
clu
d
ed
with
HI
V
p
r
ev
en
ti
o
n
[
2
5
]
.
T
h
r
o
u
g
h
t
h
e
am
alg
am
atio
n
o
f
d
ata
-
ce
n
tr
ic
m
eth
o
d
o
lo
g
ies
an
d
th
e
ex
p
lo
itatio
n
o
f
d
ig
ital
in
ter
f
a
ce
s
,
in
ter
f
er
en
ce
s
ar
e
ca
p
ab
le
o
f
b
ein
g
tailo
r
ed
to
ex
te
n
d
s
p
ec
ialized
aid
an
d
r
eso
u
r
ce
s
b
ased
u
p
o
n
s
in
g
u
lar
b
e
h
av
io
r
al
h
ea
lth
s
y
m
p
to
m
s
co
u
p
led
with
r
is
k
d
eter
m
in
an
ts
.
T
h
is
p
er
s
o
n
aliza
tio
n
am
p
lifie
s
in
v
o
lv
em
en
t
an
d
s
im
p
lifie
s
th
e
attain
m
en
t
o
f
in
d
is
p
en
s
ab
le
s
er
v
ices
in
clu
s
iv
e
o
f
m
en
tal
well
-
b
ein
g
co
n
s
u
ltatio
n
an
d
HI
V
ex
am
in
atio
n
s
,
u
ltima
tely
b
o
ls
ter
in
g
p
r
o
ac
tiv
e
h
ea
lth
-
s
ee
k
in
g
p
r
o
cliv
ities
am
id
s
t
ad
o
lescen
ts
[
2
6
]
.
T
h
ese
en
d
ea
v
o
r
s
e
x
alt
th
e
im
p
o
r
tan
ce
o
f
ad
j
u
s
tin
g
in
ter
f
er
en
ce
s
to
h
ar
m
o
n
ize
with
t
h
e
v
ar
ieg
at
ed
ex
p
er
ien
ce
s
a
n
d
o
b
s
tacle
s
en
co
u
n
ter
ed
b
y
y
o
u
n
g
in
d
iv
id
u
als,
th
e
r
eb
y
m
ag
n
if
y
in
g
t
h
e
im
p
ac
t
alo
n
g
with
th
e
ef
f
icien
c
y
o
f
m
en
t
al
h
ea
lth
p
r
ev
e
n
tiv
e
m
an
eu
v
er
s
with
in
y
o
u
th
f
u
l
p
o
p
u
latio
n
s
.
3
.
3
.
T
ec
hn
o
lo
g
ica
l inno
v
a
t
i
o
ns
f
o
r
m
ent
a
l hea
lt
h pre
v
ent
io
n a
m
o
ng
a
do
lescent
s
3
.
3
.
1
.
T
elehea
lt
h a
nd
t
elet
h
er
a
py
New
-
f
an
g
led
tech
n
o
lo
g
ies,
lik
e
teleh
ea
lth
an
d
teleth
er
a
p
y
,
t
h
ey
g
o
t
l
o
ad
s
o
f
p
o
ten
tial
in
d
ea
lin
g
with
ad
o
lescen
t
m
en
tal
n
ee
d
s
.
T
h
is
r
em
o
te
s
tu
f
f
,
g
iv
e
ea
s
e,
ea
s
y
ac
ce
s
s
,
an
d
m
o
r
e
p
r
iv
ac
y
f
o
r
th
at
s
ee
k
er
m
en
tal
aid
.
W
ith
v
id
eo
co
n
f
er
en
cin
g
,
m
ess
ag
es,
an
d
m
o
b
ile
ap
p
s
,
ad
o
lescen
ts
ca
n
ch
at
with
ce
r
ti
f
ied
m
en
tal
h
ea
lth
ex
p
er
ts
r
ig
h
t
f
r
o
m
h
o
m
e.
R
esear
ch
,
it
s
h
o
ws
th
at
teleth
er
ap
y
,
is
u
s
ef
u
l
th
in
g
in
s
to
p
p
in
g
a
n
d
h
a
n
d
lin
g
m
en
tal
is
s
u
es
am
o
n
g
a
d
o
lescen
t.
Plu
s
,
teleh
ea
lth
,
it
ca
n
g
et
to
ad
o
lescen
ts
in
r
u
r
al
o
r
u
n
d
e
r
s
er
v
ed
p
lace
s
wh
er
e
m
en
tal
r
eso
u
r
ce
s
,
th
e
y
'
r
e
s
h
o
r
t
.
So
,
u
s
in
g
tech
n
o
lo
g
y
in
m
en
tal
h
ea
lth
ca
r
e,
we
ca
n
f
ill
th
e
g
ap
i
n
s
er
v
ice
ac
ce
s
s
an
d
g
iv
e
q
u
ick
h
elp
to
t
h
e
y
o
u
n
g
o
n
es in
n
ee
d
[
2
7
]
.
T
h
e
o
u
tb
r
ea
k
o
f
C
OVI
D
-
1
9
as
a
p
an
d
em
ic
h
as
d
is
tr
ac
ted
all
asp
ec
ts
o
f
h
u
m
an
life
b
y
u
tili
zin
g
tech
n
o
lo
g
y
to
in
ter
ac
t
r
e
m
o
t
ely
,
in
clu
d
in
g
h
ea
lth
s
cr
ee
n
i
n
g
.
T
h
is
m
ak
es
ac
ce
s
s
to
h
e
alth
s
er
v
ices
m
o
r
e
f
lex
ib
le
(
f
ewe
r
b
ar
r
ier
s
)
,
af
f
o
r
d
ab
le
p
r
ices,
an
d
wid
e
r
s
er
v
ic
e
av
ailab
ilit
y
.
T
h
e
u
s
e
o
f
a
u
d
i
o
-
v
is
u
al
tech
n
o
lo
g
y
in
telem
en
tal
h
ea
lth
ca
n
h
elp
p
s
y
ch
o
lo
g
ical
in
ter
v
e
n
tio
n
s
o
r
b
e
tar
g
eted
o
n
ly
with
an
i
n
ter
n
et
co
n
n
ec
tio
n
with
o
u
t
h
av
in
g
to
m
ee
t
f
ac
e
-
to
-
f
ac
e.
I
t
h
as
p
r
o
v
en
t
o
b
e
j
u
s
t
as
ef
f
ec
tiv
e
f
o
r
tr
ea
tin
g
m
e
n
tal
d
is
o
r
d
er
s
th
an
d
ir
ec
t
in
ter
v
en
tio
n
.
Ho
wev
e
r
,
in
its
r
ea
l
izatio
n
,
it
s
till
n
ee
d
s
to
b
e
d
ev
elo
p
ed
s
o
th
at
th
e
p
r
o
v
is
io
n
o
f
lo
n
g
-
ter
m
h
ea
lth
s
er
v
ices a
n
d
f
u
tu
r
e
h
ea
lth
cr
is
es c
an
b
e
p
r
ep
ar
e
d
[
2
8
]
.
Var
io
u
s
s
tu
d
ies
d
o
co
n
tain
d
o
m
in
an
t
ev
id
e
n
ce
th
at
tech
n
o
lo
g
y
-
b
ased
m
o
b
ile
ap
p
lica
tio
n
s
an
d
telem
en
tal
h
ea
lth
ar
e
q
u
ite
p
r
o
m
is
in
g
.
Statis
tical
an
aly
s
is
s
h
o
ws
th
at
tech
n
o
lo
g
y
-
b
ased
in
t
er
v
en
tio
n
s
ca
n
b
e
a
p
o
ten
tial
tr
ea
tm
en
t
o
p
tio
n
f
o
r
m
an
ag
in
g
m
e
n
tal
h
ea
lth
s
y
m
p
to
m
s
in
ad
o
lescen
ts
an
d
y
o
u
n
g
ad
u
lts
,
esp
ec
ially
in
r
u
r
al
Am
er
ica
[
2
9
]
.
L
o
n
g
b
ef
o
r
e
th
e
p
a
n
d
em
ic,
teleth
e
r
ap
y
was
claim
ed
as
a
f
o
r
m
o
f
tr
ea
tm
en
t
f
o
r
m
en
tal
d
is
o
r
d
er
s
in
ch
ild
r
e
n
a
n
d
ad
o
lescen
ts
,
wh
o
h
ad
a
h
ig
h
ac
ce
p
tan
ce
r
ate
an
aly
ze
d
f
r
o
m
s
ev
er
al
s
tu
d
ies.
T
eleth
er
ap
y
an
d
telep
s
y
ch
iatr
y
(
v
id
eo
-
b
ased
p
s
y
c
h
iatr
ic
co
n
s
u
ltatio
n
s
)
ar
e
also
m
o
r
e
c
o
m
m
o
n
ly
ch
o
s
en
b
y
th
eir
p
ar
e
n
ts
th
an
f
ac
e
-
to
-
f
ac
e
/f
ac
e
-
to
-
f
ac
e
tr
ea
tm
en
t.
Sev
e
r
al
s
u
r
v
ey
s
in
2
0
2
1
also
r
ep
o
r
t
ed
th
at
s
atis
f
ac
tio
n
in
s
er
v
ice
was sti
ll d
o
m
in
ated
b
y
th
e
m
o
d
er
ate
to
g
o
o
d
ca
teg
o
r
y
o
f
teleth
er
ap
y
d
u
r
in
g
C
O
VI
D
-
19
[
3
0
]
.
3
.
3
.
2
.
M
o
bil
e
a
pp
lica
t
io
ns
f
o
r
m
ent
a
l w
ell
-
being
I
n
s
o
d
o
in
g
,
s
cr
u
tin
izin
g
tec
h
-
b
ased
r
eso
lv
es
to
allev
iate
ad
o
lescen
t
m
en
tal
h
ea
lth
tr
i
b
u
latio
n
s
,
m
er
g
in
g
m
o
b
ile
ap
p
s
ap
p
e
ar
s
a
h
o
p
ef
u
l
p
ath
to
war
d
f
o
s
ter
in
g
m
en
tal
g
o
o
d
-
b
ei
n
g
.
E
x
p
lo
itin
g
AI
ad
v
an
ce
m
e
n
ts
,
as
ac
ce
n
tu
ated
in
[
3
1
]
,
m
ig
h
t
o
v
er
h
au
l
s
u
ici
d
e
d
eter
r
e
n
ce
tactics
b
y
b
etter
in
g
r
is
k
ev
alu
atio
n
an
d
b
esp
o
k
e
in
ter
v
e
n
tio
n
s
.
