1. We Have Spent Time, Money, and Effort Making Self-Help Digital Mental Health Interventions: Is Anyone Going to Come to the Party?
- Author
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Fitzpatrick S, Crenshaw AO, Donkin V, Collins A, Xiang A, Earle EA, Goenka K, Varma S, Bushe J, McFadden T, Librado A, and Monson C
- Subjects
- Humans, Self Care methods, Mental Health, Telemedicine economics, Mental Health Services economics, Mental Disorders therapy
- Abstract
Although efficacious psychotherapies exist, a limited number of mental health care providers and significant demand make their accessibility a fundamental problem. Clinical researchers, funders, and investors alike have converged on self-help digital mental health interventions (self-help DMHIs) as a low-cost, low-burden, and broadly scalable solution to the global mental health burden. Consequently, exorbitant financial and time-based resources have been invested in developing, testing, and disseminating these interventions. However, the public's assumed desirability for self-help DMHIs by experts has largely proceeded without question. This commentary critically evaluates whether self-help DMHIs can, and will, reach their purported potential as a solution to the public burden of mental illness, with an emphasis on evaluating their real-world desirability. Our review finds that self-help DMHIs are often perceived as less desirable and credible than in-person treatments, with lower usage rates and, perhaps accordingly, clinical trials testing self-help DMHIs suffering from widespread recruitment challenges. We highlight two fundamental challenges that may be interfering with the desirability of, and engagement in, self-help DMHIs: (1) difficulty competing with technology companies that have advantages in resources, marketing, and user experience design (but may not be delivering evidence-based interventions) and (2) difficulty retaining (vs initially attracting) users. We discuss a range of potential solutions, including highlighting self-help DMHIs in public mental health awareness campaigns; public education about evidence-based interventions that can guide consumers to appropriate self-help DMHI selection; increased financial and expert support to clinical researchers for marketing, design, and user experience in self-help DMHI development; increased involvement of stakeholders in the design of self-help DMHIs; and investing in more research on ways to improve retention (versus initial engagement). We suggest that, through these efforts, self-help DMHIs may fully realize their promise for reducing the global burden of mental illness., (©Skye Fitzpatrick, Alexander O Crenshaw, Victoria Donkin, Alexis Collins, Angela Xiang, Elizabeth A Earle, Kamya Goenka, Sonya Varma, Julianne Bushe, Tara McFadden, Andrea Librado, Candice Monson. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 19.09.2024.)
- Published
- 2024
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