Venkat Raman
Auckland, May 18, 2024
The challenges faced by governments and other stakeholders in addressing digital mental issues, adapting to the existing and emerging technology including the use of Artificial Intelligence and most importantly, providing effective and timely solutions to people in need were among the issues discussed at a high-level meeting of mental health experts in Wellington last week.
The Round Table, held in two parts at the Ministry of Health in Wellington on May 8, 2024, was hosted jointly by the Ministry and eMental Health International (eMHIC) and its Executive Director Professor Anil Thapliyal, is regarded as a cornerstone conclave to review the international best practice in the design, development and implementation of a comprehensive digital mental health strategy and integrate digital mental health solutions into the wider ecosystem of mental health and psychosocial support services.
Experts from across the world
The experts at the Round Table were Professor Andrew Greenshaw, University of Alberta, Canada, Katherine (Kathy Hay), CEO and President, Kids Help Phone (Canada), Dr Martin Orr, a Psychiatrist specialising in Digital Mental (New Zealand), Dr Janine Bycroft, General Practitioner and Founder of Health Navigator of Charitable Trust New Zealand), Emma Rawson Te-Patu, President-Elect, World Federation of Public Health Associations (New Zealand), Adrian Te-Patu, Board Member, Mental Health Foundation of New Zealand, Professor Anil Thapliyal, Executive Director, eMental Health International Collaborative.
Professor Thapliyal said that the First Round, facilitated by the University of Alberta Psychiatry and Neuroscience Professor Andrew (Andy) Greenshaw, also discussed ways and means of ensuring that people who have experienced mental health issues are at the centre of strategies.
“The importance of leveraging digital mental health to bridge gaps in workforce capacity and increasing access to mental health support in remote and rural communities with limited access to care. This expert gathering underscored the enormity of challenges faced by people wanting to access appropriate mental health services at the time and place of their choosing and the capacity struggles of mental health providers and governments to meet the ever-increasing demand for services. Social structures have evolved with the economic pressures accrued by Covid-19 adding to the complexities. The role of eMental Health International Collaborative is critical in achieving global objectives in mental health,” he said.
Later, at a private gathering hosted by Professor Thapliyal at the Northern Club in Auckland (on April 10), Professor Greenshaw brainstormed the pending issues and emphasised the need to address access to mental health services.
Serious challenges ahead
“We have long known that access to traditional mental health services faces a myriad of challenges, including capacity constraints, workforce burnout, entrenched stigma, low mental health literacy, and geographical barriers experienced by remote and rural populations to name a few. We have also long known that digital mental health plays a vital role in addressing these challenges,” he said.
According to Professor Greenshaw, while governments and funding organisations have been allocating financial resources for mental health programmes, ‘this will never be sufficient because of the constant increase in demand for related services.’
Professor Thapliyal, Adrian Te-Patu and Emma Rawson Te-Patu, respectively President-Elect and Board Member of the Mental Health Foundation of New Zealand examined the performance of the New Zealand government and service providers in implementing the best international practices in the digital health domain and the role of AI.
They noted that the role of digital technologies is critical to improve access, ease workforce constraints and provide early intervention services.
New Zealand’s premier role
“New Zealand is positioned at the forefront of digital mental health leadership and solution adoption built on a robust evidence base, consumer engagement, solid systems and infrastructure. Pioneering initiatives like Whakarongorau, or New Zealand Telehealth Service as it is widely known, showcase numerous best practice exemplars in the niche digital mental health domain,” they said.
The Wellington Roundtable also explored potential opportunities for international collaboration to further the aims set by New Zealand and provide opportunities for the country’s stakeholders to share their existing and emerging work in digital mental health.
The issues discussed included (1) How can governments facilitate effectively integrating digital mental health solutions into existing mental health and psychosocial support services, ensuring seamless coordination and collaboration across the wider ecosystem? (2) How do we truly ensure that digital mental health solutions/tools are designed by and for people with lived experience? (3) What can we learn from those who have done this well? (4) What best practices exemplars do we have to share on digital mental health tools or approaches to address mental health workforce capacity challenges? (5) What innovative digital mental health approaches have been employed to increase access to mental health support in remote and rural communities with limited traditional care options?
Artificial Intelligence in E-Mental Health
The second part of the Roundtable deliberated on Artificial Intelligence and its application to E-Mental Health.
Mental health relies on softer skills like rapport building, forming relationships with patients and observing their emotions and behaviour. Clinical data on mental health is more subjective and qualitative like patient statements and written notes. And yet, mental health has a lot to benefit from AI.
Scholarly articles indicate that the use of AI is increasing in various fields of mental health like affective disorders, psychosis, and geriatric psychiatry. The benefits are various like lower costs, and a wider reach but it comes with its own disadvantages.
This reporter learnt from Katherine (Kathy) Hay, Chief Executive and President of Kids Help Phone, Canada the importance of connecting with younger members of the community and understanding their state of mind.
Her team of counsellors and crisis responders made more than 4.6 million connections with young people in various provinces and territories in 2020.
“There is an ever-growing mandate to serve the youth when, where and how they need mental health support,” she said.
Her organisation drives the strategic direction, innovation and culture as Canada’s only national, 24/7 multilingual e-mental health service for young people.
World Mental Health Report
The World Mental Health Report of the World Health Organisation, published in February 2023, was a call for action and a reminder of the huge personal and societal impact of mental illnesses. It said that significant effort is required to engage, inform and motivate policymakers to act and develop more effective, context-sensitive and structurally competent care models.
The Report found that a staggering one billion people (more than one in eight adults and adolescents) worldwide have a mental disorder. Depression (280 million people) and anxiety (301 million) are the largest groups, but also developmental disorders, attention-deficit hyperactivity disorder, schizophrenia, bipolar and conduct disorders affect millions of people worldwide.
“The disease burden of these disorders is huge. Mental disorders are the leading cause of ‘years lived with disability’ (YLDs) across all disorders. One in every six YLDs can be attributed to a mental disorder. Further, the actual disease burden of mental disorders is considerably higher because of the marked premature mortality of this group.
“Mental disorders are also financially extremely costly. Because many mental disorders affect working-age people, the costs in terms of production losses are enormous. It has been estimated that 12 billion productive workdays are lost every year to depression and anxiety alone, at a cost of nearly US$1 trillion,” it said.
Thapliyal becomes ‘Honorary Champion’
Ms Hay honoured Professor Anil Thapliyal with the ‘Honorary Champion of the Kids Help Phone Feel Out Loud National Movement in Canada Award’ at a ceremony in Auckland on May 10, 2024.
“As the Executive Director of eMental Health International Collaborative, Professor Thapliyal has had a longstanding and highly productive association with Canadian Federal and Provincial Health authorities. This association has included leading pan-Canadian mental health provider agencies. I am happy to present this ‘Honorary Champion Award’ to him and we are sure that we will continue to benefit from his association,” she said.
Professor Thapliyal said that he was humbled by the honour.
