Students and staff at universities have “a culture of mistrust” around the impact of relying on digital technologies for mental healthcare, according to research published last week by The Alan Turning Institute.
It has also made recommendations on how universities can best make use of digital mental health tools, including the development of a ‘trustworthy assurance’ methodology.
Titled Trustworthy Assurance of Digital Mental Healthcare, the report says there is currently a lot of uncertainty over the tools, a lack of transparency and accountability, and that rising demand is outpacing any increases in the availability of trusted services and resources.
Among the key concerns are a lack of clear and meaningful consent procedures, an insufficiency of data privacy policies, worries that in-person care is being eroded by digital technologies, a perceived lack of diversity in development teams and a varying quality and accessibility of the services.
The Turing Institute says that students are concerned by the lack of empathy offered by technology and the dangers of social isolation from relying on digital; while university mental health administrators have voiced concerns over the clinical effectiveness and the management of risks on digital mental health platforms.
Lack of structure
Developers, meanwhile, have concerns about the lack of structure for trustworthy innovation, ethics not being integrated into workflows and what they see as burdensome regulations.
In addition, policy makers are worried about the lack of clarity around ‘wellbeing’ services on digital platforms.
The findings come from a series of interviews and participatory workshops, which took place with 25 university students and university administrators from across 10 UK universities.
Recommendations include the adoption of the trustworthy assurance methodology in designing and developing new services. This involves a structured argument of linked claims and evidence, a process for developing an assurance case and agreed standards for reviewing and evaluating the argument.
Others are for the development of standards and common capacities, research on how the assurance methodology can be embedded into a project lifecycle, and better engagement with users of the services.
National crisis
The institute says a crisis in student mental health across UK universities worsened during the pandemic. For many universities, the additional challenges faced by the Covid-19 pandemic have resulted in an increased reliance on digital technologies, from online chatbots to cognitive behavioural therapy delivered by smartphones.
Dr Chris Burr, its lead author and ethics fellow, said: “Digital technologies are already transforming mental health research and the provision of mental healthcare services.
“However, the increasing availability of such technologies raises important ethical questions for affected users about their right to privacy and the varying quality of care offered. It also offers significant challenges for regulators and developers about how best to manage the design, development, and deployment of these technologies.
“The lack of transparency around these technologies at present is contributing to a culture of distrust which impacts vulnerable people getting support.
“Our research aims to address some of these concerns, which we hope will help make these technologies more responsible and trustworthy. Most importantly, we hope that our work can contribute to improving mental health services for those who need them.”
Benefits with caution
Rianna Walcott, a workshop participant and mental health advocate, said: “In my experience digital mental health services can be really beneficial. I found my therapist online using these services.
“But it’s important that they’re carefully monitored and used with some caution. There shouldn’t be a one size fits all approach, particularly when it comes to mental health care because different people will use technology differently.”
