By Craig A. DeLarge, Director of Strategic Marketing at Ksana Health
The pandemic has resulted in an increase in mental health inquiries. The peer-reviewed journal, Nature, published a study reporting an analysis of eight million calls to helplines in 19 countries and regions (Brülhart, et. al 2021). The study found that call volumes jumped during the first wave of coronavirus infections. Loneliness and concerns about the pandemic drove most of the callers, rather than imminent threats such as suicidal thoughts or abuse. The study concluded that “monitoring public mental health is difficult because data are often patchy and low-frequency.” The lead author noted, “We don’t really have a great way of monitoring mental health.”
A 2021 McKinsey & Company analysis of telehealth claims as an indicator of telehealth uptake, found that across 23 healthcare specialties, psychiatry proved to have the highest penetration (50 percent), followed by substance use treatment (30 percent). Given this uptake, mental health care providers have an unprecedented opportunity to expand access to high-quality care. The American Psychological Association estimates that today there may be as many as 10,000 to 20,000 digital mental health apps in IOS and Android app stores. Popular offerings include BetterHelp, Calm, Headspace Health, Sleepio, 7Cups and Talkspace. Some of these are gaining household name status. Appetite for these tools reflects an opportunity for mental health professionals to improve access and therapeutic alliance with their clients.
This increased demand for mental health services, the rise in risk for exposure to infectious disease and the availability of tele-psychiatrist and technology solutions supply, has made remote and digital means of mental health services delivery more popular. Remote and digital means of mental health service delivery have grown in the form of teletherapy, mobile apps, virtual reality and remote monitoring. Responsible use of digital health tools is a huge opportunity to improve mental health services delivery. A Frontiers in Digital Health editorial defines, “Responsible Digital Health,” as “any intentional systematic effort designed to increase the likelihood of a digital health technology developed through ethical decision making, being socially responsible and aligned with the values and well-being of those impacted by it.” With regard to enabling practitioners with tools for monitoring and measurement to drive better health outcomes, responsible use involves accountability for effectiveness, safety, usability, security and equity in how these technologies are developed and deployed.
Practitioners’ Guidance and Oversight Remain Essential
As this opportunity emerges, many mental and behavioral health professionals are concerned about the perceived downsides of these technologies. The reality is technology will not replace behavioral health professionals. Contexts where a human behavioral health practitioner’s guidance is combined with the use of a digital mental health tool are effective for improving health outcomes. Providers who are equipped with support systems to leverage these tools will replace those who do not. Those that responsibly adopt data-driven coordinated care, will have a greater opportunity to provide superior care. This opportunity for superior care is tied to a need for greater digital mental health literacy and evidence which can improve adoption and improve treatment.
Prioritizing Virtual Care Competency Improves Care, Patient Experience
Digital health literacy involves growing provider and patient/client understanding of the many ways digital technology can be responsibly used to improve providers’ ability to improve care and outcomes along with patient access and insight. This is done through education supported by published, well-evidenced research and effective experience across word-of-mouth networks. Greater literacy smooths the path toward responsible adoption. An example of such an educational program is DOORS (Digital Outreach for Obtaining Resources & Skills), developed by The Division of Digital Psychiatry at Beth Israel Deaconess Medical Center.
Data’s Vital Role: Demonstrating Effectiveness and Safety
Digital health evidence which is growing, though this growth is occurring for a relatively small number of total offerings (Neary, 2018). The fact is that the quality of the majority of digital mental health offerings are questionable. This can be answered by a greater knowledge of, and reliance on evidence-based approaches. Digital mental health formularies, like OneMind PsyberGuide and MindApps, are playing an important role in distinguishing evidenced solutions from those who are not. They generally use the common evaluation criteria of efficacy, safety, privacy, and usability.
As health care providers and public literacy and understanding of available evidence grows we will see corresponding waves of evolving adoption from early adopters to early majority and on from there, as we have seen with so many other technologies. Though exuberant about these potentials, practitioners navigating this bright future for mental and behavioral health care delivery must continue to prioritize attention to efficacy, safety, security, usability, stigma and equity as critical to maximizing the benefits of this technology.
May we all find and play our role in moving this potential forward.
References
Brülhart, M., Klotzbücher, V., Lalive, R. et al. Mental health concerns during the COVID-19 pandemic as revealed by helpline calls. Nature 600, 121–126 (2021). https://doi.org/10.1038/s41586-021-04099-6
Neary, M., 2018, State of the Field for Mental Health Apps, Cognitive Behavioral Practice, 25(4): 531–537. doi:10.1016/j.cbpra.2018.01.002.: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584258/
Craig A. DeLarge is a digital healthcare strategist, mental health advocate & educator at The Digital Mental Health Project, where he produces education and research helping to improve the “responsible” adoption of digital technology in behavioral health services & therapies. He is additionally Director of Strategic Marketing at Ksana Health, the continuous behavioral health measurement & intervention company spun out of The University of Oregon’s Center for Digital Mental Health.
In his career, as a digital & healthcare marketer, strategist, and educator, he has worked in world-class firms like Novo Nordisk, GlaxoSmithKline, Merck & Co., Takeda, and Johnson & Johnson. He has also taught marketing, communications, leadership, and business ethics at several colleges, including Temple University, Philadelphia University, Chestnut Hill College, St. Joseph’s University, and Penn State University. His career is focused on “improving health” & “developing leaders”.
He holds bachelor’s and master’s degrees in Marketing and Design Management from Philadelphia University (USA) (BSc), and from the University of Westminster (UK) (MBA), respectively. He is currently a graduate Public Health student at King’s College, London. He is also a certified professional coach and published author of The WiseWorking Handbook (2014).
He resides in Philadelphia, PA, USA.
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