Digital interventions in mental health: evidence syntheses and economic modelling

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Sometimes it surprises me what gets media attention and what doesn’t. Had missed this when it came out at the start of the year and I have taken away two things:

  1. We need to better understand how digital can personalise these services (channels, integration, experience etc.) and how this affects the effectiveness for the user.
  2. We need to get better at measuring our digital interventions in terms of value.
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Thanks, Jon, and this was particularly interesting as it fed into one of my cultural myths about the role of technology. I would extend the argument that we need better understand health interventions’ impacts in general. Maybe Pharmac has a point after all and we should be prioritising interventions that demonstrably work and actually reduce inequity.

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Yeah - I think the tricky question Pharmac avoids (or has done so to date) is both cost to change (whole other story) and benefits accruing outside the health system.

It is an interesting thing that we are driven towards making what we do more efficient (technical efficiency) rather than doing the right things (allocative efficiency) because the health system is effectively a closed loop (we don’t see direct benefits from the non-health outcomes we drive).

And of course, this analysis reflects another attempt to measure and compare the technical efficiency of this model of care which it should do, but also worth noting in general these deliver “benefits to society in general” which might be a better measure.

Jon

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This analysis is excellent and quite refreshing. I agree with your points and had “discussions” with the Pharmac economists on the costs of cheap medications to society, like benzodiazepines.

Greig

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Hi Jon: Our work with the World Economic Forum on Digital Mental Health showed, that it is very much a ‘buyer-beware’ world out there. Literally $billions of Private Equity funding pours into Digital Mental Health / Wellbeing tools every quarter. The good news is, that for the discerning users, there are excellent interventions and ‘digital prescriptions’ that work, have been proven to be effective in randomized control studies and make a real difference. Another important point to note, is the fact that Digital is NOT substitution play, but an ‘adjunct’ play to peer group / lived experience support as well as other clinical interventions. It is best used as a tool that permeates everything you do with regards to delivering your Mental Health & Addiction services as opposed to some sort of ‘bolt-on’. I was very impressed with St Vincent’s approach to Digital Mental Health in Sydney and how they deliver services outside their hospital walls - even extending into Correctional Facilities.

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