Mental health problems, such as depression, anxiety or psychosis, constitute a major individual, family, and public health concern. The EU has devoted 4% of its GDP annually to direct and indirect costs of mental health care, which is equivalent to the resources spent on cancer care. Mental health care is thus highly in need of better health promotion, better disease prevention, and treatments better targeted to people’s needs. One paradigm shifting approach is to transition towards highly person-centered care. Currently, and despite good efforts, mental health care has failed to shift towards a person-centered approach. There are two main reasons why: (1) Insufficient existence of tools to support patient engagement and providing relevant, qualitative information to clinicians for goal orientation and shared decision-making (2) a lack of effective educational, organizational, technological and regulatory strategies for the effective implementation of these tools in routine healthcare practices. With our initiative, we aim to provide solutions to both two problems.
(1) A solution to non-existence of high-quality tools to support mental healthcare: We have integrated 20 years of documented evidence into an innovative, clinical digital health tool: the Digital Mobile Mental Health (DMMH) tool. DMMH comprises a mobile application for systematic collection of patient-reported momentary mental states, symptoms, and real-world context. A data platform applies statistical algorithms to derive meaningful insights from these self-reports, integrating them with mobile sensing data for contextual information. The user interface then visualizes and distils the collected data into customized feedback for both the patient and the clinician. The science behind our tools suggests that we can: strengthen patient engagement and empowerment, improve patient self-management and recovery, provide goal direction in clinical assessment and management of care, and enhance shared decision making. To rigorously test and validate these outcomes, we are uniquely conducting a large cluster randomized clinical trial across eight clinical sites located in four different European countries (Belgium, Germany, Scotland, and Slovakia).
(2) Developing strategies for implementation: Within our initiatives, we want to maximize our chances of making our DMMH tool successful. Specifically, despite the science stating our type of product is highly beneficial for clinical use, previous attempts of related products have seen little uptake in practice. This is not unique, as very little research has been conducted on the implementation of any mobile health solutions in mental health. Hence, within our initiative we conduct highly needed studies that can inform how the local context, related to legal, ethical, behavioural and social factors, can act as barriers or facilitators for wider transfer and scale up. This will result in a policy white paper on the governance of DMMH-like tools, as technical innovation is unlikely to achieve the anticipated impact if not accompanied by supportive organisational and policy innovations. Promising initial outcomes mark the halfway point of patient recruitment (250+ patients) for our initiative. Early testimonials also appear to indicate success into improving mental healthcare, affirming the effectiveness of our implementation approach. While the true extent of added benefits will become clearer towards project completion and potential scale-up, current results are promising.