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Experts identify 10 research priorities for digital technology in mental health care

Researchers have identified the top 10 research priorities for digital technology in mental health care based on questions that are most important to people with mental health issues, their carers and health care professionals.

The 10 priorities focus on how the safety and efficacy of digital technology interventions compare with face-to-face interventions, population reach evidence, mechanisms of therapeutic change and combining digital interventions with human support to optimize effectiveness.

“Research has shown the promise, but also the limitations, of different mental health technologies, including internet-delivered cognitive behavioral therapy for various mental health conditions,” Chris Hollis, PhD, from the University of Nottingham Institute of Mental Health, England, and colleagues wrote in The Lancet Psychiatry.

“To date, the research agenda relating to mental health digital technology has largely been influenced by the research community, technology developers, and health policy makers, with little reference to, or input from, people with mental health problems, their families and carers, or non-academic clinicians,” they continued. “However, to avoid harms, increase benefit and sustain impact, it is important that user needs and priorities drive digital technology development in mental health.”

The James Lind Alliance Priority Setting Partnership project, Digital Technology for Mental Health: Asking the Right Questions, brought together people with personal experience of a mental health condition, their carers and health care providers to identify unanswered questions and prioritize the 10 most important questions about digital technology in mental health care.

In the first survey, participants were asked what questions they had about using digital technology for mental health issues; they were told that these questions were for research purposes and asked to provide up to three questions. The second survey — the interim prioritization survey — sought to rank the uncertainties in order of those considered most important. The refined set of questions were entered into a new online survey, then the participants were asked to select 10 questions central to them and could pick the three most important questions from their 10.

Participants contributed 1,369 separate questions, which were abridged by qualitative thematic analysis. After removal of out-of-scope questions and a comprehensive search of clinical evidence, 134 questions were verified as uncertainties appropriate for research, according to the results. Then, 628 participants ranked these questions online and in workshops, producing a shortlist of 26.

“Globally, this study and these service user-driven and practitioner-driven priorities, generated by robust methods, should support a growth in user-driven research in digital technology for mental health,” Hollis and colleagues wrote.

The top 10 research questions were:

• What are the benefits and risks of delivering mental health care through technology instead of face-to-face, and what impact does the removal of face-to-face human interaction have?
• How do certain mental health conditions affect how people engage with technology?
• How can treatment outcomes be maximized by combining existing treatment options with digital mental health interventions?
• At what point in the care pathway are digital interventions most safe and effective?
• How should apps for mental health be evaluated and endorsed?
• What impacts will the adoption of digital technology in mental health services have on capacity, access to services, waiting times and preferred appointment times?
• Are therapies delivered via digital technology as effective as those delivered face-to-face?
• Can the common elements of therapy that come from person-to-person interactions be maintained with digital technology interventions?
• Do digital health interventions increase reach and access to groups and people less well served by traditional mental health services?
• How can social media be used more effectively to bring people with mental health problems together and help them connect, rather than isolating them in their homes?

“Following the publication of the top ten research priorities for digital technology in mental health care, the UK’s [ National Institute of Health Research] Evaluation, Trials and Studies Coordinating Centre will begin the process of translating these priorities into researchable questions for NIHR research calls,” the authors wrote. “We intend to audit the uptake of these research priorities in NIHR researcher-led applications and commissioned calls.”– by Savannah Demko

Disclosure: Hollis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.