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. 2023 Jun 2:10:e45949.
doi: 10.2196/45949.

Mental Health Professionals' Attitudes Toward Digital Mental Health Apps and Implications for Adoption in Portugal: Mixed Methods Study

Diogo Nogueira-Leite #  1   2   3 , José Miguel Diniz #  1   2   3 , Ricardo Cruz-Correia  1   4
Affiliations

Mental Health Professionals' Attitudes Toward Digital Mental Health Apps and Implications for Adoption in Portugal: Mixed Methods Study

Diogo Nogueira-Leite et al. JMIR Hum Factors. .

Abstract

Background: Digital health apps are among the most visible facets of the ongoing digital transition in health care, with mental health-focused apps as one of the main therapeutic areas. However, concerns regarding their scientific robustness drove regulators to establish evaluation procedures, with Germany's Digitale Gesundheitsanwendungen program pioneering in app prescription with costs covered by statutory health insurance. Portugal gathers a set of conditions and requirements that position it as an excellent test bed for digital health apps. Its daunting mental health landscape reinforces the potential interest in new interventions. To understand if they would be acceptable, we need to understand the supply side's attitudes and perceptions toward them, that is, those of psychiatrists and psychologists.

Objective: This study aims to understand the attitudes and expectations of psychiatrists and psychologists toward digital mental health apps (DMHAs) in the Portuguese context, as well as perceived benefits, barriers, and actions to support their adoption.

Methods: We conducted a 2-stage sequential mixed methods study. Stage 1 consisted of a cross-sectional web survey adapted to the Portuguese context that was delivered to mental health professionals and psychologists. Stage 2 complemented the insights of the web survey results with a key opinion leader analysis.

Results: A total of 160 complete survey responses were recorded, most of which were from psychologists. This is the most extensive study on mental health professionals' attitudes and perceptions of DMHAs in Portugal. A total of 87.2% (136/156) of the respondents supported the opportunity to prescribe DMHAs. Increased health literacy (139/160, 86.9%), wider adherence to treatment (137/160, 85.6%), and proper disease management (127/160, 79.4%) were the most frequently agreed upon benefits of DMHAs. However, only less than half (68/156, 43.6%) of the respondents planned to prescribe or recommend DMHAs, with psychologists being more favorable than psychiatrists. Professionals faced substantial barriers, such as a lack of information on DMHAs (154/160, 96.3%), the level of initial training effort (115/160, 71.9%), and the need for adjustments of clinical processes and records (113/160, 70.6%). Professionals reported that having more information on the available apps and their suitability for health objectives (151/160, 94.4%), more scientific evidence of the validity of the apps as a health intervention (147/160, 91.9%), and established recommendations of apps by specific clinical guidelines or professional societies (145/160, 90.6%) would be essential to foster adoption.

Conclusions: More information about DMHAs regarding their clinical validity and how they work is necessary so that such an intervention can be adopted in Portugal. Recommendations from professional and scientific societies, as well as from governmental bodies, are strongly encouraged. Although the benefits of and the barriers to using these apps are consensual, more evidence, along with further promotion of mental health professionals' digital literacy, is needed.

International registered report identifier (irrid): RR2-10.2196/41040.

Keywords: adoption; apps; digital health; government regulation; health policy; mHealth; mental health; mobile health; psychiatrists; psychologists; technology acceptance.

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Conflict of interest statement

Conflicts of Interest: This study was conducted as part of the doctoral research project at the Health Data Science PhD Program, Faculty of Medicine of the University of Porto, Portugal. Two authors participated in this project while employed by the Faculty of Medicine of the University of Porto, as DN-L and RC-C were working on a project cofunded by the European Union concerning the digitalization of clinical trials in the north of Portugal (CR—Digital: Digitize clinical research in the North of Portugal NORTE-01-0145-FEDER-083448). The European-funded project or the Faculty of Medicine of the University of Porto were at no point involved in the research, aside from the required administrative approvals. There was also no funding, pay, or other commercial interest provided by the Faculty of Medicine of the University of Porto, aside from the costs related to the publication of this paper. The help received from Knok healthcare regarding the dissemination of the survey questionnaire entailed no reception or use of financial benefits or otherwise. All work concerning this study was conducted during the authors’ personal time.

Figures

Figure 1
Figure 1
Survey adaptation and communication workflow. CHERRIES: Checklist for Reporting Results of Internet E-Survey.
Figure 2
Figure 2
Perceptions of potential benefits for patients.
Figure 3
Figure 3
Perceptions of potential benefits for health care professionals.
Figure 4
Figure 4
Perceived barriers to prescription.
Figure 5
Figure 5
Measures to support adoption. DMHA: digital mental health app.
See this image and copyright information in PMC

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