Digitization of Mental Health Services: A Business Perspective

Introduction

Mental illness is a growing public health concern worldwide. In 2017, 10.7% of the global population experienced a mental illness, equivalent to nearly 792 million people (Dattani et al., 2021). The 2020 COVID-19 pandemic further exacerbated this crisis due to the accompanying social isolation, economic stress, loss of loved ones, and other struggles (Blumenfield & Levin-Scherz, 2020). Additionally, recent studies have found that getting infected with Covid directly increases the likelihood of developing mental health problems (e.g., depression, anxiety, and sleep disorders) during the month following the infection (Belluck, 2022). On the other hand, there has been a dearth of accessible mental healthcare due to the shortage of mental healthcare providers, long wait lines, as well as associated costs and stigma. This increasing gap between the demand and supply of mental health services calls for alternate solutions to meet patient-care needs.

Advancement in technology has opened a new frontier in mental health support by offering digital mental health services as an alternative and scalable model of care for narrowing this gap in service provision. In this chapter, we conceptualize digital mental health service as any online platform, website, or tool that provides customers the ability to care for their mental wellbeing. Technological platforms (e.g., computers and smartphones) are giving the public, doctors, and researchers new ways to access help, monitor progress, and increase understanding of mental wellbeing. By leveraging such platforms, well-established psychological treatments can be delivered directly to people with high fidelity and no-to-low human resources, empowering individuals to self-manage mental health issues (Andersson & Titov, 2014).

A wide variety of devices and mediums is available in the marketplace that can be leveraged to provide mental health treatment—e.g., online counseling, smartphone apps, virtual reality, and “serious games.” As of 2021, the U.S. Food and Drug Administration (FDA) had certified nearly half a dozen digital mental health tools for diagnosing and treating mental and behavioral health conditions, including attention-deficit/hyperactivity disorder (ADHD), cognitive impairment, and substance use disorders (Marschall, 2021). While that number is small, many more digital mental health interventions are available to consumers without specific FDA approval or a prescription. For example, innovative mental health apps (e.g., Talkspace and Betterhelp) offer combinations of digital tools (e.g., self-help services) and virtual care (e.g., support by a remote therapist) to provide a robust ecosystem for end-to-end patient care. Other virtual mental healthcare apps (e.g., Woebot and Wysa) are based completely on digital therapeutics, which are software and AI-algorithms that use prompts or exercises to address common mental health concerns, like anxiety or depression, without a live therapist’s aid. Such tools which are readily accessible to anyone with a smartphone and Internet connection, easy to use, and significantly less costly than in-person face-to-face interventions have particularly proliferated during the pandemic lockdowns. Recently, there has also been an explosion of VR-based digital interventions aiming to either supplement or replace face-to-face mental health services (Blumenfield & Levin-Scherz, 2020). For example, VR immersive therapy tools are used to treat various forms of social anxiety (Banerjee, 2020). More recently, the social distancing limitations imposed in the physical world during the pandemic, turned people towards virtual worlds (e.g., Second Life) to meet their need for socializing and maintaining their social wellbeing (Renken, 2022). Beyond the structural barriers, such apps and gamified approaches also help bypass the social and self-stigmatizing attitudes associated with traditional mental health interventions as well as discrimination or micro-aggression that some communities may experience during in-person therapy.