Equity in Digital Mental Health Interventions in the United States: Where to Next?

Digital interventions in mental health: An overview and future perspectives

As e-health offerings rapidly expand, they are transforming and challenging traditional mental health care systems globally, presenting both promising opportunities and significant risks. This article critically examines the potential and pitfalls of integrating digital technologies into mental health care, particularly in the realms of diagnosis, prevention, and treatment. It explores current advancements and evidence-based practices, and provides a vision for how future technologies can evolve responsibly to meet mental health needs. The article concludes with the TEQUILA framework, addressing essential elements and challenges for fostering a beneficial and ethical future. A responsible future for digital mental health requires building Trust by ensuring data privacy, security, and transparency in AI-driven decisions, along with Evidence-based and robust regulatory oversight to maintain Quality. Usability, design, usability tailored to diverse needs, and ethical alignment with users' Interests will all be essential, while Liability and Accreditation standards will safeguard accountability in this evolving landscape.

mHealth Applications for Childhood Anxiety Disorders: Current Landscape, Challenges, and Future Directions

Purpose of Review

We review the literature on mHealth applications for childhood anxiety disorders, highlighting current use, limitations, and future directions.

Recent Findings

Although mHealth apps targeting childhood anxiety disorders have recently increased, most have not been evaluated for clinical effectiveness, data security, or quality standards. Many apps do not contain scientifically based content and do not adequately incorporate the principles of exposure-based cognitive behavioral therapy. In addition, many apps have significant deficiencies in age-appropriateness, data security, privacy, cultural sensitivity, and accessibility. Limitations remain in terms of the standards for evaluating apps in pediatric populations.

Summary

While interest in mHealth applications for childhood anxiety disorders is increasing, more research is needed to develop effective, safe, and age-appropriate digital interventions. Priorities include scientific grounding, privacy, equitable access, gamification, and parental involvement. Studies in this direction will increase the quality of applications and strengthen equality in access to mental health services.

mHealth Applications for Childhood Anxiety Disorders: Current Landscape, Challenges, and Future Directions

PURPOSE OF REVIEW

We review the literature on mHealth applications for childhood anxiety disorders, highlighting current use, limitations, and future directions.

RECENT FINDINGS

Although mHealth apps targeting childhood anxiety disorders have recently increased, most have not been evaluated for clinical effectiveness, data security, or quality standards. Many apps do not contain scientifically based content and do not adequately incorporate the principles of exposure-based cognitive behavioral therapy. In addition, many apps have significant deficiencies in age-appropriateness, data security, privacy, cultural sensitivity, and accessibility. Limitations remain in terms of the standards for evaluating apps in pediatric populations. While interest in mHealth applications for childhood anxiety disorders is increasing, more research is needed to develop effective, safe, and age-appropriate digital interventions. Priorities include scientific grounding, privacy, equitable access, gamification, and parental involvement. Studies in this direction will increase the quality of applications and strengthen equality in access to mental health services.

Artificial intelligence conversational agents in mental health: Patients see potential, but prefer humans in the loop

Background

Digital mental health interventions, such as artificial intelligence (AI) conversational agents, hold promise for improving access to care by innovating therapy and supporting delivery. However, little research exists on patient perspectives regarding AI conversational agents, which is crucial for their successful implementation. This study aimed to fill the gap by exploring patients' perceptions and acceptability of AI conversational agents in mental healthcare.

Methods

Adults with self-reported mild to moderate anxiety were recruited from the UMass Memorial Health system. Participants engaged in semi-structured interviews to discuss their experiences, perceptions, and acceptability of AI conversational agents in mental healthcare. Anxiety levels were assessed using the Generalized Anxiety Disorder scale. Data were collected from December 2022 to February 2023, and three researchers conducted rapid qualitative analysis to identify and synthesize themes.

Results

The sample included 29 adults (ages 19-66), predominantly under age 35, non-Hispanic, White, and female. Participants reported a range of positive and negative experiences with AI conversational agents. Most held positive attitudes towards AI conversational agents, appreciating their utility and potential to increase access to care, yet some also expressed cautious optimism. About half endorsed negative opinions, citing AI's lack of empathy, technical limitations in addressing complex mental health situations, and data privacy concerns. Most participants desired some human involvement in AI-driven therapy and expressed concern about the risk of AI conversational agents being seen as replacements for therapy. A subgroup preferred AI conversational agents for administrative tasks rather than care provision.

Conclusions

AI conversational agents were perceived as useful and beneficial for increasing access to care, but concerns about AI's empathy, capabilities, safety, and human involvement in mental healthcare were prevalent. Future implementation and integration of AI conversational agents should consider patient perspectives to enhance their acceptability and effectiveness.