Digital mental health: challenges and next steps

Summary & key facts

An international group of experts used a consensus process to map how digital tools can help mental health care. They agreed on five main themes: use symptom-focused approaches rather than only traditional diagnoses; change how services are organised and give clinicians and patients training; study how digital tools are put into practice and watch for harms; build accessible tools with people who will use them; and set standard reporting rules so evidence can be combined. The group said the COVID-19 shift to virtual care showed the chances and timing to act now, and they gave case examples in an appendix.

Key facts:

• An expert, international, cross-disciplinary panel met and used a consensus development panel approach to produce the framework and outputs.
• The panel identified five key themes for digital mental health: transdiagnostic/symptom-focused approaches; organisational change and new roles for implementation; study designs and ethical issues for digital data; accessibility and co-desi
• The group said digital approaches may work better across traditional diagnostic systems and suggested transdiagnostic or symptom-based approaches could be more useful than existing diagnostic categories.
• Clinical implementation needs organisational change, including training for clinicians and patients, and new roles such as digital navigators and non-clinicians delivering protocolised treatments.
• Designing studies to measure implementation effectiveness is crucial; the paper notes that measurement of potential harms from digital data and interventions is only just beginning.
• The authors recommend accessibility and co-design with users to make digital innovations lasting, and call for standardised reporting guidelines to allow effective evidence synthesis.
• The paper notes that the COVID-19 pandemic and the move to virtual consultations highlighted both the potential to improve access and the urgency to act on digital mental health innovations.

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.

Topics

Digital Mental Health Interventions Mental Health and Psychiatry Telemedicine and Telehealth Implementation

Categories

Applied Psychology Psychology Social Sciences

Tags

Computer science Computer security Digital health Epistemology Health care Key (lock) Knowledge management Law Medical education Medicine Mental health Mental illness Nursing Philosophy Political science Psychiatry Psychological intervention Psychology Quality (philosophy)

Conditions & symptoms

Anxiety Depression Anxiety or worry Poor sleep Sadness or low mood