E-mental health options in the COVID-19 pandemic and beyond.

According to the United Nations, there is a high risk that the COVID‐19 crisis will evolve into a mental health crisis if no immediate action is taken. Potential causes of psychological distress during the pandemic are many, including fear of infection and consequences of physical and social distancing (e.g., loneliness) or economic turmoil (e.g., job loss). The United Nations recommends the widespread availability and use of mental health care and psychosocial support as a means to minimize the psychological consequences of the COVID‐19 crisis. However, mental health care is often underfunded and structurally poorly prepared for the challenges ahead. Currently, there are also unique challenges to contact‐based mental health services, such as risk of infection (or fear thereof) in inpatient settings or in community initiatives (e.g., self‐help groups). Thus, the transmissibility of COVID‐19 via direct contact hinders many forms of traditional treatment options in mental health care.

To date, there is common agreement that e‐mental health provides valuable options for mental health care during the pandemic. , , , E‐mental health encompasses the use of digital technologies to deliver, support, or enhance mental health services. For example, during the pandemic in China, e‐mental health options (e.g., online psychological counseling, online mental health education, and online psychological self‐help interventions) were widely used. In Germany, reimbursement possibilities for recently deregulated video consultations have been expanded in response to the COVID‐19 outbreak. Thus, the pandemic may accelerate regulatory processes required for e‐mental health services. As a quick emergency response, governments worldwide should expand the legal frameworks required for the application and reimbursement of e‐mental health options.

The COVID‐19 crisis does not only lead to short‐term psychological difficulties, but negative long‐term mental health consequences are also expected. In light of the growing demand and expected economic turmoil, which may limit resources, sustainable, innovative, and cost‐effective solutions in mental health care are needed in the long term. The current crisis provides an opportunity to align mental health‐care policies with the current state of knowledge regarding the effectiveness of e‐mental health options. National health policy‐makers should further accelerate e‐mental health options. To meet this aim, sustainable policy measures are needed that include adequate funding and reimbursement strategies, but also high standards of usability and rigorous quality control for e‐mental health products. Importantly, not all available e‐mental health options must necessarily be implemented or reimbursed. For example, thus far, the evidence for the effectiveness of standalone apps in mental health care is rather limited. Adequately funded research is needed to assess how the applicability and effectiveness of e‐mental health options in routine practice and future crises can be further improved, taking into account users’ perspectives. , Many mental health professionals are gaining firsthand experience with e‐mental health options in the current pandemic, which may positively influence attitudes towards their use in clinical practice. Specific training of mental health professionals will be necessary to meet quality standards for safe and effective use of e‐mental health options. In sum, we support current calls for the upscaling of e‐mental health options in the face of the COVID‐19 crisis. Additionally, sustainable policy solutions, training capacities, and adequate research funding are imperative to ensuring the long‐term uptake, acceptance, and quality of e‐mental health options.

Disclosure statement

Professor Gaebel and Dr Stricker have nothing to disclose.