My View: Growing challenges and exciting solutions in eMental Health

VIEW - Anil Thapliyal, executive director, eMental Health International Collaborative

As 2021 is coming to a close, we have all got a story to share. Whether it be not being able to attend someone’s funeral, a wedding postponed, distance learning for schools and universities, lack of socializing, or domestic and international travel predicaments. Mental health and wellbeing challenges are commonplace, faced by us and by our loved ones.

We are not alone in this struggle. On Oct 8, 2021, The Lancet published global estimates of the impact of the pandemic on mental health. An estimated 53.2 million additional cases of major depressive disorder (an increase of 27.6%), and 76.2 million additional cases of anxiety disorders (an increase of 25.6%) were diagnosed during the COVID-19 pandemic. Locations hit hardest by the pandemic in 2020 had the highest increases in mental health diagnoses.

As a result, a spike in digital uptake is occurring across all parts of the healthcare system. ORCHA – which reviews app technology and provides libraries for healthcare professionals to recommend apps to service users – has seen those recommendations increasing by a staggering 6500%.

With so many apps on the market, a growing challenge is ensuring they are safe and effective for service users. For this reason, “accreditation” (safety and efficacy) and “activation” (implementation) were the two core pillars of the 7th annual eMental Health International Congress held on 10th, 11th and 12th November.

A rich line-up of eMental Health Experts representing Lived Experience, academia, policy and strategy, workforce, and industry from around the world discussed how to approach this new era of eMental Health. It was heartening to hear the passionate challenge laid down by Congress speakers including keynotes Liz Ashall-Payne (UK), Alex Dalton (Australia) and Prof Yuri Quintana (Harvard Medical School) on getting accreditation and activation right by design.

Some of the staggering statistics shared at the Congress are now permanently etched in my memory. These included only 30% people in need in the USA being able to access mental health services, waitlist times for in-person mental health care ranging from 1 to 3 years depending on which country you live in, around 5 million digital health downloads per day, and only 29.3% of eMental Health products globally meeting baseline quality criteria.

Despite these challenges, the Congress provided a refreshing opportunity to celebrate the many brilliant eMental Health innovations that have been implemented successfully and are working around the world.

The following are my five key highlights from the 2021 annual Congress:

Increased participation of the Lived Experience community
The 7th Annual eMental Health Congress saw a big increase in participation by Lived Experience advocates. This representation is crucial to getting solutions right. As I have said in in the past “if the eMental Health solutions don’t work for the people accessing them, their families and carers, then they don’t work at all”.

I wish to acknowledge the commendable leadership of Philip Grady, Ministry of Health; Karen Orsborn, Mental Health Wellbeing Commission; and Taimi Allan, Changing Minds for their sincere efforts in enabling the significant inclusion of people with lived experience in this year’s Congress.

Philip Grady, Acting Deputy Director General, Mental Health and Addiction, Ministry of Health officially opening the 7th Annual eMental Health International Congress.

Launch of the Position Statement on Ethics and Law for eMental Health
This year’s Congress saw the launch of the world’s first Position Statement on Ethics and Law in eMental Health. Publication of this Position Statement is a multi-country initiative under the auspices of eMHIC. It is being co-led by Dr Piers Gooding from Australia and Richman Wee from New Zealand with an active input from five other subject matter expert contributors from the USA, Singapore, Norway and Australia.

Participation and endorsement from mental health and addiction leaders
Extensive advocacy and active involvement came from mental health and addiction administrators from New Zealand, Australia, USA, Canada, Singapore, Sweden, UK, World Economic Forum and Harvard Medical School. It was great to have the personal endorsement via video of Former Congressman Patrick Kennedy, Founder of the Kennedy Forum who is a passionate eMental Health advocate. It was evident from the wide range of impassioned presentations that eMental Health is no longer a fringe innovation, but an integral part the mental health care continuum.

Former Congressman Patrick Kennedy, Founder of Kennedy Forum, speaking to Congress delegates on 11th November 2021.

Launch of the eMental Health Assessment Framework for New Zealand
New Zealand’s Ministry of Health launched their eMental Health Assessment Framework at the Congress. Referred to as the ‘Digital Mental Health and Addiction Tool (DMHAT)’ framework, it aims to help developers and vendors meet baseline standards, to deliver safe, trusted, and effective digital mental health and wellbeing solutions. The Ministry of Health also officially launched the formation of a New Zealand Collaborative for the eMental Health Assessment Framework, accessible from the eMHIC website or via the following url - https://emhf.emhicglobal.com/

eMental Health Assessment Framework (DMHAT) being presented at the Congress by Dr Arran Culver, Chief Clinical Advisor, Mental Health and Addiction, Ministry of Health, Dr Janine Bycroft, CEO, Health Navigator and Karōria Johns, Partnerships and Community Development Lead, Health Navigator

eMental Health Leadership Excellence Awards for Implementation and Global Impact
Despite the many global issues surrounding mental health, the Congress provided an opportunity to celebrate the many brilliant eMental Health innovations that have been implemented successfully in New Zealand and around the world. Uptake of eMental Health solutions has increased rapidly with 25% more people using digital solutions than before the pandemic. Six national awards for excellence in eMental Health innovation leadership were given to national winners from the USA, Canada, Sweden, UK, Australia, and New Zealand. In addition, two exemplary leaders were awarded Special Lifetime Achievement Awards for their exceptional contribution towards eMental Health domain development.

The eMHIC Board has commissioned the establishment of an eMental Health Hall of Fame to immortalise these brilliant global thought leaders. As a brief preview, the following New Zealanders were the recipients of the 2021 eMental Health Awards:

• Tane Cassidy, CEO of Health Promotion/Te Hiringa Hauora was awarded the NZ eMH National Award for 2021. The award was presented to him by Shayne Hunter, Deputy Director General, Data and Digital, Ministry of Health, New Zealand.
• Derek McCormack, Vice-Chancellor, Auckland University of Technology, received a Special Lifetime Achievement Award for “Leadership Excellence for Enabling eMental Health Domain Development Globally”. The award was presented to him by Philip Grady, Acting Deputy Director General, Mental Health and Addiction, Ministry of Health, New Zealand.
• Fran Silvestri, CEO and President, International Initiative for Mental Health Leadership, received a Special Lifetime Achievement Award for “Leadership Excellence for Fostering Collaboration Globally”. The award was presented to him by Dr Janice Wilson, CEO, Health Quality and Safety Commission. New Zealand.

You can find more about all the 2021 award winners at https://emhicglobal.com/hall-of-fame/.



Screenshot of eMHIC’s eMental Health Hall of Fame.

Other Congress highlights included the establishment of Special Interest Groups in areas such as Ethics and Law; Strategy, Policy and Standards; International Phone and Text Helplines; Workforce; The role of AI in Mental Health; criminal justice and High Performance Sports.

2021 has been an incredibly journey in every conceivable way. I am so pleased to see that the eMental Health domain is beginning to mature as a sector, but we still have a long way to go. Our ongoing challenge is ensuring that safe and effective digital solutions reach those in need at a time and place of their choosing, and that the solutions work for them.

If you would like to provide feedback on this update, please contact the editor Rebecca McBeth.

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