Zhao X, Stadnick N, Ceballos-Corro E, Castro Jr J, Mallard-Swanson K, Palomares K, Eikey E, Schneider M, Zheng K, Mukamel D, Schueller S, Sorkin D. Facilitators of and Barriers to Integrating Digital Mental Health Into County Mental Health Services: Qualitative Interview Analyses. JMIR Form Res 2023;7:e45718. DOI: 10.2196/45718
This article identified barriers, facilitators, and best practices for implementing digital mental health interventions (DMHIs) according to the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. This qualitative interview study is part of a larger state-funded project in which six county behavioral health departments in California explored the use of DMHIs as part of mental health services. Interviews were conducted with clinical staff, peer support specialists and leadership. The interview was structured using the EPIS domains of relevant inner context (i.e., individual and organizational characteristics), outer context (i.e., patient characteristics, policy, fiscal mandates), innovation factors (i.e., fit of the innovation), and bridging factors (i.e., community-academic partnerships). Sixty-nine interviews were included for analysis. Three main themes were identified: readiness of individuals, readiness of innovations, and readiness of organizations and systems. Readiness of individuals included patients’ access to technology and digital literacy to participate in DMHIs. Innovation-level readiness pertained to accessibility, clinical usefulness, safety and fit of DMHIs. On the organization and system level, providers and leaders held positive views about DMHIs. Based on these findings, successful implementation of DHMIs requires readiness at the individual, innovation, and organizational levels. The authors recommend equitable device distribution and digital literacy training at the individual level. Adapting DMHIs to fit clients’ needs, as well as clinical workflow, is also recommended. To improve at the organization level, providers and local behavioral health departments should be supported with appropriate technology and training.