No more shiny things: Digital mental health priorities show e-health has grown up

By Dan Robotham

The Top 10 research priorities for digital technology and mental health will no doubt be discussed at the Mindtech conference today (5 December 2018). The McPin Foundation were a funding partner in this project, and my colleague Thomas Kabir was an author on the resulting published paper.

When Mindtech began this process with James Lind Alliance I wondered whether the concept of ‘digital health’ would be outdated by the time they finished. After all, who thinks twice about online banking or online shopping anymore? The digital aspect of banking and shopping has been integrated into the overall experience to the point where it is no big deal.

This still isn’t the case for using digital technology for healthcare. There has always been the temptation to see digital healthcare as an add-on. Nonetheless, the priority research questions show that we are half-way there. I was struck by how ‘real’ the priority research questions are. Looking through the top ten, you can see themes about access to healthcare, concerns about the quality of services, equality, community and isolation. These questions were chosen by clinicians and people who have experienced mental health problems, so they reflect real (and timeless) areas of concern.

Equally encouraging is the lack of questions about shiny things and gadgets. Historically this has been a problem with so-called digital healthcare. Developers and IT companies have entered the space, finding imaginary problems to solve without really understanding the context and complexity of the situation. The NHS has been sold many dubious (and expensive) IT products that cannot be implemented. It was refreshing that the top-ten list contains no questions about ‘what is the best app for…’ or ‘how can we use the latest sensor technology to…’ Instead, it confirms what most of us already knew; shiny things are not a priority for digital healthcare according to the people that matter most (i.e., those who receive and those who provide mental health services).

The next stage is to think about how these priority research questions are going to be answered. Their views will be even more important here. Any research on these topics needs to be done in collaboration with service users and clinicians. Researchers and software developers need to listen and follow their lead. It is great to see that the National Survivor User Network (NSUN) have already thought about the potential of digital healthcare and have organised design events for its members and other user-led organisations. At McPin, we are working with Mindtech and Oxford University to test Virtual Reality therapy (gameChange), which sees people who have used mental health services involved in designing new Virtual Reality scenarios. This is a real opportunity to change the direction of healthcare, we must grasp it or risk the agenda being co-opted back by those who love shiny things.