In Germany, more and more people are using medical services for mental illness. This poses great challenges for the health care system. Internet-based interventions offer opportunities to counteract the current health care shortages – as long as they are based on scientifically recognised psychotherapeutic techniques and fulfil safety standards.
Smartphones, tablets and computers have become people’s constant companions. Thanks to newly developed applications they are also entering the health care system. As low-threshold location- and time-independent treatment alternatives, such applications represent a valuable addition to regular care. The offerings have multiplied, particularly in the field of mental health.
Internet-based interventions – also referred to as e-mental health products – can help reduce symptoms and decrease stress in various phases of the illness. The spectrum of applications includes universal and targeted prevention for risk groups, psychotherapeutic internet interventions to bridge waiting times – as a complement to traditional methods – and relapse prevention after completion of treatment.
The internet already offers a multitude of options to treat mental illness symptoms, making it difficult to navigate the market.The internet already offers a multitude of options to treat mental illness symptoms, making it difficult to navigate the market. Many internet-based interventions have good efficacy, particularly in the treatment of depressions and anxiety disorders. However, every effective treatment has side effects and internet-based programmes are no exception. These risks need to be further researched and communicated. A task force on internet psychotherapy, set up the DGPPN and DGPs, has therefore presented criteria that can help doctors, psychotherapists and, last but not least, users to choose effective and worthwhile interventions.
Against this background, the DGPPN and the Coalition for Mental Health (“Aktionsbündnis Seelische Gesundheit”) are involved in the transnational project eMEN. The name eMEN stands for “e-mental health innovation and transnational implementation platform North-West Europe”. The project is supported by Interreg and thus part of the European Union’s structural and investment policies for European territorial collaboration. The funding amount is 3.22 million euros.
The project is headed by the Netherlands, one of the forerunners in the field of e-mental health, and supported by partners in Belgium, France, Ireland, Great Britain and Germany who contribute their respective technological, clinical, scientific and political expertise. The project thus creates an international e-mental health network. eMEN wants to bring together people with mental health problems and their caregivers, doctors, psychologists and members of other health and social professions, small and medium-sized companies, developers of e-mental health technologies and of course political and other public decision makers. The eMEN project is thus a promising combination of e-mental health activities in science, product development, policy consultations and public communication.
The extent of awareness, acceptance and use of e-mental health applications differed a lot at the in the six partner countries at beginning of the eMEN project. While the Dutch have already gained a lot of experience with the use and implementation of digital applications in standard care, the situation in France is still very different. Therefore, a central concern of the eMEN project is to impart knowledge on various aspects of e-mental health, such as application security, legal framework and special ways of application, such as wearables.
We invited interested parties to get in touch and find out more about e-mental health at theme-specific seminars and conferences. In Germany, three events have already taken place. These seminars covered mainly scientific foundations and political conditions of e-mental health applications. In order to add a practical component to the speakers' theoretical presentations, we set the stage for small and large providers of e-mental health applications to introduce their products and provide participants with an insight into the world of Internet-based interventions. In addition, all applications could be tested at trial stations. All events appealed to participants and were well attended. The next German event is scheduled for November 2019 in Berlin. Up-to-date information on upcoming events, also in the other partner countries, can be found here.
In all eMEN partner countries pilot studies will be used to test best practice examples for e-mental health implementation. Seven applications for PTSD, anxiety disorders and depression are optimized in collaboration with the developers and adapted to local conditions. Testing the applications in practice provides valuable information on how processes must be designed in order to integrate the products sensibly and successfully into standard care. The studies give an idea on which niches e-mental health applications can fill and which requirements must be complied for implementation of e-mental health solutions. The DGPPN collects data on the attitude among professionals and sheds light on the benefits of e-mental health applications for inpatient care. In addition, we would like to find out which factors can promote or hinder the implementation into standard care. Our goal is to interview about 100 experts in 10 clinics in Germany (data collection in April/May 2019).
The experience from the pilot studies will help to better understand and recognize requirements for implementation of e-mental health applications. Successful best practice examples will serve as a model for future projects in which digital applications will be integrated into standard care.
Further, the knowledge gained from the pilot studies will be used to generate a transnational policy recommendation for implementation of e-mental health solutions, which will be rendered to the European Commission. Another important pillar of this work is the identification of the specific legal and political context of each partner country. All eMEN partners conducted interviews with relevant stakeholders to highlight and consider the needs, demands and concerns of all stakeholders. This country-specific research showed that the awareness and knowledge about e-mental health applications must be increased in order to reduce fear of contact, to counter prejudices and to show potentials. From stakeholder interviews we also derive that training and further education opportunities on e-mental health solutions and application of digital interventions must be established. So far issues of reimbursement and liability have been inadequately regulated in all partner countries. The establishment of clear regulations is one of the most important prerequisites for the use of digital interventions in everyday clinical practice. Concrete short-term recommendations for action as well for policy are developed under the leadership of LVR-Institute for Healthcare Research (LVR-IVF). These policy recommendations aim to facilitate the integration of e-mental health solutions into local health systems, publication is planned for November 2019.
In order to secure the results of the eMEN project in the long run, a transnational cooperation platform will be set up. Here, the experiences and "lessons learned" in terms of product development, implementation and knowledge transfer are recorded and will benefit future e-mental health projects. The platform aims to be a point of contact for all e-mental health stakeholders to facilitate the introduction of digital interventions into standard care. You can register in advance for the platform on the eMEN project website.
(status: March 2019)
29 November 2018 | Berlin | E-mental health in Europe: learning from our neighbours
11 June 2018 | Dusseldorf | Second eMEN event in Germany: e-Mental-Health implementation: The digital revolution in mental healthcare
12 October 2017 | Berlin | First eMEN event in Germany