My View: Digital mental health - fringe innovation or integral part of care pathways

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

Pressures on mental health and addiction services are mounting globally, as existing systems struggle to meet the rising demands for services. This issue is exacerbated even further by difficulties in recruiting and retaining mental health professionals. Increasingly, people are turning online to seek information, self-help, self-management options and mental health support services.

However, the landscape for the commissioners for healthcare systems is not an easy one. According to research conducted by the Organisation for the Review and Care of Health Apps (ORCHA), over 350,000 digital health solutions are out there on the market, but only one-third of them are deemed safe and effective. This begs the question: How do we make sure every individual is recommended the right solutions?

Traditionally mental health services have been procured in silos, such as primary care, hospital-based services, or health promotion. A siloed approach is simply not scalable enough to meet the current demand and fails to provide the seamless and integrated experience that many people have come to expect.

Practical insights
More than 5 million people around the world are downloading a digital health solution every single day. A significant portion of today's health consumers have already transitioned and actively engage with digital health solutions. This prompts us to consider how we can guarantee the successful integration of these solutions into mainstream healthcare, specifically tailored to the populations we serve.

For that, we need to understand how digital mental health fits into the broader ecosystem of care pathways, including the wellbeing sector, primary care, secondary care, public health, and broader population mental health approaches.

To get it right, we must also take note of the emerging international best practices in the digital mental health domain, including policy, strategy, accreditation, activation, integration, and interoperability.

Leading examples
Many countries have proactively begun integrating digital mental health solutions into their national systems of mental health and psychosocial support services. They are also actively exploring innovative online solutions to bridge gaps in capacity and improve access to services and support.

There are so many best practice implementation exemplars from around the world. Notable among them are the digital mental health standards in Australia, the Mental Health Apps Accreditation Framework led by the Mental Health Commission of Canada, and Bridge the Gapp—an eMental Health Strategy implemented by the Government of Newfoundland and Labrador's Department of Health and Community Services.

Equally compelling initiatives are currently being undertaken by England, Singapore, Scotland, and Denmark, and Ireland is set to publish their National Digital Mental Health Plan during the 9th eMental Health International Congress in Ottawa, Canada in September 2024.

Adding to the momentum, I have been invited by the US Federal Health Agency National Association of the State Mental Health Program Directors (NASMHPD) to deliver a keynote address to 50 State Mental Health Commissioners in Washington DC on July 30, 2023, which reflects the proactive efforts of major nations in investing resources towards getting digital mental health right for the consumers.

International initiatives and opportunities
In May 2023 eMHIC and the Asia-Pacific Economic Cooperation Digital Hub for Mental Health have formally agreed to align their respective organisations to strengthen each other’s strategic aims and objectives.

This Digital Hub serves as the central coordinating centre for APEC's mental health initiatives, facilitating collaboration among government, public, and private sectors. Its primary objective is to foster the sharing, development, scaling up, and evaluation of innovative evidence- and practice-based programs for mental health.

In 2021, eMHIC made a significant contribution by publishing an Ethics and Law Position Statement for Digital Mental Health. This statement has received endorsement and adoption by UNICEF, informing the implementation of their digital mental health initiatives in Low to Middle Income countries.

Coming back to home ground, the Ministry of Health published New Zealand’s eMental Health Framework, commonly known as the Digital Mental Health and Addiction Toolkit (DMHAT) in 2019.

We have made humble beginnings. Rather than reinventing the wheel, our focus should be on investing in the activation of DMHAT. We have an amazing opportunity in front of us as a nation to get the implementation of digital mental health into care pathways right by design.

Picture: Anil Thapliyal, executive director, eMental Health International Collaborative

If you want to contact eHealthNews.nz regarding this View, please contact the editor Rebecca McBeth.

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