E-mental health in Europe: learning from our neighbours

eMEN event ‟E-mental health in Europe: learning from our neighbours”

On 29^th November, DGPPN organized the third public event within the framework of the eMEN project in Germany, in cooperation with the German Alliance for Mental Health. The seminar was embedded in the annual DGPPN Congress and as such was certainly a highlight of the program. The event focused on the different political and legal conditions for the use and implementation of e-mental health applications in the north western European partner countries. The reason for this was also to present the first results of the eMEN working group, which focuses on transnational policy recommendations for e-mental health implementation. 180 participants attended the event. As in previous events, the audience once again consisted of a good mix of mental health professionals, politicians, people with lived experience and developers. Seven companies presented innovative applications that can be used in various fields of psychosocial care. During breaks, participants had the opportunity to gain hands-on-experience of the programs and talk to representatives and developers. Another aspect that helped to bridge the gap between theory and practice was a session in which experts shared their experiences with implementation of e-mental health applications in different care contexts.

The presentations

Dr. Markus Müschenich presented an overview of the potential of digital applications for different contexts of care. Dr. Müschenich is the founder of FLYING HEALTH and an expert in the future of medicine. He showed how e-health products are changing various care sectors and what further developments are already foreseeable. It became clear that a disruptive potential emanates from these applications and that so-called killer applications can set new impulses for care. They hit a nerve and add value to treatment as usual. When asked, "How are we doing tomorrow?", he sums up that we are better off with e-health support.

Professor Wolfgang Gaebel, head of the eMEN working group "Transnational Policy Solution for E-Mental Health Implementation", presented the first results of the group. In an overview, he showed the different legal and political framework conditions for the implementation of e-mental health services in the partner countries. He pointed out specific barriers in different cases. Overall, he noted that there is an increase in e-mental health activities in all partner countries, i.e. in research or model projects. Based on successful international examples, he summarized the lessons learned and gave a viewpoint on the necessary fields of action. It became clear that among other things, it requires better information on existing services, their use and their effectiveness in order to increase acceptance of digital services, as well as a better digital infrastructure and more research on implementation. Professor Gaebel advocated a comprehensive, multidisciplinary and strategic approach that addresses the multiple challenges. The eMEN project is committed to this.

Kevin Cullen, Oyono Vlijter and Bianca DeRosario further highlighted the situation in Ireland, the Netherlands and France.

Kevin Cullen, Mental Health Reform, Ireland, published a state-of-the-art report at the beginning of 2018 on the status of e-mental health services in Ireland. In his presentation, he highlighted various e-mental health application examples that are currently available on the Irish market. In Ireland, the use of digital products can also supplement the classic therapy models and thus contribute to an improvement in psychosocial care. According to Cullen, next helpful steps on the way into routine care would be pilot projects on a large scale and the development and establishment of "innovation hubs". Here, different stakeholders such as developers, users, and clinicians, should be brought together to support co-development.

Oyono Vlijter, the lead of the eMEN project, presented the latest developments in the Netherlands. Contrary to expectations, the rate of use of e-mental health services in the Netherlands is currently at 15%. Many e-mental health projects would not be successful and clearer frameworks would be needed to structure usage. From the beginning of next year, there will be new regulations in the Netherlands that encourage the use of e-mental health applications through better financial incentives.

Bianca DeRosario of the WHO Collaborating Center EPSM Lille Métropole, presented the EQUME study, which examined the acceptance and use of different stakeholders regarding e-mental health services. The largest group surveyed were the caregivers, and GPs were most familiar with the products. There was a debate within the focus groups about terminology, and concerns were expressed that human interaction would be replaced by digital applications. Interesting findings were the benefits users saw in the e-mental health applications. They suspect that the use of applications could create a better balance between healthcare professionals and patients.

In conversation with Professor Ulrich Sprick, head of outpatient care services and day clinics of the St. Alexius / St. Josef Hospital in Neuss, and Professor Martin Siepmann, medical director of the Psychosomatic Clinic Bad Neustadt in Bad Neustadt / Saale, Professor David Ebert, President Elect of The International Society of Internet Interventions (ISRII), asked for valuable experiences the two had made in implementing e-mental health services in routine care. Professor Sprick, who uses net-step in outpatient therapy, reported therapists' initial scepticism towards the applications. However, with increasing experience and knowledge of the programme, this would disappear. An advantage of using applications is above all the reach of the program, so that patients who are not able or willing to use face-to-face- therapy, could also be included. Professor Siepmann, who had implemented deprexis in an inpatient setting, added that inpatient outcomes can be stabilised and maintained by supporting digital interventions. However, financing these interventions still needs to be clarified.

In five-minute short presentations, seven companies presented their e-mental health applications. The spectrum ranged from therapy-accompanying apps to video-conferencing systems, self-management programs and virtual reality applications. The applications differed in terms of the target groups they address and the fields of indication for which they can be used. During all breaks, participants were able to get a closer look at the products and gain their first experiences. On-stage presentations were the Moodpath App, Balsam App, RADIUS, Café Sunday, MyMind, GET.ON and Mindance. Selfapy, gruppenplatz.de, HausMed, Nevego and Arztkon-sultation.de were also on site.