As we approach the one year mark since the World Health Organization confirmed the COVID-19 pandemic, it’s no understatement to say that the last 12 months have been a whirlwind, and a transformative time for many reasons. As a result, there is a real collective longing for a return to normality.
With vaccinations being administered at pace and infection levels showing promising signs of reduction, our attention has naturally turned to how and when we can ease back into our pre-pandemic lifestyles. Some aspects of the “new normal” can be reversed overnight, such as relaxing of curfews or stay-at-home orders.
There are other aspects of our lives, however, which won’t return to pre-pandemic normality as quickly as we may like. Chief among these is our poor mental health. Students of previous pandemics will know that the full impact of the mental health burden often lags 2-3 years behind the infectious disease, meaning that we could be living with the effects well into this decade.
The mental health impact of the pandemic has been well researched; by October, mental health was top of the charts in terms of published papers and preprints on the effects of COVID-19.
The vast majority of these papers point to a looming crisis. According to a poll of 1,800 psychologists commissioned by the American Psychological Association, 74% of psychologists said they were seeing a greater number of patients with anxiety disorders compared with before the pandemic. Tellingly, 30% said they were seeing more patients overall. Tragically, there are many who could not access services altogether; a study of 190 million emergency department visits found that visit rates for mental health conditions, suicide attempts, drug overdoses and child abuse and neglect were higher in March through to October 2020, than the same period in 2019.
These studies have truly exposed the barriers to mental healthcare, many of which are not new. In 2016, 11.8 million Americans had a need for mental health services that went unmet. Of these, nearly 38% could not afford the high costs of treatment. Whilst anti-stigma campaigns are showing moderate signs of success, there remains a real stigma around mental health issues in the US. 2020 erected brand new barriers; physical distancing policies, including stay-at-home orders, made it much more difficult for people with mental health concerns to access in-person psychiatric and peer support services.
Put simply, we must do everything in our collective power to break down barriers to mental health care in 2021, if we are to build back to prosperity. The National Alliance on Mental Illness estimates that untreated mental health illness costs us up to $300 billion each year due to lost productivity and associated costs due to absenteeism, employee turnover and increases in medical and disability expenses, and this figure is likely to rise post COVID-19.
This is where I believe technology can be our greatest asset. With more people than ever before living with a mental disorder, evidence-based, ethical and personalized digital solutions present the most accessible route to quality mental health care, especially given the ubiquity of hardware like smartphones. In light of the shortage in clinical staff, digital technology is the only practical solution capable of scaling quickly enough to meet the booming demand for mental health support quickly and at a fraction of the cost of training new psychiatrists. Smartphone apps are a scalable and discreet solution that provide a route to care for those who feel unable to talk to others about their mental health issues. In short, apps are needed now more than ever to form part of integrated care plans, complementing traditional practices such as counselling.
Impact of digital health
We’ve already seen a massive uptick in digital mental health solutions, during the COVID pandemic. Approximately 76% of clinicians now solely treat patients via telemedicine. Early into the pandemic, first-time downloads of the top 20 mental wellness apps in the US hit 4 million by April, up 29% from the total downloads in January, showing that people took a new approach to healthcare. Investors have taken note as well, with many mental health startups raising record amounts of capital.
While digital mental health solutions are increasing in popularity, they still face challenges if they are to receive widespread adoption. For instance, app creators must win consumer trust by proving that they can handle personal and sensitive data ethically and responsibly. Currently 81% of Americans feel that the risks of sharing personal data outweigh the benefits, and therefore the onus is on providers to demonstrate high standards of security and responsibility in order to ultimately gain that trust. This must go beyond mere compliance with HIPAA, and requires the development and implementation of a robust ethical framework to underpin any digital mental health app.
Digital solutions must also be able to meet the individualized needs of users. At present many apps take a one-size-fits-all approach, overlooking technology’s ability to adapt to peoples’ unique symptoms and personal preferences. Personalization is about more than offering multiple types of intervention; it’s the recognition that people engage in technology in a variety of different ways. Across our platforms, we understand that while some users enjoy going through a program in a step-by-step fashion, others opt to pick up activities as and when they need them. These insights truly reflect the breadth of people needing mental health help in a very challenging time.
In 2021, we can no longer afford to have barriers to mental healthcare. As a sector, digital health providers must strive to demonstrate consistent standards of efficacy, accessibility, affordability, ethics and privacy. COVID-19, and the flaws it has exposed in mental healthcare provision, has provided a golden opportunity. Together, we must seize this moment.