Fu
r
th
er
m
o
r
e,
m
o
b
ile
h
ea
lth
a
p
p
em
p
lo
y
m
en
t,
as
ex
p
lain
e
d
in
[
3
2
]
,
o
f
f
er
s
a
s
h
if
tin
g
m
eth
o
d
o
lo
g
y
to
f
o
r
m
in
g
s
o
u
n
d
h
ab
its
an
d
tack
lin
g
ad
o
lescen
t
m
en
tal
tr
o
u
b
les.
B
y
h
ar
n
ess
in
g
th
e
o
m
n
ip
r
esen
t
n
atu
r
e
o
f
m
o
b
ile
s
in
y
o
u
t
h
s
'
ex
is
ten
ce
s
,
th
ese
cu
ttin
g
-
ed
g
e
ed
u
ca
ti
v
e
ac
tio
n
s
p
r
o
p
o
s
e
a
f
o
r
war
d
-
lo
o
k
in
g
way
to
b
r
ee
d
p
o
s
itiv
e
ac
tio
n
s
an
d
h
alt
th
e
b
u
r
g
e
o
n
in
g
o
f
m
e
n
tal
h
ea
lth
d
ilem
m
as.
Me
r
g
in
g
AI
-
in
s
p
ir
ed
in
s
ig
h
ts
with
m
o
b
ile
h
ea
lth
ap
p
s
c
o
u
ld
la
y
a
f
o
u
n
d
atio
n
f
o
r
s
p
ec
if
ic
i
n
ter
v
en
ti
o
n
s
th
at
h
ar
m
o
n
ize
with
ad
o
lescen
ts
,
p
lau
s
ib
ly
m
o
ld
in
g
a
s
ce
n
ar
io
wh
e
r
ein
tec
h
ac
ts
as
a
r
ev
o
lu
tio
n
ar
y
in
s
tr
u
m
en
t
in
p
r
o
tectin
g
y
o
u
n
g
p
eo
p
le'
s
m
en
tal
welln
es
s
.
Glo
b
ally
,
in
d
iv
id
u
als
with
m
en
tal
h
ea
lth
d
is
o
r
d
er
s
ar
e
m
o
r
e
lik
ely
to
h
av
e
ac
ce
s
s
to
s
m
ar
tp
h
o
n
es
th
an
to
m
en
tal
h
ea
lth
ca
r
e.
T
h
e
m
ec
h
an
is
m
s
u
n
d
er
ly
in
g
m
en
tal
h
ea
lth
an
d
tech
n
o
lo
g
y
in
ter
ac
tio
n
ar
e
well
u
n
d
er
s
to
o
d
with
in
t
h
e
f
ield
o
f
h
u
m
a
n
-
co
m
p
u
ter
i
n
ter
ac
tio
n
(
HC
I
)
.
T
h
is
in
clu
d
es
p
r
ed
icti
n
g
h
o
w
in
d
i
v
id
u
als
ex
p
r
ess
th
eir
m
en
tal
h
ea
lth
i
s
s
u
es
o
n
lin
e
an
d
s
o
cially
th
r
o
u
g
h
s
o
cial
m
e
d
ia
an
al
y
s
is
an
d
m
e
n
tal
h
ea
lth
f
o
r
u
m
s
.
Fo
r
ex
a
m
p
le,
d
ata
ac
cu
r
ac
y
f
r
o
m
T
witter
ca
n
p
r
ed
ict
th
e
lik
elih
o
o
d
o
f
p
o
s
tp
ar
tu
m
d
ep
r
ess
io
n
an
d
m
ajo
r
d
ep
r
ess
iv
e
d
is
o
r
d
er
wi
th
o
v
er
7
0
%
ac
cu
r
ac
y
.
R
ed
d
it,
as
a
s
o
cial
m
ed
ia
p
latf
o
r
m
,
ca
n
also
d
etec
t
ch
an
g
es
in
u
s
er
s
,
p
o
ten
tially
i
n
d
icatin
g
a
s
h
if
t
to
war
d
s
u
icid
al
id
ea
tio
n
b
ased
o
n
r
ec
o
r
d
ed
d
ata,
o
r
id
e
n
tify
in
g
s
ig
n
s
o
f
co
m
p
le
x
m
en
tal
h
ea
lt
h
d
is
o
r
d
er
s
s
u
ch
as
s
ch
izo
p
h
r
e
n
ia
[
3
3
]
.
Op
p
is
an
o
th
er
u
n
iv
e
r
s
al
m
o
b
ile
ap
p
licatio
n
p
r
o
m
o
tin
g
m
en
tal
h
ea
lth
,
esp
ec
ially
f
o
r
teen
a
g
er
s
ag
ed
13
–
1
9
T
.
T
h
is
ap
p
ca
n
b
e
d
o
w
n
lo
ad
ed
f
o
r
f
r
ee
th
r
o
u
g
h
t
h
e
Go
o
g
le
Play
Sto
r
e
an
d
o
th
er
Ap
p
Sto
r
es
.
A
s
tu
d
y
in
No
r
way
m
en
tio
n
s
th
at
Op
p
was
cr
ea
ted
to
im
p
r
o
v
e
we
ll
-
b
ein
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d
m
en
tal
h
ea
lth
,
i
n
cr
ea
s
e
k
n
o
wled
g
e
ab
o
u
t
m
en
tal
h
ea
lth
,
e
n
h
an
c
e
s
tr
ess
-
co
p
in
g
s
k
ills
,
en
c
o
u
r
ag
e
h
el
p
-
s
ee
k
in
g
b
e
h
av
io
r
,
b
o
o
s
t
s
elf
-
esteem
,
im
p
r
o
v
e
s
leep
q
u
ality
,
a
n
d
r
e
d
u
ce
m
en
tal
h
ea
lth
is
s
u
es
am
o
n
g
its
u
s
er
s
.
An
o
th
er
m
o
b
il
e
ap
p
,
NettOp
p
,
is
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2252
-
8
8
0
6
Tech
n
o
lo
g
y
t
o
s
u
p
p
o
r
t m
en
ta
l h
ea
lth
a
d
o
lescen
ts
:
a
liter
a
tu
r
e
r
ev
iew
(
Lin
a
Ha
n
d
a
ya
n
i
)
49
d
esig
n
ed
f
o
r
teen
s
ag
e
d
1
1
–
1
6
wh
o
h
av
e
ex
p
e
r
ien
ce
d
n
eg
ativ
e
ev
en
ts
o
n
s
o
cial
m
ed
ia
[
3
4
]
.
T
h
e
#
L
I
FEGO
AL
S
ap
p
also
p
r
o
v
i
d
es
an
o
p
tio
n
f
o
r
tee
n
s
in
ev
i
d
en
ce
-
b
ased
m
o
b
ile
h
ea
lth
in
te
r
v
en
tio
n
s
,
f
ea
tu
r
in
g
ac
tiv
ity
tr
ac
k
in
g
,
s
elf
-
r
e
g
u
lati
o
n
tech
n
iq
u
es,
g
am
if
icatio
n
el
em
en
ts
,
a
s
u
p
p
o
r
tiv
e
c
h
atb
o
t,
an
d
h
ea
lth
n
a
r
r
ativ
e
v
id
eo
s
.
Alth
o
u
g
h
th
is
in
ter
v
e
n
tio
n
is
n
o
t
ex
p
licitly
in
tr
o
d
u
ce
d
as
a
to
o
l
f
o
r
en
h
an
cin
g
m
en
tal
h
ea
lth
,
th
e
in
f
o
r
m
atio
n
o
n
life
s
ty
le
m
an
a
g
em
en
t b
e
n
ef
its
ca
n
co
n
tr
i
b
u
t
e
to
a
h
ea
lth
ier
m
in
d
[
3
5
]
.
3
.
3
.
3
.
Wea
ra
ble
t
ec
hn
o
lo
g
y
f
o
r
m
o
nito
ring
T
ec
h
n
o
lo
g
ical
p
r
o
g
r
ess
io
n
s
h
av
e
p
r
e
p
ar
ed
r
o
u
te
f
o
r
cr
ea
ti
n
g
wea
r
ab
le
g
ad
g
ets
wh
ich
ca
n
tr
ac
e
d
iv
er
s
e
f
ac
ets
o
f
p
er
s
o
n
’
s
h
ea
lth
an
d
welln
ess
,
also
co
n
tain
in
g
m
e
n
tal
h
ea
lth
asp
e
cts.
W
ea
r
ab
le
tech
co
n
v
ey
i
n
g
b
en
e
f
it
o
f
n
o
n
s
to
p
an
d
r
ea
l
-
tim
e
tr
ac
k
in
g
,
p
er
m
itti
n
g
p
r
em
atu
r
e
d
is
co
v
er
y
o
f
lik
ely
is
s
u
es
lik
e
s
tr
ess
,
an
x
iety
,
o
r
d
ep
r
ess
io
n
.
T
h
ese
g
ad
g
ets
ca
p
ab
le
to
lo
g
p
h
y
s
io
lo
g
ical
cu
es
s
u
ch
as
h
e
ar
t
r
ate
v
ar
iab
ilit
y
,
s
leep
p
atter
n
s
,
an
d
ac
tiv
ity
lev
els,
p
r
o
v
id
in
g
u
s
ef
u
l
d
ata
f
o
r
b
o
th
p
er
s
o
n
s
an
d
h
ea
lth
ca
r
e
o
p
er
ativ
es.
I
n
s
p
ec
tin
g
h
as
in
d
icate
d
h
o
p
ef
u
l
r
esu
lts
in
u
tili
zin
g
wea
r
ab
le
tech
f
o
r
m
en
tal
h
ea
lth
s
u
p
er
v
is
io
n
,
with
r
esear
ch
s
p
o
tlig
h
tin
g
t
h
e
p
r
o
s
p
ec
tiv
e
f
o
r
p
r
em
atu
r
ely
in
te
r
v
en
tio
n
an
d
cu
s
to
m
-
tailo
r
e
d
t
r
ea
tm
en
t
p
la
n
s
.
B
y
f
u
s
in
g
wea
r
ab
le
tech
in
to
p
r
e
v
en
tiv
e
tactics
f
o
r
m
en
tal
h
ea
lth
with
in
teen
ag
er
s
,
awa
r
en
ess
p
o
s
s
ib
ly
en
h
an
ce
d
,
tim
ely
in
ter
v
en
tio
n
s
f
ac
ilit
ated
,
an
d
o
v
er
all
r
esu
lts
im
p
r
o
v
ed
f
o
r
th
is
v
u
l
n
er
ab
le
g
r
o
u
p
[
3
6
]
.
