Digital mental health: challenges and next steps

Abstract

Digital innovations in mental health offer great potential, but present unique challenges. Using a consensus development panel approach, an expert, international, cross-disciplinary panel met to provide a framework to conceptualise digital mental health innovations, research into mechanisms and effectiveness and approaches for clinical implementation. Key questions and outputs from the group were agreed by consensus, and are presented and discussed in the text and supported by case examples in an accompanying appendix. A number of key themes emerged. (1) Digital approaches may work best across traditional diagnostic systems: we do not have effective ontologies of mental illness and transdiagnostic/symptom-based approaches may be more fruitful. (2) Approaches in clinical implementation of digital tools/interventions need to be creative and require organisational change: not only do clinicians and patients need training and education to be more confident and skilled in using digital technologies to support shared care decision-making, but traditional roles need to be extended, with clinicians working alongside digital navigators and non-clinicians who are delivering protocolised treatments. (3) Designing appropriate studies to measure the effectiveness of implementation is also key: including digital data raises unique ethical issues, and measurement of potential harms is only just beginning. (4) Accessibility and codesign are needed to ensure innovations are long lasting. (5) Standardised guidelines for reporting would ensure effective synthesis of the evidence to inform clinical implementation. COVID-19 and the transition to virtual consultations have shown us the potential for digital innovations to improve access and quality of care in mental health: now is the ideal time to act.

From alcohol detoxification to treatment: A qualitative interview study on perceived barriers and assessed potential of mHealth among individuals postdetoxification.

“…Existing literature has argued that mHealth interventions may address the prevalent treatment barrier of service users' preference for self-help, yet such assertions have mostly been based on indirect and hypothetical accounts (Smith et al, 2023). This study not only This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

“…Existing literature has argued that mHealth interventions may address the prevalent treatment barrier of service users’ preference for self-help, yet such assertions have mostly been based on indirect and hypothetical accounts (Smith et al, 2023). This study not only anchors such statements in empirical data but also expands upon them by providing novel insights into the diverse and nuanced reasons why potential service users anticipate benefitting from the self-directed approaches facilitated by mHealth.…”

A survey of autonomous monitoring systems in mental health

“…Ecological momentary assessment (EMA) is a form of real-time, repeated evaluation that can be facilitated by the use of a smartphone to obtain a more precise picture of a person's sensations, symptoms, and behaviors (Baryshnikov et al, 2023).The use of a smartphone or other digital mental health therapies has shown preliminary promise in reducing depressive and anxious symptoms, suggesting overall improvement in mental health (Donker et al, 2013;Firth et al, 2017;Torous et al, 2018). Critical to this is alignment of developer's efforts with patient needs and the need to integrate these innovations into clinical service delivery (D'Alfonso, 2020; Kruzan et al, 2023;Smith et al, 2023).…”

Digital Mental Health for Schizophrenia and Other Severe Mental Illnesses: An International Consensus on Current Challenges and Potential Solutions

“…These innovations allow patients to undertake a variety of clinically relevant tasks (such as self-monitoring or therapy tasks) outside the in-person clinical encounter. This can be completed independently or with the support of digital navigators or technicians [ 6 ] and could reduce the need for specialist clinician support. However, despite their potential, these approaches are mostly still in development and have often proved to be challenging to implement in real-world clinical and community settings [ 6 ].…”

“…This can be completed independently or with the support of digital navigators or technicians [ 6 ] and could reduce the need for specialist clinician support. However, despite their potential, these approaches are mostly still in development and have often proved to be challenging to implement in real-world clinical and community settings [ 6 ].…”