Stakeholder perspectives on evidence for digital mental health interventions: Implications for accreditation systems

Philip J Batterham; Alison L Calear; Bridianne O'Dea; Mark E Larsen; David J Kavanagh; Nickolai Titov; Sonja March; Ian Hickie; Maree Teesson; Blake F Dear; Julia Reynolds; Jocelyn Lowinger; Louise Thornton; Patrick Gorman

doi:10.1177/2055207619878069

Stakeholder perspectives on evidence for digital mental health interventions: Implications for accreditation systems

Digit Health. 2019 Sep 19:5:2055207619878069. doi: 10.1177/2055207619878069. eCollection 2019 Jan-Dec.

Authors

Affiliations

¹ Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia.
² Black Dog Institute, University of New South Wales, Sydney, Australia.
³ Centre for Children's Health Research, Institute of Health & Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.
⁴ eCentreClinic and MindSpot Clinic, Department of Psychology, Macquarie University, Sydney, Australia.
⁵ School of Psychology and Counselling, University of Southern Queensland, Ipswich, Australia.
⁶ Brain and Mind Centre, University of Sydney, Sydney, Australia.
⁷ Matilda Centre, University of Sydney, Sydney, Australia.
⁸ Think Feel ACT, Melbourne, Australia.

Abstract

Background: Digital mental health interventions can be effective for treating mental health problems, but uptake by consumers and clinicians is not optimal. The lack of an accreditation pathway for digital mental health interventions is a barrier to their uptake among clinicians and consumers. However, there are a number of factors that may contribute to whether a digital intervention is suitable for recommendation to the public. The aim of this study was to identify the types of evidence that would support the accreditation of digital interventions.

Method: An expert workshop was convened, including researcher, clinician, consumer (people with lived experience of a mental health condition) and policymaker representatives.

Results: Existing methods for assessing the evidence for digital mental health interventions were discussed by the stakeholders present at the workshop. Empirical evidence from randomised controlled trials was identified as a key component for evaluating digital interventions. However, information on the safety of users, data security, user ratings, and fidelity to clinical guidelines, along with data from routine care including adherence, engagement and clinical outcomes, were also identified as important considerations when evaluating an intervention. There are considerable challenges in weighing the evidence for a digital mental health intervention.

Conclusions: Empirical evidence should be the cornerstone of any accreditation system to identify appropriate digital mental health interventions. However, robust accreditation systems should also account for program and user safety, user engagement and experience, and fidelity to clinical treatment guidelines.

Keywords: Internet interventions; accreditation; apps; dissemination.