T
h
e
u
s
e
o
f
tec
h
n
o
l
o
g
y
ca
n
b
e
in
v
o
l
v
e
d
i
n
th
e
ap
p
r
o
ac
h
to
m
en
t
al
h
ea
l
th
i
n
a
d
o
l
esce
n
ts
b
y
p
r
o
v
i
d
i
n
g
d
i
r
e
ct
p
h
y
s
io
lo
g
i
ca
l
m
a
r
k
er
i
n
f
o
r
m
at
io
n
to
s
u
p
p
o
r
t
s
elf
-
r
e
g
u
l
ati
o
n
.
T
h
is
ca
n
h
e
lp
u
s
e
r
s
f
o
c
u
s
o
n
t
h
e
s
t
r
ess
t
h
e
y
ar
e
e
x
p
e
r
i
en
ci
n
g
an
d
a
p
p
l
y
i
n
ter
v
en
ti
o
n
s
t
o
r
e
d
u
c
e
it
[
3
7
]
.
Hea
l
th
m
o
n
it
o
r
i
n
g
an
d
i
n
te
r
v
en
t
io
n
a
r
e
p
o
te
n
ti
al
p
o
i
n
ts
o
f
f
er
ed
b
y
m
o
b
ile
a
p
p
s
,
esp
ec
iall
y
in
a
d
o
les
ce
n
ts
a
g
e
d
1
3
-
1
8
y
e
ar
s
.
A
q
u
a
n
t
ita
ti
v
e
s
tu
d
y
wi
th
a
s
u
r
v
e
y
p
r
o
v
e
d
th
at
th
e
l
e
v
el
o
f
an
x
i
et
y
a
n
d
d
e
p
r
ess
io
n
in
u
s
er
s
d
ec
r
ea
s
e
d
s
ig
n
i
f
i
ca
n
tl
y
.
T
h
e
f
e
at
u
r
es
a
v
a
ila
b
l
e
i
n
th
e
ap
p
h
el
p
th
em
k
n
o
w
m
o
r
e
a
b
o
u
t
m
en
tal
h
ea
lt
h
a
n
d
i
m
p
r
o
v
e
t
h
ei
r
e
m
o
ti
o
n
m
a
n
a
g
e
m
e
n
t
s
k
il
l
s
[
3
8
]
.
Mo
o
d
m
o
n
ito
r
in
g
th
r
o
u
g
h
t
r
ac
k
in
g
s
y
m
p
to
m
s
,
f
ee
lin
g
s
,
an
d
b
eh
a
v
io
r
s
is
a
cr
u
cial
asp
ec
t
o
f
co
g
n
itiv
e
b
eh
a
v
io
r
al
th
er
a
p
y
(
C
B
T
)
.
T
h
is
m
o
n
ito
r
in
g
is
u
s
ef
u
l
f
o
r
id
en
tif
y
in
g
tr
ig
g
er
s
,
d
ev
elo
p
in
g
co
p
in
g
s
tr
ateg
ies,
ad
ju
s
tin
g
tr
ea
tm
en
ts
,
an
d
h
elp
in
g
tee
n
ag
er
s
b
etter
u
n
d
er
s
tan
d
th
ei
r
b
eh
a
v
io
r
s
.
C
B
T
is
co
n
s
id
er
ed
a
m
an
u
alize
d
th
er
ap
y
wid
ely
ac
ce
s
s
ib
le
to
in
d
iv
id
u
als
wit
h
m
en
tal
h
ea
lth
n
ee
d
s
in
th
e
UK
d
u
e
to
its
af
f
o
r
d
a
b
ilit
y
.
Mo
n
ito
r
i
n
g
f
ea
t
u
r
es
ar
e
also
im
p
lem
en
ted
wit
h
r
em
o
te
s
en
s
in
g
f
u
n
ctio
n
s
(
ac
tiv
e
an
d
p
ass
iv
e)
to
tr
ac
k
v
ar
i
o
u
s
p
h
y
s
ical
an
d
m
e
n
tal
co
n
d
itio
n
s
,
s
u
ch
as
s
leep
p
atter
n
s
,
ex
er
cise,
a
n
d
m
o
o
d
a
ctiv
ity
.
T
h
is
f
ea
tu
r
e
is
a
co
r
e
c
o
m
p
o
n
en
t
i
n
th
e
d
esig
n
o
f
m
en
tal
h
ea
lth
ap
p
licatio
n
s
.
Scien
tific
r
ev
iews
h
av
e
s
h
o
wn
th
at
s
elf
-
m
o
n
ito
r
in
g
ac
ts
as
a
t
h
er
ap
eu
tic
in
ter
v
en
tio
n
b
y
r
ed
u
ci
n
g
p
s
y
c
h
o
lo
g
ical
d
is
tr
ess
,
p
r
o
m
o
tin
g
tr
ea
tm
en
t
ad
h
er
en
ce
,
an
d
s
u
p
p
o
r
tin
g
tee
n
ag
er
s
'
s
elf
-
ef
f
icac
y
[
3
9
]
.
3
.
3
.
4
.
Virt
ua
l
re
a
lity
t
hera
py
I
n
th
e
s
p
h
er
e
wh
er
e
tech
in
n
o
v
atio
n
len
d
s
a
h
an
d
to
th
war
t
m
en
tal
h
ea
lth
wo
es
am
o
n
g
th
e
y
o
u
n
g
,
v
ir
tu
al
r
ea
lity
th
er
ap
y
(
VR
T
)
m
ay
b
e
a
n
o
tewo
r
th
y
in
s
tr
u
m
en
t.
VR
T
cr
af
ts
an
im
itat
ed
wo
r
ld
p
lu
n
g
in
g
in
d
iv
id
u
als
in
t
o
r
eg
u
lated
h
ea
l
in
g
in
s
tan
ce
s
,
p
r
esen
tin
g
an
u
n
u
s
u
al
way
to
tr
ea
tm
en
t.
B
y
m
ak
in
g
a
s
ec
u
r
e
s
p
o
t
f
o
r
f
o
lk
s
to
f
ac
e
th
eir
d
r
ea
d
an
d
wo
r
r
y
,
VR
T
m
ig
h
t
b
e
n
o
tab
ly
u
s
ef
u
l
f
o
r
h
ea
lin
g
p
h
o
b
ias,
p
o
s
t
-
tr
au
m
atic
s
tr
ess
d
is
o
r
d
er
,
a
n
d
an
x
iety
m
ess
es.
Mo
r
eo
v
er
,
VR
T
allo
ws
f
o
r
cu
s
to
m
-
m
a
d
e
tr
ea
tm
e
n
t
s
ch
em
es
tu
n
ed
to
p
er
s
o
n
al
n
ee
d
s
an
d
ad
v
an
ce
l
ev
els,
h
en
ce
b
o
o
s
tin
g
th
er
ap
y
s
u
cc
ess
.
Stu
d
y
p
ap
er
s
h
a
v
e
h
in
ted
at
p
r
o
m
is
in
g
r
esu
lts
d
ep
lo
y
in
g
VR
T
alo
n
g
s
id
e
tr
ad
itio
n
al
way
s
,
th
er
eb
y
b
etter
in
g
r
esu
lts
f
o
r
teen
s
f
ac
in
g
m
en
tal
h
ea
lth
tr
ib
u
latio
n
s
.
As
tech
m
o
v
es
ah
ea
d
,
wea
v
in
g
VR
T
in
to
m
en
tal
h
ea
lth
in
ter
v
en
tio
n
s
h
as
a
s
tu
p
en
d
o
u
s
ca
p
ac
ity
f
o
r
tr
an
s
f
o
r
m
in
g
tr
ea
tm
en
t str
ateg
ies an
d
b
etter
in
g
o
u
tco
m
e
s
f
o
r
y
o
u
n
g
s
ter
s
[
4
0
]
.
Me
n
tal
h
ea
lth
is
n
o
t
o
n
ly
ab
o
u
t
a
h
ap
p
y
life
an
d
h
ea
lt
h
y
g
r
o
wth
o
f
in
d
iv
i
d
u
als
b
u
t
also
ab
o
u
t
im
p
r
o
v
in
g
th
e
r
elev
an
t
n
atio
n
al
h
ea
lth
s
tatu
s
.
T
h
e
ap
p
licati
o
n
o
f
v
ir
tu
al
r
ea
lity
(
VR
)
tech
n
o
lo
g
y
in
s
o
lv
in
g
ad
o
lescen
t
m
en
tal
h
ea
lth
p
r
o
b
lem
s
at
v
ar
i
o
u
s
lev
els
is
a
s
tr
ateg
y
th
at
ca
n
b
e
p
u
r
s
u
ed
lik
e
C
h
in
a'
s
.
VR
h
as
a
co
m
p
lex
ch
ar
ac
ter
is
tic
th
at
b
len
d
s
m
u
ltime
d
ia,
n
u
m
er
ical
im
ag
e
p
r
o
ce
s
s
in
g
,
s
en
s
o
r
tech
n
o
l
o
g
y
,
an
d
c
o
m
p
u
ter
g
r
ap
h
ics
th
at
em
er
g
ed
in
th
e
late
2
0
th
ce
n
tu
r
y
.
I
ts
ap
p
licatio
n
to
s
cien
ce
ed
u
ca
tio
n
in
C
h
in
a
is
ab
le
to
im
p
r
o
v
e
th
e
p
s
y
ch
o
lo
g
ical
well
-
b
ein
g
o
f
ad
o
lescen
ts
th
r
o
u
g
h
th
e
ex
tr
ac
tio
n
o
f
c
o
lo
r
f
ea
tu
r
es
an
d
g
r
ay
-
le
v
el
co
cu
r
r
e
n
ce
m
atr
i
x
,
m
ar
ch
in
g
c
u
b
es
alg
o
r
ith
m
s
,
as
well
as
s
y
n
th
esis
.
T
h
e
p
o
p
u
lar
ity
r
ate
o
f
s
tu
d
en
ts
in
c
r
ea
s
ed
b
y
2
6
.
9
%
an
d
th
e
n
u
m
b
e
r
o
f
s
tu
d
en
ts
with
a
s
u
b
h
ea
lth
y
m
e
n
tality
d
ec
r
ea
s
ed
b
y
1
6
.
