In an increasingly digital world, individuals continue to turn to digital tools to address a wide range of challenges and concerns. Whether it’s managing daily tasks, seeking information, or connecting with others, the integration of technology into our lives has become pervasive.
Nowhere is this more evident than in the realm of mental health solutions. As society grapples with the complexities of modern life, the trends in mental health solutions are adapting and evolving in tandem with digital technology. These trends are marked by promising developments that hold the potential to revolutionize how we approach mental health care and support in the coming years. Below are my four key trends to watch in shaping the future of mental health treatment and support, offering new avenues for accessibility, convenience and effectiveness.
Red Hot Growth of EMDR-Based Apps
Eye movement desensitization and reprocessing (EMDR) is a therapeutic technique for addressing trauma and other mental illnesses. Right now, demand for EMDR is at an all-time high and is expected to increase. Google searches for the term “EMDR” have doubled over the past two years, whereas other generic searches for therapy are roughly the same over the same period.
There is a new wave of understanding of how trauma can have an impact on anxiety, depression or other life experiences. Many people are starting to realize that some of their experiences would be considered trauma to a mental health professional and are wanting to address this with a technique that helps achieve a state of readiness toward peaceful resolution.
New awareness of trauma-informed care has led to an intense demand for EMDR therapy. Mental health professionals feel that EMDR is very effective, and whenever there is a spike in demand, the market seems to try to capitalize on the sudden wave of interest with new apps.
A search on Apple’s app store reveals more than 20 apps which claim to assist with self-administered EMDR. But are there dangers to self-administering EMDR?
Training for EMDR is very complex for a seasoned therapist. To attempt to do EMDR on your own may give a false impression of the lack of efficacy of EMDR since it is not the way that EMDR was initially designed. Thus, the harm from such apps would be indirect as they would cause patients to miss out on an opportunity for more effective therapist-led EMDR. But the EMDR apps could help some with mild cases seeking treatment for trauma-informed care.
Keep on the lookout for more EMDR apps throughout 2023.
Tapered Expectations of Artificial Intelligence and Genetic Testing
I don’t believe that we are going to see significant advances with AI in mental health during the remainder of 2023. AI as a stand-alone therapy entity is going to throttle back for a while. I don’t think we are ready for an AI bot as a full-fledged therapy option. There is a growing trend toward a consumer desire for digital media to convey closeness, warmth and transparency. TikTok is driving this movement with raw, unadulterated, soul-bearing confessionals from laypersons, professionals and celebrities on mental health topics. This is the opposite of what a bot could provide right now.
AI may take a stronger foothold into the back engine of EHR systems. For example, a bot could aid clinicians with the process of handling patient messages in a patient health portal. Many patient messages pertain to rescheduling appointments and refilling medications. This could be detected by a bot, and next steps could be queued up for a clinician to review and approve more quickly.
Similarly, genetic testing had caught much momentum in 2020-2021, but there has been a better understanding that genetic testing does not reveal as much actionable information as originally expected.
For example, genetic testing may yield results about a certain individual’s metabolism rates of some medications. However, the metabolism rates may be classified as “intermediate,” which leaves the patient and clinician with an equivocal decision-making tool. Furthermore, some patients may have significant side effects from a medication they are a poor metabolizer of, and vice versa, making genetic testing not as informative as one hoped.
This trend reflects my clinical experiences where fewer and fewer patients are asking for genetic testing compared to two years ago.
Cooling Off of Venture Capital-Backed Mental Health Platforms
Venture capital-backed mental health platforms have seen explosive growth over the past two years. Driven by money-making potential, overall investments in U.S.-based digital startups doubled from $14.9 billion in 2020 to $29.1 billion in 2021. In the midst of polished marketing campaigns, negative press is starting to catch up, and some are under federal investigation for prescribing practices.
