Maximising the potential of digital in mental health

Introduction

Digital technologies, platforms and applications are a reality within the delivery of mental healthcare pathways in England. The COVID-19 pandemic saw an explosion in the use of, and interest in, digital innovations and how they can meet population needs either caused or exacerbated by lockdowns and social distancing. Many of these solutions are now a part of the wider healthcare landscape focused on improving the mental health of the population and the delivery of health services. However, challenges remain in how digital is described; how innovation, research and development is supported; and how clarity is given to the system on the role and place of digital mental health. Work is underway to help meet these challenges but we heard that, alongside this, more clarity, coordination and collaboration is needed to make the desired impact.

Digital has the potential to play a much more significant role in meeting additional unmet need in a way that traditional service models cannot. It can make operations and services more efficient, for example through electronic patient records; it can deliver services in ways that widen access and enable earlier interventions; and it can support people while they are on a waiting list for care or treatment. To realise this potential, collaboration and partnerships between the statutory, voluntary and independent sector are critical to success. Success will also rely on engagement and co-production with people who use mental health services, and members of the public more broadly.

Why digital mental health?

We know from evidence that greater use of digital mental health technology provides key opportunities and benefits, including but not limited to:
 

1. Improved access: Digital mental health solutions can overcome geographical barriers, making mental health services more accessible to people in remote areas, those with limited mobility, and those who would prefer not to have in-person visits. Digital mental health platforms, such as telemedicine apps, online counselling services, and clinically moderated peer support platforms, allow people to access mental health support through smartphones, tablets, or computers. These platforms can provide secure communication channels between patients and mental health professionals, ensuring privacy and convenience.
    
2. Early intervention and prevention: Digital tools can enable early detection of mental health issues by tracking patterns in behaviour and mood. Through data analysis, these tools can identify signs of distress and provide timely interventions, preventing conditions from worsening. Digital mental health tools, like mobile apps and wearable devices, can collect and analyse user data to detect early signs of distress. Machine learning algorithms can identify patterns in user behaviour, emotions, and engagement, triggering proactive interventions or providing personalised coping strategies.
    
3. Closing the demand-versus-supply gap: The demand for mental health services exceeds the available supply. Digital mental health technology can help bridge this gap by offering scalable solutions that reach a larger number of individuals simultaneously, and at lower cost. Digital mental health solutions can offer self-help resources, such as guided meditation and stress management apps, which empower individuals to manage their mental health independently. Additionally, virtual support groups and peer-to-peer platforms can foster a sense of community and reduce the burden on mental health professionals.

The size of the opportunity for each benefit depends on several factors, such as support for innovation; procurement ability; policy and agency understanding and support; technological advancements; public awareness and regulatory support. We set out a summary table of the key benefits, opportunities and challenges later in the report. As technology continues to evolve and awareness improves, the impact of digital solutions in improving the delivery of mental health services and population mental health can grow significantly. The size of the opportunity for each benefit and the role of digital technology in tackling them will continue to expand as technology advances. However, it's crucial to ensure that digital mental health solutions are evidence based, user friendly, and maintain high standards of data privacy and security.

There is a significant amount of work taking place looking to utilise digital in mental health services in order meet the challenges providers face in improving the country’s mental health and delivering more accessible and effective care, treatment and support. However, we need to go further to truly maximise the potential of digital. There is great potential and a willing range of partners and stakeholders to seize the opportunities provided. This now requires greater national and local co-ordination, clarity about the direction of travel and the purpose and evidence for digital, and greater collaboration across a range of sectors and disciplines. Without this, we will miss an opportunity to make progress at scale and pace, open up greater access to care and support and play our part as a leading force in international digital mental health.

...this report captures the sector’s view on the building blocks that would enable further progress in developing and applying digital solutions to meet modern mental health needs

As the voice of NHS-funded mental health and learning disability service providers and commissioners, we wanted to explore the current challenges and opportunities the mental health sector faces in using digital products and services and develop a set of practical ideas for what can help in the immediate and longer-term future.

Based on engagement with statutory, voluntary and independent sector leaders, this report captures the sector’s view on the factors – building blocks – that would enable further progress in developing and applying digital solutions to meet modern mental health needs. We believe these building blocks will position digital as an effective enabler in improving mental health and the lives of people living with and recovering from mental health problems. As set out in our vision for the future, this would also serve to reduce the postcode lottery of care to ensure that speedy access to high-quality help is secured.

Our aim is to stimulate further conversations and action across the mental health sector with local, regional and national partners. We will work together to advocate for more attention, focus and action on digital mental health, to enable digital to play its part in responding to the many challenges and opportunities that exist.