9
%
af
te
r
r
ec
eiv
in
g
s
cien
ce
ed
u
ca
tio
n
u
s
in
g
VR
[
4
1
]
.
VR
is
also
u
s
ed
as a
n
ap
p
r
o
ac
h
in
r
eh
ab
ilit
atio
n
,
p
r
o
m
o
tio
n
o
f
e
m
o
tio
n
al
well
-
b
ein
g
in
in
p
atien
ts
,
an
d
m
en
tal
h
ea
lth
tr
ea
tm
en
t
r
an
g
in
g
f
r
o
m
p
h
o
b
ia
d
is
o
r
d
e
r
s
,
p
o
s
t
-
tr
au
m
atic
s
tr
ess
,
an
d
o
b
s
ess
iv
e
-
co
m
p
u
ls
iv
e
d
is
o
r
d
e
r
,
to
au
tis
m
s
p
ec
tr
u
m
d
is
o
r
d
er
(
ASD)
[
4
2
]
.
Vir
tu
al
r
ea
lity
is
ab
le
to
m
ak
e
u
s
er
s
n
o
t
lo
n
ely
(
ex
p
e
r
ien
cin
g
a
s
en
s
e
o
f
p
r
esen
ce
)
,
b
ein
g
in
a
p
lace
o
f
in
f
o
r
m
atio
n
,
wh
er
e
th
is
s
itu
atio
n
is
a
tu
r
n
in
g
p
o
i
n
t
in
t
h
e
r
elatio
n
s
h
ip
b
etwe
en
h
u
m
an
s
an
d
co
m
p
u
ter
s
.
VR
th
er
ap
y
is
an
i
n
teg
r
ated
ap
p
r
o
ac
h
to
clin
ical
p
r
ac
tice
in
wh
i
ch
th
e
th
er
ap
is
t
m
u
s
t
b
e
a
b
le
t
o
cr
ea
te
a
d
ialo
g
u
e
b
etwe
en
tr
ad
itio
n
al
p
s
y
c
h
o
th
e
r
ap
y
an
d
n
ew
tech
n
o
lo
g
ies.
Hea
d
-
m
o
u
n
ted
d
is
p
lay
(
HM
D)
is
th
e
m
o
s
t
wid
ely
u
s
ed
VR
to
o
l
in
ac
h
iev
in
g
m
ed
iated
d
ir
ec
t
ac
tio
n
s
.
E
x
p
lo
r
in
g
th
e
p
r
o
ce
s
s
is
an
in
ter
esti
n
g
p
ar
t
o
f
u
n
d
er
s
tan
d
i
n
g
h
o
w
th
e
m
ec
h
an
is
m
o
f
ch
an
g
e
d
u
r
in
g
th
er
ap
y
tak
es
p
lace
.
T
h
e
f
lex
ib
il
ity
o
f
VR
allo
ws
d
is
r
u
p
tiv
e
v
ar
ia
b
les
in
p
s
y
ch
o
th
er
ap
y
to
b
e
elim
in
ate
d
.
A
s
y
s
tem
atic
r
ev
iew
p
r
o
v
es
th
at
v
ir
tu
al
r
ea
lity
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
2
0
2
6
:
43
-
56
50
ex
p
o
s
u
r
e
th
er
ap
y
(
VR
E
T
)
is
a
v
alid
alter
n
ativ
e
to
in
v
iv
o
th
er
ap
y
in
th
e
tr
ea
tm
e
n
t
o
f
s
o
ci
al
an
x
iety
d
is
o
r
d
er
in
its
v
ar
io
u
s
f
o
r
m
s
[
4
3
]
.
3
.
3
.
5
.
Art
if
icia
l
inte
llig
ence
in m
ent
a
l hea
lt
h c
a
re
T
h
ese
p
r
o
g
r
ess
io
n
s
in
tech
n
o
lo
g
ical
ad
v
an
ce
m
en
ts
h
av
e
also
f
ac
ilit
ated
th
e
am
alg
a
m
atio
n
o
f
ar
tific
ial
in
tellig
en
ce
(
AI
)
with
in
th
e
d
o
m
ain
o
f
m
e
n
tal
h
ea
lth
ca
r
e,
m
an
if
esti
n
g
a
p
o
ten
tial
r
o
u
te
f
o
r
en
h
an
ce
m
e
n
t
in
ea
r
ly
in
ter
v
en
tio
n
a
n
d
tr
ea
tm
e
n
t
s
tr
atag
em
s
f
o
r
a
d
o
lescen
t
in
d
iv
id
u
als.
AI
-
d
r
iv
e
n
m
ec
h
an
is
m
s
p
o
s
s
ess
th
e
ca
p
ac
ity
to
ev
alu
ate
ex
te
n
s
iv
e
d
at
asets
to
d
is
ce
r
n
p
atter
n
s
an
d
t
en
d
en
cies
th
at
m
ay
s
y
m
b
o
lize
th
e
in
cip
ie
n
ce
o
f
m
en
tal
h
ea
lth
af
f
lictio
n
s
,
th
e
r
eb
y
allo
win
g
h
ea
lth
ca
r
e
o
p
er
ativ
es
to
en
g
ag
e
p
r
ee
m
p
tiv
ely
.
Fo
r
in
s
tan
ce
,
AI
co
m
p
u
tatio
n
al
m
o
d
els ca
n
s
cr
u
tin
ize
s
o
cial
m
ed
ia
em
is
s
io
n
s
o
r
d
ig
ital c
o
n
d
u
ct
to
ascer
tain
p
er
s
o
n
s
s
u
s
ce
p
tib
le
to
d
ep
r
ess
iv
e
o
r
a
n
x
io
u
s
s
t
ates,
th
er
eb
y
p
r
o
v
is
io
n
in
g
p
r
o
m
p
t
ass
is
tan
ce
an
d
m
ea
n
s
.
Ad
d
itio
n
ally
,
AI
c
o
n
v
er
s
atio
n
al
ag
en
ts
ca
n
ex
ten
d
u
n
in
ter
r
u
p
ted
s
u
p
p
o
r
t
an
d
t
h
er
a
p
eu
tic
d
ialo
g
u
es
to
in
d
iv
id
u
als,
p
o
ten
tially
m
iti
g
atin
g
th
e
s
tig
m
a
a
f
f
iliated
with
r
eq
u
is
itio
n
in
g
aid
a
n
d
am
p
lif
y
in
g
t
h
e
ac
ce
s
s
ib
ilit
y
to
m
en
tal
h
ea
lth
p
r
o
v
is
io
n
s
[
4
4
]
.
B
y
lev
er
a
g
i
n
g
th
e
ca
p
a
b
ilit
ies
in
tr
in
s
ic
to
AI
,
m
en
tal
h
ea
lth
ca
r
e
s
er
v
ices
ca
n
u
n
d
er
g
o
tr
a
n
s
f
o
r
m
atio
n
to
m
o
r
e
ad
ep
tly
s
atis
f
y
th
e
r
eq
u
is
ites
o
f
ad
o
lescen
ts
,
cu
lm
in
atin
g
i
n
au
g
m
en
ted
o
u
tco
m
es a
n
d
welf
ar
e.
I
n
s
o
m
e
ca
s
es,
ar
tific
ial
in
tellig
en
ce
ca
n
d
is
tin
g
u
is
h
b
etwe
e
n
a
d
iag
n
o
s
is
o
f
a
d
is
ea
s
e
an
d
th
e
s
am
e
s
y
m
p
to
m
s
s
o
th
at
it
ca
n
r
ec
o
m
m
en
d
a
p
p
r
o
p
r
iate
tr
ea
tm
e
n
t.
T
h
e
r
esu
lts
o
f
s
tr
u
ctu
r
al
MRI
s
ca
n
s
in
b
ip
o
lar
o
r
u
n
ip
o
lar
d
ep
r
ess
ed
p
atien
ts
ar
e
id
en
tifie
d
th
r
o
u
g
h
im
ag
in
g
f
ea
tu
r
es
in
A
I
.
I
n
a
d
d
itio
n
,
m
eth
o
d
o
lo
g
ies
in
AI
ca
n
also
d
ec
ip
h
e
r
p
atter
n
s
f
r
o
m
d
ata
o
b
tain
e
d
f
r
o
m
a
s
p
ec
if
ic
(
u
s
u
ally
lo
n
g
)
tim
e
s
p
an
to
v
alid
ate
d
iag
n
o
s
es
b
ased
o
n
th
e
e
v
o
lu
tio
n
o
f
m
e
n
tal
h
ea
lth
co
n
d
itio
n
s
th
at
o
cc
u
r
.
A
s
tu
d
y
s
h
o
wed
th
at
a
u
to
en
co
d
er
s
(
g
en
e
r
ativ
e
tis
s
u
es)
wo
r
k
with
f
MRI
an
d
s
MRI
d
ata
to
d
iag
n
o
s
e
atten
ti
o
n
d
ef
icit
h
y
p
er
ac
tiv
it
y
d
is
o
r
d
er
(
ADHD
)
with
an
ac
cu
r
ac
y
r
ate
o
f
u
p
to
6
7
% u
s
in
g
th
e
in
p
u
t m
u
ltimo
d
e
f
ea
t
u
r
e
[
4
5
]
.
C
h
atGPT
as
an
em
er
g
in
g
AI
p
r
o
d
u
ct
also
h
as
th
e
p
o
ten
tial
to
s
u
p
p
o
r
t
th
e
m
en
tal
h
ea
lth
o
f
ch
ild
r
en
an
d
ad
o
lescen
ts
in
v
a
r
io
u
s
way
s
.
First,
g
u
id
an
ce
o
n
e
v
id
en
ce
-
b
ased
tr
ea
tm
e
n
ts
,
ass
ess
m
en
t
to
o
ls
an
d
p
r
ac
tices
to
o
v
er
c
o
m
e
a
n
x
iet
y
,
d
ep
r
ess
io
n
,
an
d
h
y
p
er
ac
tiv
ity
in
ADHD
ca
n
b
e
ea
s
ily
o
b
tain
ed
b
y
h
ea
lt
h
p
r
o
f
ess
io
n
als.
Seco
n
d
,
n
e
g
ativ
e
s
tig
m
a
r
elate
d
to
m
en
tal
h
ea
lth
is
m
u
ch
m
in
im
al
b
ec
au
s
e
C
h
atGPT
d
o
es
n
o
t
co
r
n
er
u
s
er
s
with
p
o
o
r
m
en
tal
co
n
d
itio
n
s
.
