Embracing Digital Innovations in Mental Healthcare

By now, it is unquestionable that the continuous advancements in digital technology have entailed remarkable evolutions in how humans execute a diverse array of responsibilities. Affecting much more than just our personal lives and how we fulfil our own personal needs, digital development has also opened paths for revolutionary methods in how we can offer and carry out certain services for the needs of other individuals. Mental healthcare is one particular example from a wide range of services that have been influenced by the presence of modern technology. Digital innovations present powerful opportunities that could potentially transform mental healthcare and the effectiveness of its practices, as it will allow for higher connectivity between people, services, and data in groundbreaking ways.[i] But how exactly can we embrace the presence of digital development into the world of mental healthcare?

To understand the answer, one must in advance understand the gravity of mental health issues. It is estimated that depression affects around 300 million people across the globe and that mental health problems constitute at least 10% of all global diseases.[ii] However, the growing number of mentally affected individuals has not been matched by an adequate response from health systems, who have struggled to meet high demand for mental healthcare. All over the globe, there are broad disparities between the need for treatment and its actual provision by health services. Up to 85% of people with mental disorders in low and middle-income countries receive no treatment for their disorder.[iii] High-income countries fare slightly better, with between 35% and 50% of mentally affected people being unable to access adequate healthcare.[iv]

One argument that could explain the lack of mental healthcare, especially in low and middle-income countries, is that governments have a tendency to overlook the magnitude of mental illnesses. Governments in developing countries mainly focus on tackling the three most prevalent infectious diseases, which are HIV/AIDS, malaria and tuberculosis, causing a lack of attention towards mental health issues. While high-income countries spend an average of 5% of total health spending on mental health, low and middle-income countries only spend less than 2%.[v] Indonesia itself spends no more than 1% of its healthcare budget for mental issues which highlights how mental healthcare is far from being regarded as a priority by the government.[vi] Moreover, health funds in developing countries are also used for treating highly prevalent non-infectious diseases such as diabetes and respiratory problems related to smoking, which further limits the budget allocated for mental healthcare.[vii]

In addition to this, developing countries also face the issue of psychiatrist scarcity. The number of trained medicals and professionals in the field of mental healthcare is highly inadequate when compared to the total population in each respective country. For example, India has only around 3,000 psychiatrists and 565 neurologists to serve a population of more than one billion, while Zimbabwe has only around 10 psychiatrists and 29 neurologists to serve 11 million.[viii] To further complicate the issue, patients in developing countries also face the negative social stigma of being diagnosed with a mental disease. Suicides which are related to factors such as depression is considerably looked down upon in countries such as Indonesia, where religious norms take prevalence over the awareness of mental health issues. Societies still blame victims of suicide for being unable to abide by religious norms (in which suicide is forbidden) and fail to recognize the need for better access to mental healthcare. Such a stigma prevents people from seeking and receiving appropriate treatment while also possibly causing the loss of social and educational opportunities.[ix]

Therefore, the presence of digital technology is then widely believed to be able to reduce the disparity between demand and provision of mental healthcare. Technology will provide higher levels of flexibility, choice and control to both patients and caretakers, where patients will still be able to access certain aspects of mental healthcare outside of routine work hours – possibly even 24 hours a day for every day of the week. Distance between mentally affected individuals and clinics would also no longer be a significant obstacle, as healthcare providers are now starting to experiment with the use of video call technology to improve access for therapy.[x] Additionally, the popularity of smartphones and social media will also further widen access towards mental healthcare services, especially for specific demographic age groups who were previously unable to do so.[xi] This refers to young generations who had previously found it difficult to access more traditional means of mental healthcare services. Growing social media platforms will allow for increased access towards information and support from peers, clinicians and professionals, significantly modifying the traditional model of how these services are usually offered and delivered. Thus, mental healthcare will no longer be confined to merely face-to-face appointments with professionals at hospitals and clinics.

Furthermore, digital technology development has also seen the creation of mobile apps that allow patients to record their mood & behaviour, while implementing highly valid measures such as the PHQ-9 depression scale.[xii] Through the usage of these apps, patients will be less dependent upon the supervision of clinicians and professionals, as they will be able to monitor their conditions using personal mobile devices and gadgets. The collection of data through these apps will then be useful in detecting potential mental health issues and will allow for professional intervention and assistance at an early stage.

In the case of low and middle-income countries, digital innovations may potentially solve a number of issues that have so far inhibited the provision of adequate mental healthcare. First, the usage of digital technology may reduce the negative consequences of psychiatrist scarcity in developing countries. By digitalizing mental healthcare services, trained professionals and medics will have the opportunity to access a larger number and a more diverse account of patients in need. This not only lessens the burden of psychiatrists (which may improve the quality of their services) but it also increases the number of people who can receive adequate treatment. In addition, due to the negative social stigma that is usually linked to mental health issues in developing countries, digitalized forms of counselling would greatly empower those who were previously unwilling to access such services.  This is possible because digital counselling reduces the fear of prejudice that might have previously prevented them from seeking mental healthcare.

Nonetheless, the implementation of digital technological innovations within the sector of mental healthcare services is still currently in its early stages. There lay particular obstacles ahead before digital technology will be applied on a widespread level across the globe; most noticeable of which is the disparity of technological development between high and low-income countries, and also the concern of health data privacy and security within digital means. Underdeveloped economies in particular will face the challenge of developing the necessary technology to support digitalized forms of mental healthcare services. Governments in these countries must therefore be willing to allocate more substantial amounts of funds for technological development. However, this may prove to be difficult for particularly impoverished countries whose resources are already greatly limited, as they will prioritize more urgent domestic matters. In such a case, assistance in the form of transfers of technology from developed countries will be highly necessary. The social stigma surrounding mental health issues itself is another problem that will need to be tackled, both by developed and developing countries alike.

What remains certain is that efforts to integrate digital technology into mental healthcare systems must continue, as the adoption of technology within this specific sector has so far largely lagged behind other sectors such as shopping, travel and education. Combining the use of traditional mental healthcare services along with the unprecedented innovations offered by digital technology will then prove to be imperative if healthcare providers no longer want to be left behind.

Editors: Diah Ratna Pratiwi, M.Dev & Nabeel Khawarizmy Muna, S.IP

Picture: pexels

[i] L. Simons, ‘Digital technology for mental health: Asking the right questions’, Nesta (online), 13 April 2017, https://www.nesta.org.uk/blog/digital-technology-mental-health-asking-right-questions.

[ii] World Health Organization, ‘Mental disorders’, October 2015, http://www.who.int/mediacentre/factsheets/fs396/en/.

[iii] World Health Organization.

[iv] World Health Organization.

[v] J. Emont, ‘https://www.usnews.com/news/best-countries/articles/2016-09-14/developing-countries-struggle-with-treating-mental-illness’, US News (online), 14 Sep 2016, https://www.usnews.com/news/best-countries/articles/2016-09-14/developing-countries-struggle-with-treating-mental-illness.

[vi] Emont.

[vii] Emont.

[viii] ‘Mental Health Care in the Developing World’, Psychiatric Times Vol. XXI(1), January 2002.

[ix] ‘Mental Health Care in the Developing World’.

[x] J. Martin, ‘Using digital technology to access mental health care’, Kings Fund (online), 8 September 2015, https://www.kingsfund.org.uk/audio-video/jen-martin-digital-technology-mental-health-care.

[xi] C. Hollis, et. al, ‘Technological innovations in mental healthcare: harnessing the digital revolution’, The British Journal of Psychiatry, 2015.

[xii] C. Hollis, et. al.