Digital tools boost mental health reach but experts stress the need for validation

SINGAPORE – Incorporating technology and digitalisation in mental health services can expand access and reach more people in need, but experts say rigorous checks are essential to ensure the tools are safe and effective.

Speaking on a panel at the Singapore Mental Health Conference on July 17, Ms Alice Ong, director of preventive health programmes and rewards at the Health Promotion Board (HPB), noted that technology has been very helpful in addressing persistent stigma surrounding mental health.

Citing the MindSG platform as an example, she said the website drew three million views when it was launched in 2021. As at 2024, it had accumulated 12 million page views.

Dr Swapna Verma, chairman of the medical board at the Institute of Mental Health (IMH), said that besides stigma, there are also manpower constraints in the mental health sector. Digital mental health services, she said, offer confidential and easy access to care.

But such services – whether delivered online, via an app or a physical wearable such as a smartwatch – need to be properly researched and validated.

“It’s like medication. I won’t prescribe a medication unless I see good evidence from a randomised controlled trial,” said Dr Swapna, adding that technology needs to be relevant and culturally sensitive too, or people might not use it.

Another panellist, Ms Liz Ashall-Payne, founder of the Organisation for the Review of Care and Health Apps (Orcha), agreed on the importance of understanding the needs and preferences of different patients to ensure usability.

“If three people have low-level anxiety, but one’s a child, one’s a teenager and one’s an older person, they would want a different interface,” said Ms Ashall-Payne, whose organisation conducts independent reviews of health apps.

There are about 365,000 digital health technologies around the world, she said, and Orcha has reviewed about 35,000 products. It found that only 20 per cent of these technologies are secure, cyber safe and clinically effective.

Some indicators of reliable digital mental health tools include the involvement of recognised professionals or clinicians in the product development, and published research on the technology.

IMH has been using internet-delivered cognitive behavioural therapy (CBT) to help patients learn coping skills like breathing techniques and time management.

Traditionally, such skills are taught face to face by professionals, but with digitalisation, patients can learn the techniques at their convenience while still receiving personalised check-ins from their psychologists. Studies have shown that internet-delivered CBT can be as effective as the in-person version.

Ms Krista Vanderheide, assistant secretary at the Australian Government Department of Health and Aged Care, said that in December 2023, the country announced an investment of A$456.7 million (S$380 million) in digital mental health to develop a new national approach to help people navigate digital services.

The Australian government would also take the lead in accrediting digital mental health services.

Ms Vanderheide added that the government’s information and communication technology (ICT) unit “is always really deeply trained in how to make sure there’s clinical safety and ICT cyber safety”.

The eighth edition of the Singapore Mental Health Conference took place on July 16 and 17, with a heavy focus on digital mental health and artificial intelligence.

Jointly organised by IMH, National Council of Social Service, Agency for Integrated Care and HPB, the event drew more than 1,000 attendees on the first day.