Re-envisioning Digital Mental Health: addressing the research-to-practice gap

David Mohr, Ph.D. & Madhu Reddy, Ph.D.
Northwestern University

ABSTRACT:
Depression is a common problem that imposes a tremendous societal burden in terms of cost, morbidity, quality of life, and mortality. However, few people are able to obtain adequate or appropriate treatment for depression. Digital mental health (DMH) technologies such as web-based and mobile applications have shown great potential, with a large number of randomized controlled trials (RCTs) consistently demonstrating efficacy, particularly when coupled with support from a clinician or coordinator. Yet for all of the promise, evidence shows these findings do not carry over when these tools are implemented in real-world settings. Indeed, a large-scale implementation trial of two well-known web-based tools (Beating the Blues and MoodGym) for treating depression found that patients did not want to engage with the tools. This research-to-practice gap is not being addressed by our current approaches for designing, implementing, and evaluating DMH technologies. In particular, we face three major challenges: (1) these technologies are often designed without sufficient stakeholder input throughout the design process; (2) we often plan for implementation only after the efficacy testing is completed; and (3) technological capabilities, care systems, and user expectations change rapidly but we currently are not flexible and rapid in how we respond to these changes.

In this presentation, we will discuss how we are attempting to address these research-to-practice gaps through our Accelerated Creation-to-Sustainment (ACTS) model developed by our multidisciplinary team of clinical sciences and HCI researchers. In particular, we will focus on the work that we are doing to try to better understand the needs of users, both patient and healthcare organization stakeholders, in terms of DMH technologies and services. We will then conclude with some thoughts about future directions for the field of digital mental health.