Cited by 1,199Digital Mental Health InterventionsMobile Health and mHealth ApplicationsTelemedicine and Telehealth Implementation

The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality

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Torous, John, Bucci, Sandra, Bell, Imogen H., Kessing, Lars V., Faurholt‐Jepsen, Maria, Whelan, Pauline, Carvalho, Andre F., Keshavan, Matcheri +2 more·2021·World Psychiatry

Abstract

As the COVID‐19 pandemic has largely increased the utilization of telehealth, mobile mental health technologies – such as smartphone apps, vir­tual reality, chatbots, and social media – have also gained attention. These digital health technologies offer the potential of accessible and scalable interventions that can augment traditional care. In this paper, we provide a comprehensive update on the overall field of digital psychiatry, covering three areas. First, we outline the relevance of recent technological advances to mental health research and care, by detailing how smartphones, social media, artificial intelligence and virtual reality present new opportunities for “digital phenotyping” and remote intervention. Second, we review the current evidence for the use of these new technological approaches across different mental health contexts, covering their emerging efficacy in self‐management of psychological well‐being and early intervention, along with more nascent research supporting their use in clinical management of long‐term psychiatric conditions – including major depression; anxiety, bipolar and psychotic disorders; and eating and substance use disorders – as well as in child and adolescent mental health care. Third, we discuss the most pressing challenges and opportunities towards real‐world implementation, using the Integrated Promoting Action on Research Implementation in Health Services (i‐PARIHS) framework to explain how the innovations themselves, the recipients of these innovations, and the context surrounding innovations all must be considered to facilitate their adoption and use in mental health care systems. We conclude that the new technological capabilities of smartphones, artificial intelligence, social media and virtual reality are already changing mental health care in unforeseen and exciting ways, each accompanied by an early but promising evidence base. We point out that further efforts towards strengthening implementation are needed, and detail the key issues at the patient, provider and policy levels which must now be addressed for digital health technologies to truly improve mental health research and treatment in the future.

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  • Widespread access to technology has not been accompanied by sufficient mental health advocacy, leaving the detrimental effects of technological exposure unaddressed.

    “In particular, widespread access to technology has not been accompanied by sufficient mental health advocacy, leaving the detrimental effects of technological exposure unaddressed [49].”

    From SAFEvR MentalVeRse.app: Development of a Free Immersive Virtual Reality Exposure Therapy for Acrophobia and Claustrophobia (2024) · cites this paper as [49]

    The Social media section says the relationship between social media and mental health has received much attention, and describes efforts to flag self-harm content and challenge stigma. It also says screen time or exposure itself is not strongly associated with adverse mental-health outcomes. Rather than saying harmful effects of technological exposure have gone unaddressed, the paper presents a more nuanced picture and describes responses to specific risks; it does not assess whether mental-health advocacy is sufficient. (LLM, conf=0.85)

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  • Mobile health interventions, such as smartphone applications and text messaging, are commonly used to target a wide range of health behaviors in adults and represent a rapidly growing area among youth.

    “Mobile health interventions, such as smartphone applications and text messaging, are commonly used to target a wide range of health behaviors in adults and rep resent a rapidly growing area among youth 290 .”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [290]

    The Child and adolescent mental health section (page unavailable) describes growing evidence for digital therapies in young people and notes that many technologies tested in youth were first developed for adults. The paper also discusses smartphone interventions for several mental health conditions, but it does not establish that apps and text messaging are commonly used to target a wide range of health behaviors in adults; its focus is mental health. (LLM, conf=0.83)

    Experimental — accuracy not yet measured
  • VR is an emerging technology with the potential to transform mental health treatment.

    “Virtual reality (VR) is an emerging technology with the potential to transform mental health treatment [1-3].”
  • Digital mental health interventions have the potential to decrease barriers to mental health treatment.

    “Digital mental health interventions have the potential to decrease barriers to mental health treatment.185”
  • Research into problem gaming has advanced particularly in the areas of epidemiology, neurobiology and interventions, and has stimulated scientific interest in problematic engagement in other online activities.

    “Research into problem gaming has advanced particularly in the areas of epidemiology, neurobiology and interventions, and has also stimulated scientific interest in problematic engagement in other online activities (e.g., social networking sites, Internet pornography use, and ecommerce) 213,214 .”

    From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [214]

    The Social media section discusses excessive social-media use, but does not say that research on problem gaming stimulated interest in it or other online activities. Searches for gaming, epidemiology, neurobiology, and the named online activities found no passage addressing the claimed advances or influence. (LLM, conf=0.75)

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Authors
Torous, J., Bucci, S., Bell, I. H., Kessing, L. V., Faurholt‐Jepsen, M., Whelan, P., Carvalho, A. F., Keshavan, M., Linardon, J., & Firth, J.
Affiliations
  • Beth Israel Deaconess Medical Center (US)
  • Greater Manchester Mental Health NHS Foundation Trust (GB)
  • The University of Melbourne (AU)
  • Rigshospitalet (DK)
  • Centre for Addiction and Mental Health (CA)
  • Deakin University (AU)
  • University of Manchester (GB)
Venue
World Psychiatry
Publisher
Wiley
Published
2021-09-09
Volume
20
Issue
3
Pages
318-335
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
OpenAlex
W3197232629
Cited by
1,199
References
227
Citations by year
2026: 314 · 2025: 328 · 2024: 236 · 2023: 206 · 2022: 106 · 2021: 9
FWCI
123.69
Type
journal article
Language
en
Open access
Locations
  • World Psychiatry (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Research Explorer (The University of Manchester) (submittedVersion, other-oa)
Funders
  • American Psychiatric Association Foundation
  • UK Research and Innovation (P123958)
  • National Institute for Health and Care Research (NIHR300794)
  • National Institute of Mental Health (K23MH116130)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
digital psychiatry, mental health apps, virtual reality, chatbots, social media, digital phenotyping, artificial intelligence, telemedicine, remote intervention, i-PARIHS framework, implementation research, major depressive disorder, anxiety disorders, bipolar disorder, psychosis, eating disorders, substance use disorders, child and adolescent mental health, early intervention

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