On
th
e
co
n
tr
ar
y
,
C
h
atGPT
ac
tu
ally
h
elp
s
teen
ag
er
s
to
m
an
ag
e
th
eir
m
en
tal
h
ea
lth
with
a
v
ar
iety
o
f
r
elev
an
t
in
f
o
r
m
atio
n
.
T
h
ir
d
,
th
is
AI
ca
n
p
r
o
v
id
e
d
ir
ec
t
io
n
an
d
s
u
p
p
o
r
t
to
p
ar
en
ts
an
d
ca
r
eg
i
v
er
s
to
b
e
m
o
r
e
s
k
illed
in
d
ea
lin
g
with
th
eir
ch
ild
r
en
with
u
n
h
ea
lth
y
m
en
tal
co
n
d
itio
n
s
.
Ho
wev
er
,
C
h
atGPT
also
h
as
lim
itatio
n
s
in
d
iag
n
o
s
is
s
o
th
at
its
u
s
e
is
o
n
ly
ar
o
u
n
d
p
r
ev
en
tio
n
an
d
tr
ea
tm
e
n
t
r
ec
o
m
m
en
d
atio
n
s
in
g
e
n
er
al,
n
o
t sp
ec
if
ic
ac
co
r
d
in
g
to
in
d
iv
id
u
al
n
ee
d
s
[
4
6
]
.
3
.
4
.
I
m
ple
m
ent
a
t
io
n c
ha
lleng
es a
nd
et
hica
l c
o
ns
idera
t
io
ns
3
.
4
.
1
.
P
riv
a
c
y
a
nd
da
t
a
s
ec
u
rit
y
I
n
r
esp
ec
t
to
ex
p
lo
itin
g
tech
s
o
as
to
a
v
er
t
m
en
tal
h
ea
lth
d
ilem
m
as
am
id
s
t
y
o
u
t
h
s
,
th
e
p
iv
o
tal
m
atter
s
o
f
p
r
i
v
ac
y
alo
n
g
s
id
e
d
ata
s
a
f
eg
u
ar
d
in
g
ju
s
t
ca
n
'
t
b
e
s
id
e
lin
ed
.
W
h
en
tech
in
te
r
v
en
tio
n
s
ten
d
er
h
o
p
ef
u
l
p
r
o
s
p
ec
ts
f
o
r
ea
r
ly
s
p
o
ttin
g
a
n
d
p
r
o
m
p
t
ad
d
r
ess
in
g
,
m
atter
s
lin
k
ed
to
th
e
s
ec
r
ec
y
a
n
d
s
h
ield
o
f
d
elica
te
in
f
o
g
o
tta
b
e
m
eticu
lo
u
s
ly
tack
l
ed
.
I
t'
s
cr
u
cial
in
en
s
u
r
in
g
ju
v
en
iles
'
p
er
s
o
n
al
d
ata
s
t
ay
s
g
u
ar
d
e
d
v
er
s
u
s
u
n
p
er
m
itted
ac
ce
s
s
o
r
m
is
u
s
e,
th
u
s
u
p
h
o
ld
in
g
t
h
eir
tr
u
s
t p
lu
s
en
g
ag
em
e
n
t w
ith
d
ig
ital m
en
t
al
h
ea
lth
s
o
lu
tio
n
s
.
B
esid
es,
s
ter
n
d
ata
s
ec
u
r
ity
ar
r
an
g
em
en
ts
ca
n
d
im
in
is
h
r
is
k
s
lin
k
ed
to
d
ata
leak
s
o
r
m
is
u
s
e.
Via
em
b
ed
d
in
g
s
tu
r
d
y
p
r
iv
ac
y
n
o
r
m
s
p
lu
s
en
c
r
y
p
tio
n
p
r
ac
tices,
d
e
v
elo
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er
s
ca
n
f
o
r
g
e
a
s
ec
u
r
e
an
d
d
e
p
en
d
ab
le
d
ig
ital
s
ettin
g
f
av
o
r
a
b
le
to
u
p
liftin
g
m
en
tal
well
-
b
ein
g
am
id
s
t a
d
o
lescen
ts
.
So
,
an
all
-
en
co
m
p
ass
in
g
m
eth
o
d
th
at
em
p
h
asizes
b
o
th
tech
n
o
v
elty
p
lu
s
d
ata
-
p
r
o
tectio
n
is
in
d
is
p
en
s
ab
le
in
e
f
f
icac
io
u
s
ly
co
n
f
r
o
n
tin
g
m
e
n
tal
h
ea
lth
h
u
r
d
les
in
th
is
s
u
s
ce
p
tib
le
co
h
o
r
t.
E
n
ter
in
g
th
e
er
a
o
f
in
f
o
r
m
at
io
n
an
d
co
m
m
u
n
icatio
n
tech
n
o
lo
g
y
(
I
C
T
)
,
v
ar
io
u
s
to
o
ls
h
av
e
b
ee
n
d
ev
elo
p
e
d
to
o
f
f
er
m
en
tal
h
ea
lth
s
er
v
ices
to
th
e
p
u
b
lic
co
n
v
e
n
ien
tly
.
I
n
cr
ea
s
ed
ac
c
ess
to
s
m
ar
tp
h
o
n
e
ap
p
licatio
n
s
an
d
r
e
m
o
te
m
o
n
ito
r
in
g
s
y
s
tem
s
o
f
th
e
in
ter
n
et
o
f
th
in
g
s
(
I
o
T
)
o
p
en
s
u
p
f
lex
ib
le
an
d
c
o
s
t
-
ef
f
ec
tiv
e
co
n
s
u
ltatio
n
an
d
th
er
ap
y
s
er
v
ices
to
s
u
p
p
o
r
t
t
h
e
tr
ea
tm
en
t
o
f
a
n
x
iety
d
is
o
r
d
e
r
s
an
d
d
ep
r
ess
io
n
.
Alth
o
u
g
h
d
ig
ital
tech
n
o
l
o
g
y
in
m
en
tal
h
ea
lth
ca
r
e
is
in
cr
ea
s
in
g
ly
m
ass
iv
e,
th
er
e
ar
e
ch
allen
g
es
in
its
r
ea
lizatio
n
.
Peo
p
le
m
ay
n
o
t
h
av
e
en
o
u
g
h
d
ig
ital
liter
ac
y
s
o
th
at
th
eir
s
k
ills
in
tech
n
o
lo
g
y
ac
ce
s
s
ar
e
lim
ited
an
d
th
e
y
ar
e
wo
r
r
ie
d
if
th
eir
p
er
s
o
n
al
d
ata
is
d
is
s
em
in
ated
[
4
7
]
.
I
n
th
is
r
eg
a
r
d
,
s
ec
u
r
ity
a
n
d
p
r
iv
ac
y
ar
e
two
ter
m
s
th
at
a
p
p
ea
r
in
th
e
u
s
e
o
f
tech
n
o
lo
g
y
.
Priv
a
cy
r
ef
er
s
t
o
a
p
er
s
o
n
'
s
r
ig
h
t
to
d
eter
m
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n
e
wh
en
,
wh
er
e
,
a
n
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h
o
w
p
er
s
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n
al
in
f
o
r
m
ati
o
n
ca
n
b
e
ac
ce
s
s
ed
an
d
s
h
ar
e
d
b
y
o
th
er
s
.
Me
an
wh
ile,
s
ec
u
r
ity
i
s
in
ter
p
r
eted
as
th
e
lev
el
o
f
ac
ce
s
s
to
p
er
s
o
n
al
i
n
f
o
r
m
atio
n
th
at
is
r
estricte
d
an
d
allo
wed
to
ce
r
tain
p
eo
p
l
e.
E
lectr
o
n
ic
h
ea
lth
r
ec
o
r
d
s
n
ee
d
to
b
e
s
ec
u
r
ed
,
o
n
e
way
is
to
b
l
o
ck
h
ac
k
er
s
w
h
en
th
ey
en
ter
t
h
e
s
y
s
tem
s
o
t
h
at
in
f
o
r
m
atio
n
ca
n
b
e
p
r
o
tecte
d
[
4
8
]
.
E
ig
h
teen
s
tu
d
ies
an
aly
ze
d
in
t
h
e
Un
ited
States
b
r
o
u
g
h
t
u
p
t
h
r
ee
p
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ac
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d
s
ec
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ity
r
is
k
f
ac
to
r
s
in
teleh
ea
lth
p
r
ac
tices.
T
h
e
lack
o
f
p
er
s
o
n
al
s
p
ac
e
f
o
r
v
u
ln
er
a
b
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r
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p
s
an
d
th
e
d
i
f
f
icu
lty
o
f
s
h
ar
in
g
s
en
s
itiv
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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N:
2252
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8
8
0
6
Tech
n
o
lo
g
y
t
o
s
u
p
p
o
r
t m
en
ta
l h
ea
lth
a
d
o
lescen
ts
:
a
liter
a
tu
r
e
r
ev
iew
(
Lin
a
Ha
n
d
a
ya
n
i
)
51
h
ea
lth
in
f
o
r
m
atio
n
ar
e
f
ac
to
r
s
th
at
h
av
e
f
ir
s
t
b
ee
n
r
ev
ea
led
t
h
r
o
u
g
h
th
e
len
s
o
f
th
e
en
v
ir
o
n
m
en
t.
Data
s
ec
u
r
ity
is
s
u
es,
lim
i
ted
in
ter
n
et
ac
ce
s
s
,
an
d
lack
o
f
ac
ce
s
s
to
t
ec
h
n
o
lo
g
y
ar
e
th
e
tech
n
o
lo
g
ical
f
ac
to
r
s
f
o
u
n
d
.
Op
er
atio
n
al
f
a
cto
r
s
s
u
ch
as
r
e
im
b
u
r
s
em
en
t,
r
ef
u
s
al
o
f
p
ay
e
r
s
,
ac
ce
s
s
ib
ilit
y
o
f
tech
n
o
lo
g
y
,
an
d
tr
ai
n
in
g
ar
e
all
th
r
ee
r
is
k
s
.