I am “all-in” for increased access to care and lowering of costs for patients. I also feel that VC-backed apps do good for the reduction of stigma and overall normalization of mental health treatment. They also help some mental health clinicians obtain jobs in the field, which helps
match supply and demand in a way that is a benefit to society.
But despite certain advantages offered, pressure within these companies to increase profitability for their investors is at odds with quality patient care, and I predict we will see more negative press with these companies. Why?
In private group discussions on social media among therapists, psychologists and psychiatrists, there are more frequent aspersions about their various unethical business practices, such as selling patient information to business partners, recruiting tactics, and perfunctory prescribing of controlled substances. The negative reputation among mental health professionals will lead to increased turnover at these businesses and overall worsen patient care.
The average consumer is becoming better informed when assessing the landscape of treatment options. Consumers are more savvy when reading reviews and trying to find the best recommendations for therapy. A quick google search will reveal waves of online chatter about bait-and-switch recruitment practices and therapists who feel they are risking their licenses to remain in compliance with corporate strategies.
Here are some problems with treating mental health therapy as a tech investment:
- Privacy policies for VC-backed firms reveal they share personal information with insurance companies and “business partners,” which can include a multitude of companies.
- VC-backed mental health platforms are incentivized to keep patients in therapy and normalize the concept of lifelong therapy.
- VC-backed prescribers and therapists are pressured to maintain high patient loads, which draws focus away from quality improvement, education and evidence-based approaches.
- Low employee satisfaction with this profit-driven business model leads to high attrition rates and, in turn, poor quality care.
Indeed, there are advantages to normalizing the seeking of mental health treatment, but one must wonder if these business practices will lead to increased regulation of this space and an overall negative impact on the field.
Previously considered a fringe treatment option, psychedelic-assisted therapy is becoming much more commonly sought and will continue to become more mainstream. Psychedelic experiences are being discussed on podcasts and eye-catching documentaries on Netflix, fueling the hype. Public consensus of acceptance of such alternative treatment options is also driving much-needed research studies on effectiveness. Psychedelics, such as ketamine, MDMA, psilocybin and ibogaine, have now burst onto the scene and into our conscious awareness.
Psychedelic-assisted psychotherapy (PAP) involves the use of a small amount of a hallucinogen to facilitate the creation of a mindset of unparalleled openness to alternative perspectives on long-held beliefs and an actual biologic creation of new neuronal pathways. PAP is most commonly used with the treatment of PTSD but is also studied and used clinically for treatment resistant depression, OCD and certain addiction disorders.
In 2022, there were 41 search results on PubMed pertaining to PAP, whereas in 2019 there were just eight. More research studies showing effectiveness on par with, or exceeding, traditional therapies combined with the public demand will make PAP a trend to continue to watch throughout the remainder of 2023.
Of course, as with most problems we encounter, many are turning toward digital tools for a solution. While telehealth exploded in popularity in 2022 due to the pandemic, I do expect that these modalities of care that involve human interaction will continue to rise, such as EMDR, psychedelic-assisted therapy, and virtual reality. I believe that the trend on social media toward transparency and closeness will yield an overall net draw away from “hands-off” mental health apps. I also think that VC-backed mental health giants will start to lose their luster (although this may be offset by aggressive marketing campaigns), prompting spinoffs of “small feeling” services that focus more on engagement and interactions.
As first seen in Health IT Answers.
Dr. Bruce Bassi
Dr. Bruce Bassi is an advisory board member of CharmHealth, physician, double board-certified in general (adult) and addiction psychiatry and is the founder and medical director of TelePsychHealth, which provides virtual mental health treatment across the United States and is based in Jacksonville, Florida. He earned a master's degree in biomedical engineering from Columbia University and subsequently graduated from medical school at the University of Michigan. He completed psychiatry residency at the University of Florida and his addiction psychiatry fellowship at Northwestern University. He enjoys writing and lecturing on the use of technology in medicine to increase clinician efficiency and enhance patient care. His clinical interests are treating addiction and sleep disorders.