Need a psychiatrist? There's an app for that!

The Medicines and Healthcare products Regulatory Agency (MHRA) and the National Institute for Health and Care Excellence (NICE) have commissioned research to explore the public perception of Digital Mental Health Technology (DMHT).

DMHT includes products designed to offer information, monitoring, guidance, diagnosis or treatment for individuals through a mobile phone app or other digital channel.  It is a broad term, encompassing everything from basic mindfulness apps to more sophisticated AI-driven therapy solutions.

Focus groups and interviews (involving current and potential users of DMHT) fed into a report, published in April, titled: Digital Mental Health Technology: User and Public Perspectives. The report forms part of a 3-year joint programme between the MHRA and NICE aimed at improving outcomes for people with mental health conditions with access to safe and effective DMHTs. The programme aims to leverage the insights and experiences of both current and potential users of DMHTs to shape the development of future regulatory and evaluation frameworks.

The report identifies several key findings:

• Most participants agree that, overall, there has been a notable improvement in attitudes towards mental health in recent years. Stigma nevertheless remains, particularly in certain settings, including the workplace.
• Capacity cannot keep up with the growing demand for mental health services.
• The consensus is that DMHT could make a valuable contribution within mental health care and support.However, it should form part of a wider integrated package of care, as opposed to being a substitute for formal diagnosis and professional help.
• Around half the participants had used DMHT to support their mental health – most of these were basic products such as mood trackers and meditation apps.A high proportion of users had since stopped - cost (many apps charge a monthly or annual subscription) and effectiveness being barriers to longer term use.
• The individual experiences captured in the report present an interesting picture – people are increasingly open-minded to the benefits which technology can offer. In today's climate, where long waiting lists restrict access to care, DMHTs can provide immediate, anonymous, and convenient options for many, and help bridge the widening gap between demand and capacity.

Nevertheless, many participants are reluctant to rely entirely on technology. For formal diagnosis and treatment, being seen by a healthcare professional is still considered the 'safer' route, and the benefits of face-to-face interaction cannot be replicated by an app.   

One key area of focus in the report is around the regulation, and quality control, of DMHT. The report highlights the potential complexities, and challenges, in ensuring a consistent approach, especially since the level of potential risk will vary considerably between different types of app.

The report provides an interesting insight into both the opportunities, and limitations of DMHT – when used in the right way, technology can play a vital role in supporting our already over-burdened mental health services.  But the consensus, for now at least, is just that – it is a supporting role.  The medical profession remains critical – as one participant put it: "Empathy is really important – you don't get this from an app".

 The report's findings will help focus further research, and the design of future regulatory and evaluation frameworks, for DMHT.  It seems likely that the MHRA and NICE will seek input from DMHT developers as part of their wider programme of research.  Developers, and their insurers, will want to keep abreast of this and seize every opportunity, where possible, to proactively engage in the research programme; the outcomes of which could significantly impact the future regulation of their products.