JMIR Publications

ABSTRACT

Digital mental health holds promise in tackling the growing demand for psychotherapeutic services. However, existing digital approaches are rarely integrated in clinical practice and rely on patients’ ability to self-diagnose and seek support. Digital health innovators are presented with opportunities and challenges to create an integrated digital ecosystem for mental healthcare. The uptake of digital tools depends on efficacy and engagement of end-users. To this aim, behavior theories offer the opportunity to identify behavioral drivers and address barriers to uptake. The agenda for innovators also includes building strong evidence-based cases for digital mental health, moving away from a one-size-fits-all wellbeing approach, to embrace the development of comprehensive digital diagnostics and validated digital tools. Innovators have the opportunity to make their clinical evaluation more insightful by assessing effectiveness and feasibility in the intended context of use with hybrid pragmatic trials. The COVID-19 pandemic has prompted regulatory flexibility and increased implementation of digital mental health, however equitable access remains a challenge, particularly in low- and middle-income countries, and the mental health gap is still present and increasing. A joint effort by digital health developers and providers is required to enable individuals to access care through digital technologies in communities where mental health services may be otherwise scarce. Shifting from the practice of designing for to designing with users will enhance traditional healthcare delivery and connect more patients to the appropriate care pathway. By laying these foundations, digital services can become integrated in clinical practice and set the scene for deeper technology-enabled changes.