Executive summary
Globally, mental health concerns are both common
and undertreated. Accessing mental health services
is not a simple demand and supply curve. For
individuals who live in areas with mental health
clinicians, barriers to accessing mental health
care remain. These barriers include, but are not
limited to, stigma, cost or access to reimbursement
models, privacy concerns, a preference for dealing
with problems independently and time constraints.
Digital mental health services, such as those
delivered by mobile phone or web-based platforms,
have the promise of delivering more affordable care,
expanding the reach and accessibility of services
and designing new treatment models that meet the
needs of the current and future generations. But
digital mental health is not straightforward, and new
technology is substantially disrupting approaches
to how mental health conditions are identified,
diagnosed, treated and supported.
Telemedicine is offering care whenever and wherever
it is needed through phone, video, email, chatbots
and even gaming. Cognitive artificial intelligence
(AI) is creating supportive digital interaction. Big
data is unearthing a new understanding of the
biopsychosocial factors. And brain–machine
interfaces, which directly connect human
consciousness with computers, are all promising to
push the boundaries of what is possible.
A dramatic increase in the creation of digital
mental health services has occurred in the past 10
years. At the same time, governments, clinicians,
large corporations and consumers have been
expressing concerns about the safety, quality,
efficacy, privacy and application of AI in these
services and the extent to which they are safe.
In 2018, the World Economic Forum’s Global
Future Council on Neurotechnologies set out
to understand the potential uses and ethical
implications of digital tools for the treatment of
mental ill health and collaborated with Deloitte
to design a Global Governance Toolkit for Digital
Mental Health.
The COVID-19 pandemic created a mental health
crisis of unprecedented scale, triggered by social
isolation, widespread unemployment, worries
over contracting the virus, insomnia, social media
exposure and the rising death toll. This accelerated
the move towards the adoption and implementation
of digital tools for mental healthcare. It also created
a renewed urgency to develop and implement
governance and regulatory frameworks to deliver
clinical efficacy, access, privacy and data protection,
as well as fairness, transparency and accountability.
The toolkit, published in 2021, was designed
to outline a way forward and provide
recommendations for policy-makers, funders,
developers, service providers and users. It became
a fundamental resource that countries could lean on
to start building their digital mental health roadmap.
The work on the state of digital mental health
regulation continues today, via interviews with
those who piloted the toolkit, those crafting their
own policies and mental health innovators. This
White Paper sheds light on the current regulation
and highlights four case studies of entities that
are leading the way in regulating the tools. Their
emerging standards provide much-needed
guidance for service developers and providers to
incorporate privacy policies, data transparency and
health information security in digital mental health
frameworks and applications.
This is only the beginning of the digital mental
health journey. The regulatory structures of the
future must be as dynamic and flexible as the
advances they govern.
Governance Frameworks in Digital Mental Health 4
