The opportunity for e-mental health to overcome stigma and discrimination
Authors: Subramaniam K. , Greenshaw A. , Thapliyal A. 
Published: August 2024

Introduction

Many with mental illness do not seek treatment, often due to stigma; be it public, self, or institutional type. To improve outcomes, stigma needs addressing.

Objectives

Understand the opportunity for e-mental health to help overcome stigma and, to provide an expert opinion to foster its adoption.

Methods

We conducted literature searches using the terms ((mental health) AND ((stigma) OR (discrimination))) AND (((((digital tools) OR (digital services)) OR (healthcare apps)) OR (digital solutions)) OR (digital technology)), limited to 2007 – 2023, identifying 223 citations, 9 of which were relevant for this evaluation, including 4 systematic reviews (
Table 1).

Results

Literature reports suggest that e-mental health may be useful for addressing stigma and reducing the treatment gap. While it was not consistently as good as face-to-face services, e-mental health tools were frequently shown to be effective in reducing stigma, improving mental health literacy, and increasing help-seeking behaviors. Tools included web-based breathing, meditation, and CBT; suicide prevention apps; and online videos and games. Experts from a 2022 global Think Tank session convened by eMHIC, opined and emphasised that embracing e-mental health must not leave people behind nor reinforce inequality and that structural barriers must first be acknowledged and overcome. Creating a shared understanding of the challenge and of terminology is essential, as is codesigning any solution together with people with lived experience.
Table 1.

Systematic literature reviews

StudyInterventionsFindingsSLR + meta-analysis, 9 studies, n=1916 (Goh et al. Int J Ment Health Nu 2021;30:1040–1056)

-

Web-based program

-

MIDonline

-

AboutFace

-

BluePages

-

MoodGYM

-

MHFA eLearning

-

Beyond Silence

Online vs offline: similarly effective for reducing public stigmaSLR, healthcare setting (Pospos,et al. Acad Psychiatry 2018;42:109–120)

-

Breath2Relax

-

Headspace

-

Meditation Audios

-

MoodGYM

-

Stress Gym

-

Virtual Hope Box

-

Stay Alive

Identified tools provide a starting point to mitigate burnout, depression, and suicidalitySLR, 13 interventions for stigma (Johnson, et al. Indian J Psychol Med 2021;44:332–340)

-

Web-based, psychoeducation interventions

-

Online games

-

Mobile app

Most interventions increased help-seeking
SLR + meta-analysis, 9 RCTs, n=1832 (Rodriguez-Rivas, et al. JMIR Serious Games. 2022; 10:e35099)

-

Video games

-

Virtual reality

-

Videoconferencing and online chat

Interventions had a consistent effect on reducing public stigma

Conclusions

Published data suggest that e-mental health is promising to reduce stigma and discrimination, with the potential to foster help-seeking and treatment engagement. Adoption requires attention to derailers and must foster inclusivity. There is an imperative to adopt e-mental health, especially evidence-based solutions.

Disclosure of Interest

K. Subramaniam Employee of: Employee of Viatris, A. Greenshaw: None Declared, A. Thapliyal: None Declared