Digital Therapies for Better Mental Health Outcomes
By Jill Horn
Mental health problems have been on the rise in recent years, in particular since the COVID-19 pandemic. At the same time, there has been an increase in the need for easily accessible mental health resources. Though the most used and to date most effective strategy for addressing and resolving mental problems has been either in-person or online face-to-face therapy, web-based interventions have become more popular due to their low stigma, high self-reliance, low-cost, and high flexibility characteristics. Especially since mental health issues belong to the most stigmatized type of disorders, non-personal web-based and computer-delivered interventions may be a successful strategy to help treat such conditions. Stigma around seeking out help for mental health seems to be especially prevalent in men, and uptake of mental health treatment is low amongst both workers and students, with only 15% of workers with a mental health problem seeking out help. Therefore, digital (i.e. web-based and computerized) mental health interventions carry the potential of becoming a great option to improve mental wellness and enhancing work effectiveness in the population at large.
“The impersonality of web-based therapy may be one of the most attractive attributes of such interventions since there is a complete anonymity of treatment.”
In order to qualify as a digital mental health intervention, a web- or computer-based treatment must directly address psychological issues such as stress, distress, depression, or anxiety through a technological medium such as computer, tablet, or laptop. Interventions as such include interactive courses that take place over a period of several weeks and require the participant to complete subsequent modules. The content of these interventions can include mindfulness exercises, journaling activities, cognitive behavioral strategies, education on the science of mental illness and mental health, and other modalities. Importantly, these interventions do not include face-to-face human support, so telehealth therapy is not included. Therefore, these interventions are completely computerized and do not in any way include communication with a mental health professional, not even via email or messages. However, these interventions do differ from merely educational platforms as they include the completion of modules and other assignments as part of the intervention. Paradoxically, the impersonality of such an approach may be one of the most attractive attributes of digital interventions since there is a complete anonymity of treatment. Furthermore, computerized mental health treatments allow for flexibility as they can be completed from anywhere at any time. They are also accessible at much lower cost than traditional face-to-face therapy, which is a major advantage of the digital approach. However, one of the great limitations of this type of treatment is a low compliance rate, with approximately 70% of users disengaging before completing the treatment and 50% of users failing to complete even just half of the treatment modules, as shown in a review analyzing ten different digital mental health intervention studies with a total of 2705 participants.
“Though overall, digital mental health interventions have been shown to successfully lower levels of stress, depression, and anxiety, as well to enhance psychological well-being and increased work effectiveness, it remains to be determined how the benefits of such digital interventions compare with various face-to-face therapy modalities that are popular today.”
Digital interventions to treat mental illness have been studied in clinical research due to their increase in popularity and effectiveness in recent years. A meta-analysis looked at 17 different clinical studies with a total of 1480 analyzed participants and found that overall, web-based interventions were successful at improving anxiety, depression, and stress in a student population when compared to inactive controls (meaning control subjects that were not undergoing an intervention of any kind). However, when compared to a control group actively undergoing another kind of education or treatment, the web-based intervention was not superior. Though overall, digital mental health interventions have been shown to successfully enhance psychological well-being, increase work effectiveness, and decreases in stress, anxiety, and depression, it has yet to be determined how the benefits of such digital interventions compare with various face-to-face therapy modalities that are popular today. The question remains whether the same processing of trauma and psychological reframing is possible in a merely digital context, or whether the face-to-face human interaction, even if it is via the internet, is necessary for the processing and healing of certain emotional wounds.
“Digital mental health interventions should be looked at as an addition rather than a substitution of face-to-face therapy for better mental health outcomes…”
Nevertheless, digital mental health resources may be a beneficial way of administering tools to the population at large for overall reduction in stress, anxiety, and depression, as well as improvement in health-related quality of life and work productivity. Digital mental health interventions should be looked at as an addition rather than a substitution of face-to-face therapy for better mental health outcomes in the population at large, as it extends the option of therapy to people in need of treatment who are not ready to seek out face-to-face therapy, be it due to stigma, financial barriers, lack of time, or personal preference. Looked at in this way, digital interventions may be a great additional resource to the already existing, successfully integrated mental health resources. More high-quality studies are necessary in addressing the effectiveness of such interventions, especially in direct comparison to face-to-face therapy, and with a focus on factors increasing compliance.
Jill Horn is a recent UCLA graduate with a degree in Neuroscience. She is deeply interested in the interconnectedness of body, mind, and spirit takes an integrative approach to health and well-being. She aspires to the public about a research-based lifestyle and mindset that promote health. Jill also deeply resonates with the One Health concept, which emphasizes the interdependence of the health of people and the health of our planet, given the climate crisis we are facing.