This report is for those interested in supporting change and innovation in mental health and to making a difference to people, families and communities through digital solutions and innovations. For those in policy, digital is a key part of the next stages of national and local strategy. For mental healthcare providers and commissioners, digital is a key component in the ecosystem of care and support. For people and communities, digital can give greater access to support, a greater sense of agency and control, and can help with improving the co-ordination and delivery of care based on need.

Context

There is a demand-supply gap in mental healthcare, seen in growing waiting lists, inequalities in health, and in access to care, treatment and support. More people than ever are seeking help for their mental health, and this is likely to continue for some time following the collective trauma of COVID-19 and the cost-of-living crisis. Shortages of mental health workers of all types have held back expansion and reform, leaving services in persistent crisis mode. In quarter 4 of 2022/23, there were 112,497 full-time-equivalent vacancies across the whole NHS, and almost a quarter of these (26,837 or 23.9 per cent) were within mental health. There is also a growing need for greater action and investment upstream in prevention, early intervention and community-based care to improve the mental health of the population and improve care and support services.

From the response to the pandemic, we know the role digital can play in supporting services, systems and people to transition to new ways of working to meet the challenges we face. Important lessons and learning can be built on, alongside a chance to broaden and build the research and evidence base, develop key standards, assessment processes and improved regulation.

Opportunities, benefits and challenges

Opportunities

1. Increased accessibility: Digital mental health solutions can reach a broader population, including those in remote areas and underserved communities, improving access to mental health support.
2. Personalisation: Technology allows for personalised interventions based on individual needs and preferences, leading to more effective and tailored mental healthcare.
3. Data-driven insights: Digital tools can collect and analyse vast amounts of data, providing valuable insights into mental health trends, treatment outcomes, and user behaviours.
4. Cost-effectiveness: Digital mental health interventions often have lower overhead costs than traditional in-person therapy, making mental healthcare more affordable for many individuals.
5. Early intervention and prevention: Technology can detect early signs of mental health issues, enabling timely interventions and prevention strategies before conditions worsen.
    

Benefits

1. Improved treatment outcomes: Digital mental health interventions, when evidence-based, can lead to positive treatment outcomes and better overall mental wellbeing for users.
2. Reduced stigma: Online platforms may reduce the stigma associated with seeking mental health support, as individuals can access help discreetly from the comfort of their own homes.
3. Scalability: Digital solutions have the potential to scale rapidly, allowing mental health resources to reach a larger audience in a short period.
4. Diverse modalities: Digital mental health encompasses various modalities such as mobile apps, virtual reality and online therapy, catering to different needs and preferences.
5. Value for money: Through direct cost savings, avoiding additional costs by intervening earlier and allowing for increased reach and ongoing support between clinical interventions, digital mental health services have shown to provide positive economic benefits and a return on investment.
    

Challenges

1. Privacy and security: Handling sensitive mental health data requires robust privacy measures to protect users' confidentiality and prevent data breaches.
2. Regulatory compliance: Adhering to healthcare regulations and standards can be complex, particularly when dealing with cross-border data sharing and tele-health services.
3. Digital divide: Not everyone has equal access to digital technology, potentially leaving some individuals without the opportunity to benefit from digital mental health interventions.
4. Quality, efficacy and managing risk: The market is flooded with mental health apps and solutions, but not all are evidence-based or effective. Ensuring the quality and efficacy of digital mental health tools is essential, alongside the ability to manage and respond to risk effectively.
5. Therapeutic relationship: Some people may find it challenging to establish a therapeutic relationship with digital tools, as they lack the face-to-face interaction that traditional therapy offers.

Addressing these challenges and maximising the opportunities and benefits requires collaboration among stakeholders, including mental health professionals, technology developers, policymakers, users and communities. Investing in innovation and research to validate the effectiveness of digital mental health interventions and setting clear guidelines for their deployment can lead to a more successful integration of technology in mental healthcare. Additionally, bridging the digital divide and addressing data privacy concerns are crucial steps in ensuring equitable and secure access to digital mental health resources for all.

The policy landscape

While we identified a significant amount of activity already underway to support digital to be an effective enabler for delivering high-quality mental health services and to support population mental health, our findings also highlighted that more needs to be done to maximise digital’s contribution in these areas. We heard that more coordination and clarity is needed on what is happening and where, alongside more opportunities for collaboration. The image in Annex 2 links to a summary of what is already underway and in the public domain, to help build shared knowledge and understanding of the digital mental health landscape and to highlight the platform that can be built on.

