Ralston AL, Andrews AR, Hope DA. (2019). Fulfilling the promise of mental health technology to reduce public health disparities: Review and research agendas. Clinical Psychology Science and Practice. doi: 10.1111/cpsp.12277
Digital mental health approaches have the potential to reach underserved populations by reducing the costs of services, improving ease of access, and reducing stigma. Researchers discussed 3 main categories of digital mental health approaches: tele-mental health (phone- and video-conferencing), internet-based and mobile self-help interventions, and digital adjuncts to care (e.g. symptom tracking, homework facilitation, in-session treatment aids, serious games). These approaches are at various stages of development and research evaluation, but have demonstrated promising evidence for impacting positive clinical outcomes. Utilization of these approaches with underserved populations have not been extensively studied. Barriers to accessing digital mental health approaches include costs of technology, gaps in connectivity, low literacy rates, and security concerns. The authors examined dissemination of digital mental health approaches using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Of note, the reach, implementation, and maintenance of digital mental health approaches have the greatest gaps in research, but also highlight inherent benefits of technology (e.g. reaching populations regardless of geographic or temporal boundaries and after treatment has ended). Novel analytic approaches (e.g., geospatial analysis, social network analysis), integration of technology in clinical settings that reach underserved populations (e.g. primary care), and conducting community-engaged research with underserved populations can address gaps in research.