So
m
e
o
f
th
e
ef
f
o
r
ts
th
at
ca
n
b
e
m
ad
e
to
s
u
p
p
o
r
t
b
est p
r
ac
tices a
r
e:
i
)
p
r
o
v
id
in
g
a
s
af
e
en
v
ir
o
n
m
en
t
with
g
u
ar
an
teed
av
ailab
ilit
y
an
d
s
u
itab
ilit
y
o
f
p
atien
t
lo
ca
tio
n
s
b
ef
o
r
e
an
d
d
u
r
in
g
tele
h
ea
lth
s
er
v
ices,
ii
)
en
ter
in
g
p
er
s
o
n
al
in
f
o
r
m
atio
n
o
n
ly
o
n
s
ec
u
r
e
web
s
ites
with
a
lo
ck
ico
n
in
th
e
UR
L
b
ar
wh
en
s
h
ar
in
g
in
f
o
r
m
atio
n
o
n
lin
e
,
an
d
iii
)
in
clu
d
in
g
teleh
ea
lt
h
s
er
v
ices
in
p
r
iv
ac
y
an
d
s
ec
u
r
ity
p
o
licies,
p
r
o
ce
d
u
r
es,
wo
r
k
f
lo
ws,
also
in
teg
r
ate
tele
m
ed
icin
e
in
to
p
r
iv
ac
y
p
r
ac
tice
n
o
tices
[
4
9
]
.
A
s
tu
d
y
an
aly
ze
d
d
ata
p
r
iv
ac
y
f
r
o
m
2
7
m
en
tal
h
ea
lth
ap
p
s
th
at
r
an
k
ed
to
p
o
n
th
e
Go
o
g
le
Play
Sto
r
e.
Un
n
ec
ess
ar
y
p
er
m
is
s
io
n
s
,
in
s
ec
u
r
e
cr
y
p
to
g
r
ap
h
ic
im
p
lem
e
n
tatio
n
s
,
leak
s
o
f
p
er
s
o
n
al
d
at
a
an
d
cr
ed
en
tials
in
lo
g
s
an
d
web
s
ite
r
eq
u
ests
ar
e
im
p
o
r
tan
t
d
ata
p
r
iv
ac
y
is
s
u
es
t
o
p
ay
atten
tio
n
to
,
esp
ec
ially
t
h
e
r
is
k
s
in
cr
ea
tin
g
u
s
er
p
r
o
f
iles
.
So
m
etim
es,
th
e
ap
p
d
o
esn
'
t
p
r
o
v
id
e
a
s
ec
u
r
e
m
ec
h
an
is
m
f
o
r
c
o
n
n
ec
ti
o
n
,
d
etec
tio
n
,
an
d
id
en
tific
atio
n
.
Sh
a
r
in
g
d
ata
b
etwe
en
th
ir
d
p
ar
ties
an
d
in
-
a
p
p
a
d
v
er
tis
er
s
ca
n
m
ak
e
it
e
asier
to
leak
d
ata.
Neg
ativ
e
s
tig
m
a
r
elate
d
to
m
en
tal
illn
ess
ca
n
o
cc
u
r
to
u
s
er
s
if
th
ey
v
io
late
ex
is
tin
g
p
r
iv
ac
y
.
Fo
r
ex
am
p
le,
a
u
s
er
'
s
lin
k
to
a
p
ar
ticu
lar
ap
p
m
ay
r
ev
ea
l
th
e
f
ac
t
th
at
th
e
y
ar
e
ex
p
er
ien
ci
n
g
an
x
iety
,
d
ep
r
ess
io
n
,
o
r
o
th
er
m
en
tal
h
ea
lth
d
is
o
r
d
e
r
s
th
at
m
ak
e
th
em
f
ee
l
m
o
r
e
v
u
ln
er
a
b
le
an
d
u
n
co
m
f
o
r
tab
le.
T
h
er
ef
o
r
e,
th
e
d
ev
elo
p
m
en
t
o
f
p
r
i
v
ac
y
-
f
r
ien
d
ly
ap
p
licatio
n
s
is
v
er
y
n
ec
ess
ar
y
f
o
r
d
ev
e
lo
p
er
s
/d
ev
elo
p
e
r
s
b
y
i
n
v
o
lv
i
n
g
u
s
er
s
an
d
h
ea
lth
p
r
o
f
ess
io
n
als
,
co
n
s
id
er
in
g
th
at
th
e
d
ata
r
ec
o
r
d
ed
is
q
u
ite
s
en
s
itiv
e
[
5
0
]
.
3
.
4
.
2
.
Dig
it
a
l
div
ide a
nd
a
cc
e
s
s
ib
ility
is
s
ue
s
Dig
ital
d
iv
id
e
s
tay
s
p
er
s
is
t
as
b
ig
b
ar
r
ier
m
en
tal
h
ea
lth
r
es
o
u
r
ce
s
ac
ce
s
s
in
g
f
o
r
ad
o
lescen
ts
,
m
o
s
tly
th
o
s
e
m
ar
g
i
n
alize
d
co
m
m
u
n
it
ies
f
r
o
m
.
I
n
ter
n
et
lim
ited
ac
c
ess
,
d
ig
ital
liter
ac
y
lack
in
g
,
a
n
d
f
i
n
an
cial
lim
its
ca
n
m
o
r
e
wo
r
s
en
m
e
n
tal
h
ea
lth
tr
o
u
b
les
f
o
r
in
d
iv
id
u
als
d
i
s
ad
v
an
tag
ed
alr
ea
d
y
.
Ad
d
r
ess
in
g
d
is
p
ar
ity
n
ee
d
in
ter
v
en
tio
n
s
tailo
r
ed
s
u
r
e
ac
ce
s
s
ib
ilit
y
eq
u
al
f
o
r
all,
r
eg
a
r
d
less
th
eir
tech
p
r
o
f
icien
cy
o
r
s
o
cio
ec
o
n
o
m
ic
s
tan
d
in
g
.
E
f
f
o
r
ts
n
ee
d
m
ad
e
p
r
o
v
id
e
s
u
p
p
o
r
t sy
s
tem
s
th
at
b
r
id
g
e
g
ap
b
etwe
en
ea
s
y
d
ig
ital r
eso
u
r
ce
s
ac
ce
s
s
o
r
s
an
d
n
o
n
-
ac
ce
s
s
o
r
s
.
I
n
itiativ
es
lik
e
f
r
ee
o
r
s
u
b
s
id
ized
in
ter
n
et
ac
ce
s
s
,
d
ig
ital
s
k
ills
tr
ain
in
g
s
,
an
d
cu
ltu
r
ally
awa
r
e
o
n
lin
e
s
u
p
p
o
r
t
s
er
v
ices
ca
n
allev
iate
d
ig
ital
d
i
v
id
e
a
n
d
m
a
k
e
m
e
n
tal
h
ea
lth
r
eso
u
r
ce
s
m
o
r
e
i
n
clu
s
iv
e
an
d
ac
ce
s
s
ib
le
f
o
r
a
d
o
lescen
ts
all
.
Hea
lth
in
f
o
r
m
atio
n
tech
n
o
lo
g
y
is
esti
m
ated
to
b
e
a
co
n
tr
i
b
u
to
r
t
o
m
in
im
izin
g
u
n
eq
u
al
ac
ce
s
s
to
h
ea
lth
s
er
v
ices.
Ho
wev
e
r
,
th
e
lo
n
g
-
last
in
g
f
in
a
n
cial,
s
o
cial,
an
d
ec
o
n
o
m
ic
g
a
p
h
as
m
ad
e
ce
r
tain
g
r
o
u
p
s
also
ex
p
er
ien
ce
a
d
ig
ital
d
i
v
id
e.
T
eleh
ea
lth
p
o
r
tals
,
f
o
r
e
x
am
p
le,
o
f
f
e
r
a
q
u
ick
a
n
d
ea
s
y
way
to
ac
ce
s
s
th
e
h
ea
lth
ca
r
e
s
y
s
tem
.
Ho
wev
er
,
th
e
r
esu
lts
ten
d
to
b
e
p
o
o
r
d
u
e
to
s
o
cial
f
ac
to
r
s
s
o
th
at
t
h
e
o
u
tp
u
t
o
f
h
ea
lth
s
er
v
ices
is
n
o
t
o
p
tim
al.
Po
v
er
ty
,
lo
w
liter
ac
y
,
lack
o
f
in
ter
est
o
r
m
o
tiv
atio
n
in
th
e
u
s
e
o
f
te
ch
n
o
lo
g
y
,
an
d
lack
o
f
tech
n
o
lo
g
y
av
ailab
le
f
o
r
ac
ce
s
s
ar
e
f
ac
to
r
s
th
at
af
f
ec
t
th
e
d
ig
ital
d
i
v
id
e
i
n
all
co
u
n
tr
ies
s
o
th
at
it
is
co
n
s
id
er
ed
a
g
lo
b
al
p
r
o
b
lem
.
L
ac
k
o
f
ac
ce
s
s
to
tech
n
o
lo
g
y
ca
n
o
cc
u
r
d
u
e
to
c
o
s
t,
in
a
d
eq
u
ate
b
r
o
ad
b
an
d
ac
ce
s
s
,
lack
o
f
atten
tio
n
to
u
s
er
s
with
d
is
ab
ilit
ies,
as we
l
l a
s
l
o
w
d
ev
ice
p
e
r
f
o
r
m
an
ce
[
5
1
]
.
T
h
e
s
h
if
t
in
h
u
m
an
ac
tiv
ity
p
atter
n
s
d
u
e
to
C
OVI
D
-
1
9
,
w
h
ich
is
all
-
d
ig
ital,
h
as
ac
tu
all
y
cr
ea
ted
a
g
ap
in
s
o
ciety
.
T
h
e
r
ea
s
o
n
is
,
n
o
t
ev
er
y
o
n
e
is
s
k
illed
in
ac
c
ess
in
g
tech
n
o
lo
g
y
.
I
n
th
o
s
e
wh
o
ar
e
less
s
k
illed
,
th
e
n
eg
ativ
e
im
p
ac
t
will
b
e
m
o
r
e
f
elt,
esp
ec
ially
th
o
s
e
r
elate
d
to
h
ea
lth
,
well
-
b
ein
g
,
an
d
s
o
cial
s
u
p
p
o
r
t.
I
n
s
o
m
e
ca
s
es,
g
eo
g
r
ap
h
ical
co
n
d
itio
n
s
m
ak
e
it
d
if
f
icu
lt
f
o
r
p
e
o
p
le
to
ac
ce
s
s
h
ea
lth
s
er
v
ices
an
d
p
u
b
lic
s
er
v
ices
f
r
o
m
t
h
e
g
o
v
er
n
m
en
t
to
lo
ca
l
au
th
o
r
ities
.
