Digital mental health: challenges and next steps.

Digital innovations in mental health offer great potential, but present unique challenges. Using a consensus development panel approach, an expert, international, cross-disciplinary panel met to provide a framework to conceptualise digital mental health innovations, research into mechanisms and effectiveness and approaches for clinical implementation. Key questions and outputs from the group were agreed by consensus, and are presented and discussed in the text and supported by case examples in an accompanying appendix. A number of key themes emerged. (1) Digital approaches may work best across traditional diagnostic systems: we do not have effective ontologies of mental illness and transdiagnostic/symptom-based approaches may be more fruitful. (2) Approaches in clinical implementation of digital tools/interventions need to be creative and require organisational change: not only do clinicians and patients need training and education to be more confident and skilled in using digital technologies to support shared care decision-making, but traditional roles need to be extended, with clinicians working alongside digital navigators and non-clinicians who are delivering protocolised treatments. (3) Designing appropriate studies to measure the effectiveness of implementation is also key: including digital data raises unique ethical issues, and measurement of potential harms is only just beginning. (4) Accessibility and codesign are needed to ensure innovations are long lasting. (5) Standardised guidelines for reporting would ensure effective synthesis of the evidence to inform clinical implementation. COVID-19 and the transition to virtual consultations have shown us the potential for digital innovations to improve access and quality of care in mental health: now is the ideal time to act.

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© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: MF-J has received support from Angelini Pharma within the past 3 years. JF has received honoraria/consultancy fees from Atheneum, Informa, Gillian Kenny Associates, Big Health, Wood for Trees, Nutritional Medicine Institute, ParachuteBH, Richmond Foundation and Nirakara, independent of this work. UWE-P has received consultant fees from Boehringer Ingelheim and lectures including travel fees from Angelini Pharma. PC has received honoraria/speaker fees from Angelini Pharma, Koa Health and Lundbeck within the past 3 years. CM has received honoraria as a consultant and/or advisor and/or for lectures from Angelini, Esteve, Exeltis, Janssen, Lundbeck, Neuraxpharm, Nuvelution, Otsuka, Pfizer, Servier and Sunovion, outside the submitted work. SM has received fees from Ethypharm, BioSerenity and Angelini Pharma. AC has received research and consultancy fees from Italian Network for Paediatric Clinical Trials (INCiPiT), CARIPLO Foundation, Lundbeck and Angelini Pharma, outside the submitted work. JT is co-founder of a mental health company called Precision Mental Wellness.