BOSTON–SilverCloud Health, a leading digital mental health platform, together with a group of international mental health stakeholders, announced that the American Psychiatric Association’s Psychiatric Services journal has published the findings of an expert group aimed at increasing the adoption of digital mental health treatments (DMHTs) within the U.S. healthcare system.
The paper, “Banbury Forum Consensus Statement on the Path Forward for Digital Mental Health Treatment,” was authored by The Banbury Forum for Digital Mental Health Treatment, a group of over 20 international stakeholders including SilverCloud Health and representing healthcare organizations, insurers, employers, patients, researchers, policymakers, digital mental health companies, and the investment community. The Banbury Forum was formed in 2019 to review the current state of evidence and identify the primary challenges to adoption of DMHTs in the U.S. healthcare system, including in response to the challenges COVID-19 presents. The resulting paper identifies the core challenges, as well as opportunities, and provides recommendations to facilitate the successful and sustainable implementation of effective digital mental health interventions in the American healthcare system.
“Through years of rigorous trialing, digital mental health treatments have consistently proven to be effective interventions while also solving the issue of access that many face, yet there is a noticeable gap in adoption, reimbursement and regulation of these treatments within the U.S. healthcare system,” said Banbury Forum member and co-author Derek Richards, Ph.D., Chief Science Officer at SilverCloud Health and Research Fellow at the School of Psychology, Trinity College Dublin.
The paper reports that more than 100 randomized controlled trials demonstrate the effectiveness of DMHTs, and determined DMHTs can effectively overcome access and provider shortage issues that are an inherent part of the U.S. system. Each year, roughly 20% of Americans experience a diagnosable mental health condition, but many don’t receive treatment due to barriers to care, such as stigma and a shortage of mental health providers. For every 100,000 Americans, there are only 30 psychologists and 15.6 psychiatrists, and nearly 120 million Americans reside in designated health professional shortage areas – areas in which the ratio of mental health professionals to residents is smaller than 1 per 30,000 people. The integration of DMHTs into care pathways could improve the efficiency of mental health services and would extend effective treatment to the millions of Americans who are currently unable to access treatment.
“Amid the pandemic, DMHTs are helping to meet the increased demand and reduce the barriers that often prevent people from seeking care in traditional settings, as demand for mental health services – even before the pandemic – has long been higher than supply,” said Ken Cahill, CEO, SilverCloud Health. “We believe now is the time for the power and clinical outcomes of these proven programs to be realized, and our hope is for policymakers and stakeholders to unite in creating a framework that enables the broad adoption of truly effective and proven tools within the U.S. healthcare system.”
“This report makes it clear that for mental health to have parity, digital mental health tools should be an integral part of the U.S. healthcare system, owing to its accessibility and potential impact on mental wellbeing for everyone, regardless of where they live,” said Banbury Forum member and co-author Patricia Areán, Ph.D., Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, who co-chaired the forum along with David Mohr, Ph.D., Professor of Preventive Medicine and Director of the Center for Behavioral Intervention Technologies at Northwestern University.
“While there is increasing recognition of the effectiveness of digital mental health treatments in improving common mental health conditions, two principal barriers to broad implementation and adoption were identified,” Mohr said. “Barriers are the absence of reimbursement mechanisms, which for many healthcare systems makes implementation financially unfeasible, and the lack of expertise among decision makers in determining which digital mental health products to use.”
The Banbury Forum was unanimous in making the following actionable recommendations:
- Guided DMHTs should be offered as a treatment option to all patients experiencing depression, anxiety disorders, and PTSD.
- DMHT products and services should be reimbursable to support integration into the U.S. healthcare landscape.
- An evidence standards framework should be developed to support digital formularies and decision making in healthcare organizations, states, and commercial health plans/payers in selecting DMHT products that are effective, safe, and equitable.