As you read this week’s blog, you may be at home, hunkered down as the World deals with the COVID-19 pandemic. It is a rare moment when the globe is united in a singular experience. Many digital mental health apps have made all their content free, or they have created COVID specific content to help people cope with stress and anxiety.
Digital mental health has an opportunity to meet needs in this unprecedented moment. People are home, grappling with illness, sudden income loss, home-schooling their children and keeping safe. How will these tools be embedded into healthcare and what are the considerations for implementation and scaling to ensure success?
A paper by Dr John Torous, from Beth Isreal Deaconess at Harvard and colleagues published in the Journal of Medical Internet Research Mental Health discusses issues of access, quality and scalability in the times of COVID-19. Health systems globally are building out telehealth and digital health capabilities whose benefits are manifold. It allows patients to access care from their clinical team via video or phone-based appointments, and it enables care teams to address non-COVID related health issues, like ongoing management of chronic conditions. Layering on apps to support people through these times is also a pursuit. The authors reflect that while we are all involved in flattening the curve, where digital health is concerned, we must also “accelerate and bend the curve” of deployment.
In the past two years, the quality of digital mental health apps has improved, but the evidence base is still limited. This evolution, coupled with the relaxation of rules governing telehealth on March 17, 2020, creates an opportunity for acceleration. To fully meet this moment, due consideration should be given to developing a more robust evidence-base for digital mental health, that moves beyond wait-list control groups toward a deeper understanding of where these tools can add value on the care continuum.
Training the mental health care workforce on matching their patients to an app that can support them is also imperative. Implementation research to date has shown a lack of confidence from providers about how these tools might help and adding them to an already full workflow seems daunting. The majority of digital devices have been created for English speaking populations; this limits their application in the very diverse USA and has built-in inequity that amplifies current flaws in our fragmented health care systems. The table below illustrates the curve that is now accelerating due to the current pandemic.
Accelerating digital mental health will require fundings for developing research, policy, reimbursement, training and social justice dimensions to how this pandemic is altering the practice of psychiatry. If we are to take the gains in learning from this challenging moment in time, we must be planful about how we harvest and accelerate together.
Thanks for reading – Trina
(Opinions are my own)
Torous J, Jän Myrick K, Rauseo-Ricupero N, Firth J. Digital Mental Health and COVID-19: Using Technology Today to Accelerate the Curve on Access and Quality Tomorrow JMIR Ment Health 2020;7(3):e18848 DOI: 10.2196/18848