An overview of and recommendations for more accessible digital mental health services

Abstract

Mental health concerns are common, and various evidence-based interventions for mental health conditions have been developed. However, many people have difficulty accessing appropriate mental health care and this has been exacerbated by the COVID-19 pandemic. Digital mental health services, such as those delivered by mobile phone or web-based platforms, offer the possibility of expanding the reach and accessibility of mental health care. To achieve this goal, digital mental health interventions and plans for their implementation must be designed with the end users in mind. In this Review, we describe the evidence base for digital mental health interventions across various diagnoses and treatment targets. Then, we explain the different formats for digital mental health intervention delivery, and offer considerations for their use across key age groups. We discuss the role that the COVID-19 pandemic has played in emphasizing the value of these interventions, and offer considerations for ensuring equity in access to digital mental health interventions among diverse populations. As healthcare providers continue to embrace the role that technology can play in broadening access to care, the design and implementation of digital mental healthcare solutions must be carefully considered to maximize their effectiveness and accessibility.

Fig. 1 |. Treatment approaches.

a | The therapeutic rationale underlying cognitive behavioural therapy (CBT; grey), acceptance and commitment therapy (ACT; blue) and psychodynamic therapy (PDT; red). In all of these therapies, individuals are learning more adaptive ways of thinking and behaving, but the means for learning more adaptive skills varies between approaches. b | PDT looks very different from CBT and ACT in face-to-face practice. c | The psycho-educational content and interactive tools for Internet-based CBT (iCBT) and Internet-based ACT (iACT) are similar. The format of Internet-based PDT (iPDT) also looks fairly similar to both iCBT and iACT in that there are psycho-educational lessons and interactive tools that examine individuals’ thoughts and behaviours.