The policy landscape is fast-paced and changing. In April 2022, the government in England opened a consultation to the public and interested stakeholders to inform the development of a cross-government ten-year mental health and wellbeing strategy. In January 2023, it was announced the responses would be incorporated into a major conditions strategy, including mental health as one of six conditions, with an interim strategy published in August 2023. The Spring Budget 2023 announced investments into digital mental health, and recommendations were made in the Hewitt review of ICSs for how digital tools and apps can play a vital role in enabling ICSs to improve population health outcomes. See Annex 3 for more detail on these developments.

The question is not can digital help meet these challenges, but how. A 2023 joint NHS Confederation and Google Health report explored the role of technology in managing, improving and supporting health and wellbeing. It found that across all age groups, 72 per cent would use technology to avoid a hospital admission, with a similar proportion happy to use technology to monitor their health and share information and data with their doctors.

In the conversations and discussions we held, people were clear that the benefits outlined above can be realised by working on the key building blocks set out in the next section. By acting on these levers of change, more progress can be made at pace and scale locally and nationally. It is essential that at all levels of the system - local, regional and national - now work more closely together to support digital to be an integral part of the ecosystem.

Methodology

We held a number of focused conversations with leaders across the mental health sector, with experts by experience and occupation included in our engagement (see Annex 2), to capture their views on digital mental health, their key priorities, what holds them back and what they would like to see next in this space. Alongside these conversations we held an online roundtable of 20 participants, hosted by the NHS Confederation’s chief executive Matthew Taylor, to explore in more depth the principles, themes and suggested actions that came up in our conversations.

Three guiding principles

From our conversations, we heard that for digital to be an effective enabler for mental health services and towards improving population mental health, there is a need for three principle foundations to guide future work: collaboration, clarity and coordination between stakeholders.

People were clear in our conversations that if we get these three core principles right, then the landscape for the future looks more promising. When taken collectively, these can help drive the culture change required to support the adoption and scaling of new technologies for the benefit of people’s mental health and the delivery of mental health services.

Any work taken forward from here should have these three principles in mind.

Collaboration

We heard that the sheer scale and complexity of the organisations and individuals involved in designing, delivering, commissioning, procuring, assessing and researching digital mental health services, mean that collaboration of effort and purpose is very challenging. People felt that finding ways to encourage and reward collaboration of effort and purpose would be helpful, as would finding ways to make collaboration across sectors easier.

Increased collaboration would ensure that the expertise across the mental health and digital sector, in statutory, voluntary and independent organisations, can be more fully utilised towards meeting the needs of mental health service providers, their staff, patients and populations.

We feel there is a role here for the Department of Health and Social Care (DHSC) and NHS England (NHSE) to help develop ways of supporting greater collaboration at national, regional and local levels. We are keen to help explore what these could be.

Clarity

We heard that people do not always know what is being done in the digital mental health space. Our respondents were unsure whether activity, funding and efforts are of benefit to people, populations and the system, or whether or not they are helping to reduce exclusion and inequalities. There is also uncertainty about how providers, commissioners and stakeholders know what is being developed, offered, commissioned, provided and bought, and whether they are effective, safe and of high quality.

Increasing clarity around what is happening in the digital mental health space and sharing this through accessible channels can help ensure that people are well informed and up to speed in a dynamic and fast-moving arena. Clarity also helps in providing mental health commissioners, providers and the general public with greater confidence that digital innovations and interventions are of high quality, safe and effective, are able to make a positive impact on mental health, and help reduce health inequalities.

Coordination

We heard that initiatives and innovations in the digital mental health space are not always coordinated between national, regional and local stakeholders. This results in less impact and reduced opportunities for learning and for sharing both the good and not-so-good experiences. While pockets of good practice and innovation do exist, it would be extremely valuable to ensure that all parts of the mental health sector are able to share and learn from practices and experiences.

Increased coordination at the national level would ensure that providers at the regional and local level were better equipped to make decisions around digital mental health, aligned to national guidelines and systems. This could enable more choice and access for patients and providers and more benefits to accrue to local population health systems.

We feel NHSE can play even more of a leadership role in co-ordinating work across the digital mental health sector, and we make suggestions on this in the next section based on what we heard from our partners and stakeholders. We see these as helpful building blocks on which to base future work.

Seven building blocks for the future

In this section, we outline the main themes that arose in our conversations and discussions and suggest what might help to take these forward as key principles and a series of seven connected building blocks. These blocks aim to build on the three key principles to address how we can harness the benefits of digital mental health, overcome the challenges or identify the levers and opportunities that can be addressed.

