Digital equity and inclusion in technology-based mental health services

Abstract

Digital mental health is rapidly growing and has the potential to address issues of mental health equity and disparities among underserved populations. Digital mental health (DMH) can increase the accessibility, efficacy and efficiency of delivering mental health services to vulnerable populations and those who need it most. At the same time, as technology keeps booming, those who are most disenfranchised are at the greatest risk of not benefitting from technological advances, which could result in DMH interventions not reaching vulnerable populations and further increasing health disparities. This chapter explores the importance of digital equity and inclusion in technology-based mental health services. We begin with an overview of the digitalisation of mental health services via the internet, mobile phones and digital ‘apps’ and discuss how the COVID-19 pandemic outbreak has further demonstrated the need for the digital mental health and policy changes required for the greater adoption of DMH by health care professionals. The authors further discuss the various ways in which DMH, including telehealth and remote monitoring, might be helpful for improving the delivery of and access to mental health care services. Despite the benefits of DMH (e.g. efficacious treatment, cost-effectiveness, accessibility), the widespread adoption of DMH interventions is not without concerns. In this chapter, the authors discuss the need for privacy in DMH and how privacy concerns may further exacerbate health disparities, which may be a leading factor in clinicians’ and users’ decisions not to engage with these services/interventions. In addition, we discuss how the technology divide (e.g. lack of adequate technological services and lack of digital literacy) further fuels equity concerns in the field of DMH. Finally, the authors discuss how digital inclusion and equity may be promoted via the integration of user-centred design into app development and research processes, as well as the role of digital health navigators in helping to bridge the technology divide and promoting high-quality care within DMH services.