Peo
p
le
with
s
ev
e
r
e
m
en
tal
h
ea
lt
h
d
is
o
r
d
er
s
(
S
MI
s
)
r
ep
o
r
t
th
at
th
e
in
ter
n
et
is
to
o
d
if
f
icu
lt
an
d
co
m
p
licated
to
u
n
d
e
r
s
tan
d
b
ef
o
r
e
o
r
af
ter
th
e
p
an
d
em
ic.
A
s
tu
d
y
f
o
u
n
d
th
at
th
er
e
is
a
d
ig
ital g
ap
b
etwe
en
th
e
SMI
g
r
o
u
p
an
d
th
e
g
en
er
al
g
r
o
u
p
(
n
o
n
-
SMI
)
[
5
2
]
.
3
.
4
.
3
.
Reg
ula
t
io
n
a
nd
qu
a
lity
co
ntr
o
l
Qu
ality
co
n
tr
o
l
also
r
eg
u
latio
n
y
ea
r
cr
u
cial
p
iece
s
in
e
n
s
u
r
i
n
g
th
e
ef
f
ec
tiv
en
ess
lik
ewise
s
af
ety
with
tech
n
o
lo
g
ical
in
ter
v
en
tio
n
s
tar
g
etin
g
th
e
p
r
e
v
en
tio
n
o
f
m
en
tal
h
ea
lth
p
r
o
b
lem
s
with
in
ad
o
lescen
ts
.
R
eg
u
lato
r
y
en
titi
es
co
n
d
u
ct
a
f
u
n
d
am
e
n
tal
r
o
le
in
s
u
p
er
v
is
i
n
g
th
e
cr
ea
tio
n
an
d
ex
ec
u
tio
n
o
f
th
ese
in
v
en
tio
n
s
to
m
ain
tain
alig
n
m
e
n
t
with
in
s
titu
ted
s
tan
d
ar
d
s
an
d
g
u
id
e
lin
es.
Mo
r
eo
v
er
,
q
u
ality
co
n
t
r
o
l
ac
tio
n
s
h
elp
in
r
ec
o
g
n
izin
g
an
d
f
ix
in
g
p
o
te
n
tial
p
r
o
b
lem
s
o
r
in
ad
e
q
u
ac
ies
i
n
th
e
tech
to
b
o
o
s
t
its
to
tal
ef
f
icac
y
.
B
y
f
o
llo
win
g
s
tr
ict
r
eg
u
latio
n
s
to
g
eth
er
with
q
u
ality
co
n
tr
o
l
p
r
o
ce
d
u
r
es,
d
ev
elo
p
er
s
m
ig
h
t
in
s
till
ass
u
r
an
ce
in
b
o
th
u
s
er
s
also
h
ea
lth
ca
r
e
p
r
o
v
id
er
s
r
eg
ar
d
in
g
th
e
d
ep
e
n
d
ab
ilit
y
an
d
s
af
ety
o
f
th
ese
d
ig
ital
an
s
wer
s
.
Via
u
n
b
r
o
k
e
n
m
o
n
ito
r
in
g
also
ev
alu
atio
n
,
r
e
g
u
lato
r
y
b
o
d
ies co
u
ld
f
o
s
ter
o
n
g
o
in
g
en
h
a
n
ce
m
en
t a
n
d
in
n
o
v
atio
n
in
th
e
m
en
tal
h
ea
lth
tech
d
o
m
ai
n
,
f
in
ally
r
esu
ltin
g
in
s
u
p
er
io
r
o
u
tco
m
e
s
f
o
r
ad
o
lescen
t
d
em
o
g
r
ap
h
i
cs.
T
h
is
f
o
cu
s
o
n
r
eg
u
latio
n
also
q
u
ality
c
o
n
tr
o
l
lay
s
em
p
h
asis
o
n
th
e
n
ec
ess
ity
o
f
en
s
u
r
in
g
t
h
at
th
ese
im
p
r
o
v
em
en
ts
b
e
b
o
t
h
ev
id
en
ce
-
b
ased
an
d
et
h
ically
m
in
d
ed
[
5
3
]
.
Seein
g
th
e
o
p
p
o
r
tu
n
ities
f
o
r
d
ig
ital
tech
n
o
lo
g
y
in
m
e
n
tal
h
ea
lth
in
ter
v
en
tio
n
s
is
co
n
s
id
er
ab
le,
b
u
t
s
o
m
e
ch
allen
g
es
n
ee
d
to
b
e
u
n
d
er
lin
e
d
.
First,
th
e
g
u
a
r
an
t
ee
o
f
th
e
f
u
lf
illme
n
t
o
f
p
atien
t
in
teg
r
ity
in
t
h
e
d
ev
elo
p
m
e
n
t
a
n
d
im
p
lem
en
t
atio
n
o
f
tech
n
o
lo
g
y
.
Seco
n
d
,
in
cr
ea
s
in
g
th
e
ev
id
e
n
ce
b
ase
to
s
u
p
p
o
r
t
th
e
ef
f
ec
tiv
en
ess
o
f
d
ig
ital
-
b
ased
clin
ical
s
tu
d
ies
q
u
ick
ly
.
T
h
ir
d
,
th
e
g
u
ar
an
tee
o
f
d
ata
p
r
o
v
i
d
e
d
b
etwe
en
p
atien
ts
,
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
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:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
2
0
2
6
:
43
-
56
52
n
u
r
s
es,
an
d
d
o
cto
r
s
d
o
es
n
o
t
th
r
ea
ten
p
r
iv
ac
y
o
r
d
am
ag
e
p
u
b
lic
tr
u
s
t.
Hea
lth
ca
r
e
in
s
titu
tio
n
s
th
en
n
ee
d
a
f
r
am
ewo
r
k
t
o
ev
alu
ate
k
e
y
f
e
atu
r
es
o
f
th
e
n
ew
tech
n
o
lo
g
y
u
s
ed
in
clu
d
in
g
p
r
ac
tical
b
en
ef
its
,
co
n
ten
t,
s
af
ety
,
co
s
t,
an
d
clin
ical
ef
f
ec
tiv
en
ess
[
5
4
]
.
I
n
th
e
Un
ited
States
,
th
e
Fo
o
d
an
d
Dr
u
g
Ad
m
in
is
tr
ati
o
n
(
FDA)
to
g
eth
er
with
th
e
Fed
er
al
T
r
ad
e
C
o
m
m
is
s
io
n
(
FTC)
s
u
p
er
v
is
es
an
d
r
eg
u
lates
ap
p
licatio
n
s
d
esig
n
ed
to
tr
ea
t
m
en
tal
h
ea
lth
d
is
o
r
d
er
s
in
th
e
ea
r
ly
s
tag
es
b
ef
o
r
e
th
ey
ar
e
co
n
s
u
m
ed
b
y
th
e
p
u
b
lic.
T
h
is
is
in
ten
d
ed
s
o
th
at
th
e
d
iag
n
o
s
is
o
r
r
ec
o
m
m
en
d
atio
n
p
r
o
v
id
e
d
d
o
es n
o
t
m
is
lead
u
s
e
r
s
[
5
5
]
.
A
s
tu
d
y
p
r
o
v
id
es
r
ec
o
m
m
en
d
atio
n
s
to
p
r
esen
t
a
r
o
ad
m
ap
o
f
th
e
s
y
s
tem
r
e
q
u
ir
em
e
n
ts
a
n
d
p
o
licies
n
ee
d
ed
i
n
d
ig
ital
-
b
ased
m
e
n
tal
h
ea
lth
s
er
v
ices.
T
h
is
d
ep
ar
ts
f
r
o
m
th
e
C
OVI
D
-
1
9
p
an
d
em
ic
wh
ich
n
ec
ess
itates
d
ig
ital
m
en
tal
h
ea
lth
in
ter
v
en
tio
n
s
as
a
r
o
u
tin
e
p
ar
t
o
f
th
e
h
ea
lth
ca
r
e
s
y
s
tem
.
T
r
ain
in
g
,
licen
s
in
g
,
s
af
ety
,
p
r
iv
ac
y
,
p
ay
m
en
ts
,
an
d
ev
alu
atio
n
s
ar
e
in
d
icato
r
s
th
at
ca
n
h
elp
in
cr
ea
s
e
th
e
ef
f
ec
tiv
en
ess
o
f
th
ese
m
en
tal
h
ea
lth
in
ter
v
en
tio
n
s
.
I
n
n
o
v
ativ
e
d
ig
ital
p
r
ac
tices
s
u
ch
as
th
e
p
h
ased
ca
r
e
m
o
d
el
an
d
th
e
p
r
o
v
is
io
n
o
f
p
r
ev
en
tiv
e
an
d
s
elf
-
m
an
ag
e
m
en
t
s
er
v
ices
o
u
ts
id
e
o
f
clin
ical
s
er
v
ices
in
to
th
e
h
ea
lth
ca
r
e
s
y
s
tem
ar
e
lo
n
g
-
ter
m
g
o
als th
at
n
ee
d
atten
tio
n
[
5
6
]
.
3
.
4
.
4
.
E
t
hica
l
us
e
o
f
t
ec
hn
o
lo
g
y
in m
ent
a
l hea
lt
h c
a
re
Ad
d
itio
n
ally
,
im
p
e
r
ativ
e
atten
d
an
ce
at
eth
ical
p
o
n
d
e
r
in
g
s
en
v
elo
p
in
g
tech
n
o
lo
g
y
'
s
u
til
izatio
n
in
y
o
u
th
f
u
l
m
en
tal
h
ea
lth
m
ain
t
en
an
ce
is
p
ar
am
o
u
n
t.
T
ec
h
n
o
lo
g
ical
f
o
r
er
u
n
n
i
n
g
m
ay
am
p
lify
r
eso
u
r
ce
an
d
s
u
p
p
o
r
t
ac
ce
s
s
in
m
e
n
tal
h
ea
lth
r
ea
lm
s
,
y
et
r
is
k
s
lo
o
m
r
eq
u
ir
in
g
m
eticu
lo
u
s
o
v
er
s
ig
h
t.
Priv
ac
y
,
co
n
f
id
en
tiality
a
n
x
iety
,
d
ata
s
ec
u
r
ity
,
an
d
alg
o
r
ith
m
ic
b
ias
o
d
d
s
s
tan
d
am
o
n
g
s
t
ca
r
d
in
al
e
th
ical
p
r
ed
icam
en
ts
d
eser
v
in
g
r
ig
o
r
o
u
s
r
ed
r
ess
.