Developing a compelling narrative

For patients and the public to have confidence in digital and reap the full benefits it can offer, we need to improve the narrative that explains how digital is used in healthcare.

NHS, voluntary and private sector leaders all agreed that the purpose of digital innovations within mental health is to improve services, solve challenges, meet the needs of the population and achieve better outcomes for people in their lives and in their recovery. The benefits set out can only be achieved if they are targeted towards the area where digital can be most effective and meet need. It's helpful when outlining this need to identify if it is focused on digital patient data or digital services delivering support, as this may influence how it is designed and by whom. When there is a compelling narrative and the positive impacts of a new innovation are clear, then it supports the cultural shift to ensure the innovation is adopted as people can see the value and feel like their views have been considered. It’s not the digital technology element that matters, what really matters is the purpose, utility and impact of the digital innovation or service. This helps move to design- and needs-led solutions, rather than technology-led solutions.

Making progress

What can help is early collaborations between services, commissioners, people with lived experience, providers and local, regional and national planners. Creating these collaborative opportunities locally and nationally is an important part of the future landscape. There is a lot to build on the role of Academic Health Science Networks (AHSNs) and, together with NHSE’s transformation directorate and mental health team, there are ways to improve collaboration to bring digital innovations to scale. This also includes the need to develop and enhance work that improves the digital literacy of health and care providers as well as the public, and considers how to overcome the cultural barriers to adoption and scaling of digital innovations.

Harnessing lived experience

Not enough is being done to harness and bring together the expertise of people with lived experience and those across the statutory, voluntary and independent sectors. 

Digital innovations and products should be co-designed using the expertise of people with lived experience of mental ill health, and experts by occupation across the statutory, voluntary and independent sector. We heard that this should be seen as a core element of service development and delivery, with lived experience and public views embedded from the start and developed as part of a service design process focused on the impact and outcomes that the digital services are aiming to achieve. This will help avoid digital solutions being seen by as an additional layer, or something extra to be built on the side of a service. We heard examples of good practice in involving those with lived experience and local communities, building this into the DNA of digital development is crucial.

Making progress

Finding ways to harness lived experience will be key. For example, the benefit of increased accessibility will be more likely to be achieved if services and initiatives are designed in partnership with people with lived experience of using mental health services. One suggestion is that any standards developed would include standards around lived experience in design, development and delivery. The NHSE Digital Mental Health team has a suite of guidance and resources on inclusive digital transformation which will be useful in building engagement into any design process.

Using the opportunity of integrated care systems

Leaders want to participate in an ecosystem of partners with shared aims to use digital to meet the needs of their populations, but more is needed for this to be a reality.

Integrated care systems offer a unique opportunity to set the cultural and practical tone for digital innovation and delivery. As a collection of partners tasked with planning and delivering joined-up health and care services to improve the lives of people who live and work in their area, they can define what is needed to meet a local population’s health needs and how digital can help enable this. This could and should cover the full range of digital services and digitisation, from interoperability to commissioning population-wide preventative digital interventions.

No one digital product will be able to meet all the needs of a system, but in combination with other services and support and as part of a wider ecosystem of partners and stakeholders that sits alongside a system, digital has a key role to play. The challenges are well known, including reducing growing inequalities, the challenge of demand outstripping supply, meeting the needs of people waiting for services, improving workforce capacity issues and reducing care staff burnout. 

There is a clear appetite for more collaboration and partnerships across the system to learn from what is working, what’s not working and finding new ways of bringing all voices to these conversations. The importance of these being led by experts within the field of mental health was identified as critical in the establishment and delivery of an effective ecosystem of partners, and will help ensure the benefits of digital are realised. 

Making progress

Integrated care systems can be leaders for digital mental health, and using digital to meet the needs of their population’s mental health. They have the unique opportunity to harness scalability for their populations, and the benefit this will realise. This will require greater national co-ordination, action to embed digital in planning guidance, and a willingness from commissioners and providers to work together to ensure that any digital services being used locally can fit into the local ecosystem of care and support. The Hewitt review helps and the calls are welcome for each ICS to have both data and digital champions who also meet as part of a wider national board.

Increasing the focus on inclusion

Digital services should be designed in a way that recognises the challenges faced by those excluded from accessing the internet or who don’t have the skills, interest or capabilities to engage in digital services.

Digital inclusion is about making sure that everyone has the capability to use the internet, access data and associated technology to do things that benefit them day to day. Alongside access to internet and devices, the importance of digital skills to be able to easily navigate and engage in an increasingly digital world must not be underestimated. It cannot be assumed that everyone has these skills. Ensuring this is addressed either nationally or as part of any digital innovation is essential in ensuring digital doesn’t exacerbate inequalities, but instead reduces them. The benefits and opportunities of digital mental health will not be fully realised if sections of the population are excluded from accessing it.

