Why are so few digital mental health tools evidence-based? The answer is complicated.

The COVID-19 crisis has catapulted digital mental health into the mainstream. It has led to a substantial increase of investment in digital mental health (e-mental health). In the first 6 months of 2020 digital health companies in the US raised $5.5 billion in venture funding (on track to become its largest funding year ever). There is increasingly more focus on behavioural health technology and its promise to deliver fast, seamless care at a time when usual treatment modalities are difficult to access. However, the question: why are so few e-mental health tools evidence-based must still be addressed. Mobihealthnews has published an interesting article about this complex topic, which is also core element of the eMEN project.

Some excerpts from the article:

“Despite the existence of validated scales for measuring symptoms (such as in depression and anxiety), which are shown to improve patient outcomes, the use of measurement-based care in mental health is low. Only 18% of psychiatrists use them to measure patient symptoms over time.”

Evidence-based medicine requires clinical practice to be guided by existing clinical data, but because mental health symptoms are not routinely measured, it is difficult to then collect evidence on whether a treatment actually works.”

“There is concern that many digital mental health companies are bringing products to market without clinical pilots to demonstrate that their solutions work. Additionally, many of these same companies may claim they are evidence-based when they are based off of vague translations of existing clinical models.”

“Another problem is that in the world of digital health, attempting to develop rigorous clinical models does not guarantee success.”

“Conversely, many mental health startups have gained traction in the market with unclear evidence for their products. Unlike clinical medicine, success for digital mental health companies isn’t just about effective treatments, but also about running an operationally and financially sound enterprise.

Ultimately, the fact that many companies lack clinical evidence does not fall on just their shoulders. Simply put, clinical research practices have not caught up to the speed of technology. Randomized controlled trials are the gold standards of clinical research but they are very expensive, time-consuming, and difficult to implement, making them nearly impossible for upstart digital health companies to achieve.”

“Academic medicine would benefit from partnering with digital health companies either to assist with clinical research or help develop new research frameworks specifically for digital health.”

“Multiple stakeholders need to collaborate to protect customers and encourage high-quality technology in the field of digital mental health.”

“The disconnect between the existing mental healthcare community and the greater technology community is an important barrier to recognize. Because mental health professionals are not educated about digital health, they have difficulty in navigating evidence-based mental health solutions and do not know how to recommend or prescribe them to patients.”

“Slowly, inroads are being made. The American Psychiatric Association recently launched an app advisor to help psychiatrists navigate the space.”

“If digital mental health is to succeed, tech companies need to include clinicians and researchers in the design of behavioral health technology from its inception. Doing so will enable companies to better consider the nuances of person-centered design in healthcare and to structure their data collection to existing clinical research standards.”

You can read the full article via the weblink below.

Why are so few digital mental health tools based in evidence? The answer is complicated

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