Rethinking progress and challenges of mental health care in China

Abstract

stand patients' and stakeholders' perspectives on digital health systems, to maximize implementation.We achieved this in Actissist 3 by holding quarterly meetings with an expert reference group comprising patient representatives and other stakeholders, who were actively involved in all aspects of trial design and app development.We also integrated extensive qualitative work with patients and other stakeholders from before the trial commenced right through to trial exit interviews post follow-up.Finally, from a global perspective, there is a need to address the exclusion of low-income individuals who cannot access the technology necessary to run digital health tools.Evidence-based digital systems should be a health care cost covered by routine processes, rather than billed to patients.The digital divide also relates to staff using digital systems in the health care context.In our qualitative work, staff often described concerns about their own ability to use technology as well as lack of confidence in the ability of health services to successfully implement a coherent and fully integrated digital system, highlighting the need for all individuals using mental health services and those delivering services to be fully trained and supported 6 .One final consideration is the lack of theory-driven work underpinning apps being developed across the health setting.It is through theoretical development and innovation that we advance our discipline.Each of the challenges set out above will need significant programmes of research, considering not only methods of evaluating digital health interventions, but also drawing on implementation science principles.Taken together, these challenges define a prioritized research agenda for digital health interventions for mental health.The promise shown in this field will only be turned into significant progress through multi-disciplinary working.

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