Exploring the societal implications of digital mental health technologies: A critical review

Introduction

Digital mental health technologies are services that rely significantly on big data and artificial intelligence and are widely championed as possible solutions to global mental healthcare shortages. Services include prediction and detection of symptoms, personalized treatment, chatbot therapy, and both personal and population-level monitoring. Existing research has focused on describing the functionality, acceptability, and efficacy of these technologies, as well as data governance challenges. This critical review explores the societal implications of digital mental health technologies in terms of its impacts on mental healthcare, population-based monitoring of mental health, and commodification of mental health data.

Methods

Searched six databases for literature on digital mental health technologies published between 2014 and 2023 following PRISMA-ScR. Conducted qualitative data analysis of 53 records using the Framework method, bringing into conversation wider literature on mental healthcare, ethics, health equity, and data capitalism.

Results

The literature on digital mental health technologies highlights three main areas of ethical concern. First, these technologies could affect treatment and management through changes in accessibility, quality and resource availability of mental healthcare in either positive or negative ways, depending on linkages with clinical services. In addition, these technologies may have ramifications due to the objectification or dehumanization of mental healthcare, the medicalization of poor mental health, and the prominence of self-management. Second, the implications of novel clinical and population-based monitoring are explored, including algorithm-triggered mental health interventions and surveillance. Third, the literature brings forth reservations about the commodification of mental health data through the practice of data capitalism.

Conclusion

This critical review suggests an urgent need for comprehensive regulation of digital mental health technologies and scholarly collaboration to curb adverse effects on mental healthcare systems and society, while remaining optimistic regarding the potential benefits of these services if implemented in collaboration with clinicians and communities who experience mental illness.