This year, Americans grappled with fear of infection, incredible loss of loved ones, financial stress, isolation and fatigue from constant uncertainty to name a few. Even though we are getting closer to returning to normality as vaccines start to roll out, we can’t write COVID-19 off just yet. We are only now beginning to see the long-lasting effects of the pandemic, specifically its dramatic impact on the mental health crisis in the United States and unfortunately, mental illness has no vaccine.
Nearly 45 million American adults live with mental illness, which has only been exacerbated this year as more than two in five U.S. residents reported struggling with mental health issues as a result of COVID-19.
Even more concerning, according to the World Health Organization, prior to the pandemic, countries around the world were spending less than 2% of national health budgets on mental health, while struggling to meet their populations’ needs. It’s evident that there is not only a lack of focus on mental healthcare, but a lack of access as well.
We’ve seen a recent influx in telemedicine and telehealth services, and provided these solutions are evidence-based and effective, this is the only way for us to scale the widespread demand for support. Put simply, we don’t have enough clinical staff to go around.
When I practiced psychiatry in the U.K.’s National Health Services (NHS), I quickly realized that we were seeing patients too late, sometimes years too late, such that they had far more serious needs than if they had been able to access good quality care earlier. Back then it was clear to me this level of supply-demand gap could only be resolved by deploying technology at scale, and the events of the last year have only reinforced that.
Investors have taken note as well, with many mental health startups raising capital. It’s clear that business leaders have begun to prioritize innovation as a way to pull ourselves out of crisis, with a renewed focus on products adapted to a changed world. We’ve already seen a massive uptick in digital mental health solutions with about 76% of clinicians solely treating patients via telemedicine. The clearest path for managing mental health at scale will be evidence-based, ethical and personalized digital solutions.
Not only will this influx help those who desire flexible care options, but telehealth has also increased the access to care for people who may have limited options in their local communities.
While increasing in popularity, digital mental health solutions have some important challenges to overcome. For one, they must win consumer trust and prove that they can handle personal data ethically and responsibly. With 81% of Americans feeling that the risks of sharing personal data outweigh the benefits, providers must show that they can responsibly secure users’ personal health data due to the sensitive nature of the information and ultimately gain that trust.
This must go beyond compliance with HIPAA and, in Europe, GDPR, and require the development and implementation of an ethical framework to underpin a provider’s digital mental health solutions. However, such efforts must be genuine and avoid falling into the trap of “ethics washing,” so I encourage providers to have the ethics frameworks audited by external experts and to commit to publishing the results.
Digital solutions must also be able to meet the needs of users on an individualized and personalized basis. Many apps meant to help manage mental health take a one-size-fits-all approach and don’t take enough advantage of the technology’s ability to adapt to peoples’ unique symptoms and personal preferences. This is not simply about offering more than one type of intervention, although that is important, it’s the recognition that people engage in technology in different ways.
For instance, at Koa Health we know that some users love going through a program in a step-by-step fashion, whereas others prefer to dip into activities as they need them, and it’s important that we cater equally well for both of these preferences. Generic approaches simply won’t work well for everyone.
Not only do digital solutions need to be responsible with data and be tailored to users, they must work harder to prove their efficacy. Recent research has shown that 64% of mental health apps claimed efficacy yet only 14% included any evidence. The growth in the adoption of technology is encouraging, but positive impact will only result from products designed for efficacy — and able to demonstrate it in high-quality trials. The stronger the evidence base for effectiveness and cost-effectiveness, the more likely healthcare providers and insurers will be to distribute the solutions.
While vaccines are on their way, the mental health impacts of the pandemic may soon overshadow the direct impacts of the pandemic. While health tech has made promising progress, it’s imperative that digital mental healthcare places a stronger emphasis on effective, ethical and personalized care to avert an even larger mental health crisis.