Developing A Digital Mental Health Quotient

Digital innovation will play a major role in mental health care in the 21st century, particularly given current diagnostic, treatment and preventive systems need improvement. In a given year, only 40% of Americans with mental illness receive treatment in the past year, and less than one-third of those receive treatment from a mental health care professional [1]. For the few who receive care, the median delay in treatment initiation after disorder onset ranges from 6 to 23 years [2]. Stigma and lack of education often hinders engagement in services. Standardisation of care around the world is notoriously lacking and evidence-based psychological therapies are insufficiently utilised.

Digital platforms provide opportunities to improve these systems via smart phone based psychotherapy and coaching apps, virtual reality, telemedicine, Big Data analytics and stepped care. Global smart phone use has increased from 9.6% in 2011 to a projected 36.5% by 2018 [3]. The number of internet users on Earth was 1 billion in 2005 and has now hit 3 billion in 2015 with further increases expected [4]. Moore’s law predicts continued exponential increases in computing power with computing power surpassing that of the human brain by 2023 [5]. Digital mental health can assist with education, engagement, access, diagnosis, treatment and prevention.

We must develop approaches to ensure effective development and use of digital mental health. The development and use will mostly occur within large health systems and will involve R&D, training and education, leadership, quality improvement, safety management and resource allocation. The McKinsey Digital Quotient (DQ) may provide some guidance for the mental health industry on managing these developments.

The McKinsey DQ ‘provides an objective, universal, and comprehensive measurement of a company’s digital maturity. The assessment allows organizations to identify clearly their digital strengths and weaknesses across different parts of the organization and compare them against hundreds of organizations around the world. It also helps companies realize their digital aspirations by providing a clear view of what actions to take to deliver rapid results and sustain long-term performance.’ The DQ evaluates four major outcomes as seen below.

 The basic template of the DQ should be modified and used for mental health organisations i.e. a Digital Mental Health Quotient should be developed

Understanding the digital strategy of mental health organisations is important. Such a Quotient would aim to optimise quality of care, outcomes, safety, access and cost. Very clear understanding of digital mental health strategies based on customer needs is essential to develop patient-centered approaches. Clinician needs should also be considered.  

The culture of digital innovation within organisations is vital. Culture must also consider evidence-based practice. Evidence-based practice in digital innovations is often difficult given the speed of new technologies and approaches often leap-frogs time-lines of clinical trials. Care must be taken to ensure clinicians are involved in development of programs, and know how to appraise mobile health apps. A culture of quality improvement and safety is essential.

The organisation should develop robust internal or external abilities for quality improvement, safety, training and education. Providing education for how clinicians, researchers and technologists work together is vital for success.

The further development of a Digital Mental Health Quotient for mental health organisations will provide a strategy to ensure digital innovations are leveraged to increase quality, outcomes, safety, access and cost. Such an approach is not too early given the pace of technological developments. One day in the future it may be possible to benchmark organisations against each other based on a Digital Mental Health Quotient.