T
h
u
s
,
d
e
m
an
d
ar
is
es
f
o
r
c
o
n
jo
in
t
ef
f
o
r
ts
o
f
m
en
tal
h
ea
lth
cu
s
to
d
ian
s
an
d
tech
n
o
lo
g
y
ar
c
h
itects
to
u
p
h
o
ld
eth
ics
d
u
r
i
n
g
tech
d
esig
n
a
n
d
en
ac
tm
e
n
t
with
in
m
e
n
tal
h
ea
lth
m
ain
ten
an
ce
.
Ad
d
in
g
to
th
is
n
ec
ess
ity
,
ac
q
u
ir
in
g
in
f
o
r
m
e
d
co
n
s
en
t
alo
n
g
s
id
e
elu
cid
ato
r
y
c
o
m
m
u
n
icatio
n
with
y
o
u
t
h
s
o
n
tech
n
o
lo
g
y
em
p
l
o
y
m
en
t
in
t
h
eir
m
en
tal
th
e
r
ap
y
r
em
ain
s
cr
u
cial
to
p
r
eser
v
e
tr
u
s
t
leap
s
an
d
tr
an
s
p
ar
e
n
cy
ch
asm
s
with
in
th
er
a
p
eu
tic
t
ies
[
5
7
]
.
E
lev
atin
g
et
h
ical
m
ed
itatio
n
s
p
er
m
its
tech
n
o
l
o
g
y
'
s
b
o
o
n
s
wh
ile
p
r
eser
v
in
g
a
d
o
lescen
t m
en
tal
welln
ess
asp
ir
atio
n
s
an
d
s
ee
k
in
g
s
u
p
p
o
r
tiv
e
m
ea
s
u
r
es.
On
e
o
f
th
e
tec
h
n
o
lo
g
ies
th
at
ca
n
b
e
u
s
ed
to
ass
ess
th
e
m
en
tal
h
ea
lth
co
n
d
itio
n
o
f
in
d
iv
id
u
als
is
v
ir
tu
al
r
ea
lity
(
VR
)
.
T
h
is
tech
n
o
lo
g
y
elicits
p
s
y
ch
o
lo
g
ical
a
n
d
p
h
y
s
io
lo
g
ical
r
ea
ctio
n
s
s
im
ilar
to
th
eir
o
r
ig
i
n
al
(
r
ea
l
-
wo
r
ld
)
en
v
ir
o
n
m
en
t.
VR
ca
n
also
ex
p
a
n
d
th
e
r
an
g
e
o
f
ass
ess
m
en
ts
o
u
ts
id
e
th
e
cli
n
ic
an
d
lab
o
r
ato
r
y
.
I
m
m
er
s
iv
e
VR
is
u
s
ed
with
a
h
ea
d
-
m
o
u
n
ted
e
n
clo
s
ed
d
ev
i
ce
(
HM
D)
th
at
will
d
is
p
lay
a
th
r
ee
-
d
im
en
s
io
n
al
im
ag
e
o
n
th
e
s
cr
ee
n
s
o
th
at
t
h
e
in
d
iv
id
u
al
will
b
e
in
a
v
ir
t
u
al
en
v
ir
o
n
m
en
t.
T
h
is
ab
ilit
y
to
m
an
ip
u
late
ca
n
im
p
r
o
v
e
m
eth
o
d
o
lo
g
ical
r
ig
o
r
as
well
as
ac
cu
r
ate
ju
d
g
m
en
t
o
f
in
d
iv
id
u
als.
T
h
e
r
esu
lts
o
f
t
h
e
u
s
e
o
f
VR
s
o
f
ar
ar
e
d
iv
id
ed
i
n
to
th
r
ee
m
ai
n
a
r
ea
s
,
n
am
ely
s
o
cial
f
u
n
ctio
n
,
co
g
n
itio
n
,
a
n
d
s
y
m
p
to
m
ato
l
o
g
y
.
E
y
e
g
az
e,
th
e
d
is
tan
ce
o
f
th
e
in
d
i
v
id
u
al
f
r
o
m
th
e
VR
av
atar
,
an
d
th
e
r
e
co
r
d
er
'
s
r
esp
o
n
s
e
to
s
im
u
late
d
s
o
cial
s
itu
atio
n
s
b
ec
o
m
e
in
d
icato
r
s
o
f
s
o
cial
f
u
n
ctio
n
in
g
.
Ma
ze
n
av
i
g
atio
n
an
d
atten
tio
n
task
s
as
s
es
s
ed
m
em
o
r
y
an
d
ex
ec
u
tiv
e
f
u
n
ctio
n
as
th
e
f
ir
s
t
o
u
tco
m
es
in
th
e
co
g
n
itio
n
s
ec
tio
n
VR
p
r
o
g
r
a
m
.
Fin
ally
,
s
y
m
p
to
m
s
o
f
m
en
tal
d
is
o
r
d
e
r
s
s
u
ch
as
p
ar
an
o
id
id
ea
s
,
d
elu
s
i
o
n
s
,
au
d
ito
r
y
h
allu
cin
atio
n
s
,
ea
tin
g
d
is
o
r
d
er
s
,
ad
d
ictio
n
s
,
an
d
p
h
o
b
ias
ar
e
th
e
ass
es
s
m
en
t o
u
tp
u
ts
in
th
e
a
r
ea
o
f
s
y
m
p
to
m
ato
lo
g
y
[
5
8
]
.
I
n
ad
d
itio
n
to
VR
,
ar
tific
ial
in
tellig
en
ce
(
AI
)
ch
atb
o
ts
s
u
ch
as C
h
atG
PT
ca
n
also
h
elp
p
s
y
c
h
iatr
is
ts
in
co
m
p
letin
g
m
ed
ical
r
ec
o
r
d
s
,
b
r
id
g
in
g
b
etwe
en
d
o
cto
r
s
an
d
p
atie
n
ts
,
p
er
f
ec
tin
g
ac
a
d
em
ic
wr
itin
g
o
r
p
r
esen
tatio
n
s
,
an
d
a
n
aly
zin
g
r
esear
ch
d
ata.
Ho
wev
er
,
a
p
s
y
ch
o
th
er
ap
y
s
y
s
tem
in
th
e
u
s
e
o
f
ch
atb
o
ts
m
u
s
t
b
e
d
ev
elo
p
e
d
.
T
h
e
i
n
co
r
p
o
r
atio
n
o
f
em
p
at
h
y
,
em
o
tio
n
r
e
co
g
n
i
tio
n
,
p
er
s
o
n
ality
r
ec
o
g
n
itio
n
,
an
d
ea
r
ly
d
etec
tio
n
o
f
m
en
tal
h
ea
lth
war
n
in
g
s
ar
e
th
e
m
ain
p
o
in
ts
.
Pra
ctica
l
'
r
ea
l
-
wo
r
ld
'
in
p
u
t
in
teg
r
atio
n
,
a
d
ev
ice
-
f
r
ien
d
ly
AI
u
s
er
an
d
p
atien
t
-
f
r
ien
d
ly
in
t
er
f
ac
e
m
u
s
t
p
ass
th
r
o
u
g
h
cl
in
ically
v
alid
ated
alg
o
r
ith
m
s
,
v
o
ice
g
en
er
atio
n
m
o
d
u
les,
as
well
as
em
o
tio
n
al
d
is
cr
im
in
atio
n
alg
o
r
ith
m
s
f
r
o
m
f
ac
ial
ex
p
r
ess
io
n
s
an
d
o
th
er
p
h
y
s
io
lo
g
ical
in
p
u
ts
.
Alth
o
u
g
h
t
h
er
e
ar
e
o
p
p
o
r
tu
n
ities
in
th
e
f
ield
o
f
m
e
n
tal
h
ea
lth
,
it
is
im
p
o
r
tan
t
to
estab
lis
h
g
en
er
ally
ac
ce
p
ted
C
h
atGPT
eth
ical
s
tan
d
ar
d
s
[
5
9
]
.
4.
CO
NCLU
SI
O
N
T
o
s
u
m
u
p
,
th
e
u
s
e
o
f
tech
i
n
p
r
ev
en
tativ
e
s
tep
s
f
o
r
teen
m
e
n
tal
h
ea
lth
is
s
u
es
s
h
o
ws
p
r
o
m
is
in
g
ar
ea
s
f
o
r
ac
tio
n
.
C
h
ec
k
in
g
o
u
t
d
if
f
e
r
en
t
d
ig
ital
to
o
ls
lik
e
ap
p
s
,
v
i
r
tu
al
r
ea
lity
s
tu
f
f
,
an
d
o
n
lin
e
th
er
ap
y
p
latf
o
r
m
s
,
s
h
o
ws
b
ig
p
o
ten
tial
to
r
ea
ch
m
o
r
e
p
eo
p
le
an
d
g
iv
e
p
er
s
o
n
alize
d
h
elp
th
at'
s
h
an
d
y
an
d
ea
s
ily
av
ailab
le
f
o
r
teen
s
.
B
u
t
ev
en
th
o
u
g
h
tech
n
o
lo
g
y
g
iv
es
m
an
y
g
o
o
d
th
in
g
s
,
it
m
u
s
t
b
e
u
s
ed
ca
r
ef
u
lly
an
d
p
r
o
p
er
ly
f
o
r
it
to
wo
r
k
well
an
d
tack
le
wo
r
r
ies
ab
o
u
t
d
ata
p
r
iv
ac
y
an
d
o
n
lin
e
s
af
ety
.
Als
o
,
s
tu
d
ies
in
th
e
f
u
t
u
r
e
n
ee
d
to
l
o
o
k
at
th
e
lo
n
g
-
ter
m
r
esu
lts
an
d
ef
f
ec
tiv
en
ess
o
f
th
ese
tech
s
o
l
u
tio
n
s
,
u
s
in
g
s
tr
ict
s
tu
d
y
d
e
s
ig
n
s
an
d
wo
r
k
in
g
to
g
eth
er
with
p
eo
p
le
in
th
e
m
en
tal
h
ea
lth
f
ield
to
m
ak
e
th
e
m
f
it
in
to
h
ea
lth
ca
r
e
s
y
s
tem
s
b
etter
.
As
tech
k
ee
p
s
m
o
v
in
g
f
o
r
war
d
,
it
is
im
p
o
r
tan
t
to
u
s
e
its
p
o
wer
to
b
o
o
s
t
m
en
tal
h
ea
lth
an
d
to
u
g
h
n
ess
in
teen
s
,
h
elp
in
g
cr
ea
te
a
h
ea
lth
ier
an
d
to
u
g
h
er
f
u
tu
r
e
g
en
er
atio
n
.
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