The U.S. healthcare system struggles to provide adequate treatment for those suffering from mental health conditions, and the number of mental health providers does not match the ever-growing need. One in five adults in the U.S. experiences some type of mental crisis each year, and one in 25 experiences a serious mental health condition. Mental health conditions account for approximately one-third of hospitalizations for those aged 18- 44 years old, and adults living with serious mental health conditions die on average 25 years earlier than others.
A significant factor in why the personal, social, and economic impact is so enormous is the challenge of accessing care for those who need it. Barriers to access include stigma, cost, and lack of in-network providers due to systemic disparities.
Digital health is a rapidly growing industry that seeks to address these and other healthcare challenges and mental health is an important and growing segment of this market. Because of the COVID-19 pandemic, clinicians have witnessed an increase in the need for scalable mental health solutions and interest, specifically, in digital solutions.
“Mental wellbeing is not a ‘nice-to-have,’ but a ‘must-have,’” said Jennifer Bruno, Vice President, Global Health Services at Johnson & Johnson. “We all need to take care of our mental health the same way we take care of our physical health, especially during this complex and unprecedented pandemic.”
Digital technologies have the potential to revolutionize mental health treatment. Resources can be used in the privacy of a person’s home or on-the-go, and many are available all day, every day, sometimes with no waiting.
Steven Schueller, Ph.D., associate professor of psychological science and informatics at the University of California, Irvine, has worked in the digital technology space for 15 years. In addition to conducting research and teaching about digital mental health, Schueller serves as executive director of One Mind PsyberGuide, a nonprofit project that evaluates digital mental health products to help people use technology to live mentally healthier lives.
Benefits of Digital Mental Health Resources: Scalability, Personalization, Convenience
Schueller’s research has made clear the yawning gap between the number of people in need of mental health services and the supply of services available. “We don’t talk often enough about the challenges of not having health providers in the right places and that’s a serious issue. I want to understand how to better reach people where they are at and provide useful mental health tools,” he said.
“In rural communities, for example, what challenges might a 17-year-old gay male face when searching for a provider to help him in his struggles while appreciating his identity?”
Studies show digital mental health interventions using web and mobile technologies have consistently demonstrated effectiveness in more than 100 randomized controlled trials conducted over two decades. Internet-cognitive behavioral therapy (I-CBT), for example, has been shown to have approximately equivalent efficacy compared to face-to-face CBT and is a safe and effective method to decrease access barriers. CBT is a scientifically backed form of psychotherapy used to treat a wide range of mental health conditions including depression and anxiety by modifying dysfunctional emotions, behaviors, and thoughts.
“When I say digital tools are not a replacement for face-to-face treatment, that is not a bad thing or good thing. Some people need in-person care; for others, digital might be better,” said Schueller. “Ultimately, It’s better to have more tools available in the marketplace so more people can get help and people can get what they want.”
Digital mental health tools also offer a convenience benefit that allows people to access services when they need them.
“Digital technologies can be used more discretely, on the go, and fit better with the schedules of busy people,” Schueller said. “Having an app, something they can use on their own time and schedule, enables them to receive care in ways that feel safe, private, and workable for them.”
The Sky’s the Limit…Yet Challenges Remain
Schueller bases his bullish projections for the future of digital mental health services on several key factors.
“Necessity is always the mother of invention. It’s not a coincidence we’ve seen a huge acceleration in the use of digital services in the past 18 months during a pandemic,” he said. “Growth was also boosted by an easing of regulations and a shift in people’s perception and comfort level as they used more digital health services more often.”
A recent survey revealed 70% of respondents aged 14-22 reported using a health app (related to stress, substance use, meditation, anxiety, etc.). The survey also showed that the more depressive symptoms a respondent exhibited the more likely they were to have used a health app.
There has also been an enormous amount of funding in this space in the past year. Venture capital investments in mental health start-ups rose 72.6% from Q1 2020 to Q1 2021, totaling $2.4 billion in 2020 and accounting for 19% of all digital health funding.
“It’s exciting to watch how the field is evolving to address the needs of different population groups and a wider array of mental health challenges,” said Schueller. “We’re seeing more digital mental health products to address the youth space and, digital products, such as Ginger or Headspace, developed to address the continuum of mental health care, starting with depression and anxiety and leading to more complex issues such as OCD or eating disorders.”
Despite considerable upside, the future of digital mental health does not come without challenges. The biggest challenge is in unmet promises. Industry app developers continue to promote the benefits of greater access to mental healthcare services through their tools, yet the reality is that there is still a lack of digital resources developed by and tailored for BIPOC communities and other underserved populations.
Digital mental health developers must also contend with what Schueller calls the engagement challenge.
“It’s easier for people to turn off their computers and stop using their apps. There is less accountability and, therefore, less engagement with digital products. To combat that, companies are introducing digital programs such as Happify and Total Brain that also rely on professional (clinician) support because they allow the best of technology and professional care to come together.”
