Ensuring the quality of digital mental health

"Despite substantial research advances showing what can be done to prevent and treat mental disorders and to promote mental health, translation into real-world effects has been painfully slow. The global burden of disease attributable to mental disorders has risen inexorably in all countries in the context of major demographic, environmental, and socio-political transitions… new opportunities should be embraced, including those offered by the innovative use of digital technologies to deliver a range of mental health interventions."

This quote, from the Lancet Commission on Global Mental Health, sheds light on the dire state of mental healthcare throughout the world and speaks to the urgency of addressing shortcomings with no delay. Sadly, the report is not describing the world we currently inhabit under the umbra of Covid-19; it was written in 2018.

Since its release, the situation has only deteriorated with the impacts of the Covid-19 pandemic on mental health. Now, even more so than prior to Covid-19, the global mental health community must look to innovative solutions to curtail the 'second epidemic' of mental ill-health sweeping the world.

BENEFITS OF DIGITAL MENTAL HEALTH: Digital mental health solutions are proving even more beneficial than before given the fact that in-person care is exceedingly difficult to come by. And there is no shortage of available solutions: over 10,000 apps in the Apple and Google Play stores claim to treat some sort of psychological difficulty - and the list does not stop with apps.

Phones and computers are enabling consumers to access services from anywhere at all hours, as opposed to waiting for and travelling to an appointment. Wearables can measure behaviour, language, facial expressions and voice tonality, creating data sets that are unlocking deeper understanding of the day-to-day fluctuations in a person's wellbeing. Artificial intelligence, machine learning and natural language processing can make diagnostic assessments based on this data, allowing new possibilities for early intervention. Augmented and virtual reality can simulate real-life scenarios a patient might encounter. Games have been developed that can more accurately diagnose specific conditions by observing behaviour and reactions, and gamified treatments are more engaging for children and adults alike.

The benefits of digital mental health are clear: increased access and affordability, less exposure to discrimination, consumer empowerment, and data-driven feedback. Governments and insurance bodies are keen to procure these services for consumers in desperate need of innovation, but the huge variety of solutions has created a new problem - where does one begin when there are so many options? How can one separate the wheat from the chaff and ensure that the disruptive tech they are using is clinically validated, ethical and efficacious?

The need is clear, and innovators themselves are eager to 'show their work' and operate inside a framework where consumers can trust they are getting quality solutions. As Yuri Marichich, Chief Medical Officer of Pear, put it: "There's a huge opportunity here to be able to help patients if we do things right… But trust with patients is so important, trust with health care providers and also payers is so important. And you can't have trust if you are trying to circumvent doing the right thing."

THE GLOBAL GOVERNANCE TOOLKIT FOR DIGITAL MENTAL HEALTH: To address this issue, the World Economic Forum (WEF) has partnered with Deloitte to create a set of standards to vet digital mental health solutions. Building on a large body of literature and past efforts, the Global Governance Toolkit for Digital Mental Health seeks to give governments, regulators and independent assurance bodies the means to create and adapt policies that address major ethical concerns, thereby protecting and empowering consumers by enabling more informed choices about their own mental health, and encouraging the strategic growth of safe, ethical and effective digital mental health services.

Building on the Empowering 8.0 Billion Minds whitepaper, the toolkit was created by researching nearly 200 case studies of solutions that had at least 10,000 users, input from the Global Future Council on Mental Health, and a pilot run in collaboration with the New Zealand Ministry of Health's Digital Mental Health and Addiction Service.

Though the New Zealand pilot has been an excellent first step, the work is far from done: digital innovation does not recognise national borders, nor do mental illnesses. The toolkit seeks to catalyse a global approach to standards-setting that will recognise this reality and the burden shared by citizens across the world.

Stephanie Allen is Leader, Global and Australia Healthcare Sector, Deloitte. Arnaud Bernaert is Head, Shaping the Future of Health and Healthcare, World Economic Forum.

The piece is excerpted from www.weforum.org