Making progress

Our conversations proposed different ways of tackling digital exclusion. One that resonated was helping to ensure that key digital services can be accessed through free data packages, as they do for some national digital services in New Zealand. Another was to look at existing initiatives that are making a difference at the local or system level, and looking to support other systems and providers to adapt and adopt these.

Creating learning opportunities

A more collaborative and partnership-focused environment, learning from international examples, would be welcome.

Learning from countries that are further ahead and applying the good practice in our own context would be a positive step forward. Helping service providers understand what works, and why, will help the sector overcome challenges such as overcoming the digital divide and ensuring privacy concerns are addressed. In Scotland, a national Digital Mental Health Innovation Cluster brings together partners from across the system on a regular basis to ‘gather and share global and local insights, identify and develop innovative products and services while building knowledge to overcome key challenges for mental health and wellbeing.’

Making progress

There is an appetite for a similar model in England to the Scottish Digital Mental Health Innovation Cluster, and plans are underway to establish a digital mental health innovation working group, to be initially facilitated by NHS England. The NHS Confederation’s Mental Health Network also works with international partners through the International Initiative for Mental Health Leadership (IIMHL) and eMental Health International Collaborative (eMHIC) to share good practice and facilitate learning between countries and systems. A number of digital innovations were shared in a recent case study series exploring International Innovations in Mental health.

Supporting innovation, research and development

Simplifying the current system of innovation, research and development would be helpful and would enable stakeholders to have a better knowledge and awareness around what is available to support innovations and research in digital mental health.

We heard the current system is complex and there was a general lack of awareness of the range of digital tools, technologies and services available, alongside what was in the development and research pipeline. Quality, efficacy and how to manage risk was identified as a key challenge in our conversations, with the market flooded with mental health apps and solutions, but not all are evidence-based or effective. People called for a way of co-ordinating and harmonising effort on research, development and innovation (RDI). This could be a role for AHSNs as they move to the next stage of their development.

Making progress

One idea we heard that might be useful was a hub or platform where funders, providers and individuals could understand what is happening, by whom and with what timeline, as this would help provide clarity. This could also help publish findings on digital innovations and interventions.

There are a number of agencies and funding bodies involved in investing in and supporting RDI. If these efforts were brought together as a ‘mission’ approach, more progress could be made. We have seen this model applied effectively in the funding of £42.7 million investment into mental health research more broadly, by NIHR and the Office for Life Sciences.

Focusing on regulation, standards, quality and safety

We heard from our conversations that now is the time to focus further on regulation, safety and quality in the digital mental health space, with opportunity for engagement in this being essential.

Regulatory compliance was identified as a key challenge, recognising that adhering to healthcare regulations and standards can be complex, particularly when dealing with cross-border data sharing and tele-health services. Our stakeholders want to see an articulation of a national approach to setting up and establishing a regulation, assessment and quality system; one that is not separate from an overarching digital health regulation system, but as a key component of this overarching system. This was identified as an important step that would allow the benefits of digital to be realised at scale.

There is a lot already to build on in mental health including the Digital Technology Assessment Criteria (DTAC), NICE’s Early Value Assessment (EVA) for Medtech, Orcha’s accreditation of digital health solutions, the upcoming MHRA Innovative Devices Access Pathway, and new funding from the Wellcome Trust of £1.8 million to the MHRA and NICE, to explore regulation of digital mental health tools over the next three years. What can help moving forward is, in addition to the work on technical standards, privacy and security, there is a system that supports standards and assessments for usability.

Making progress

There is a need for minimum standards, co-designed by the mental health sector and public, for quality, safety and privacy of applications being used as part of a public service around mental health. This would include defining what is or isn’t a clinical device, and setting out which interventions or innovations would require greater or less regulatory rigour.

We also heard that this should be evenly split between protection of data and cyber security, and patient safety. Currently, regulation feels heavily weighted to data and cyber security as opposed to safeguarding and risk management.

While it shouldn’t be ignored, there are significant challenges in regulating what has been termed the ‘wellbeing market’. The public as consumers can and will decide what and how they consume in this space. It’s important to recognise that innovations happen alongside the continuing development of traditional services. In theory there is nothing wrong with open access to a range of digital services. The issue becomes sharpened when taxpayers’ money is being used to purchase services in this arena. It is here where commissioners need to be satisfied with the evidence, impact and safety of broader wellbeing offers. What can help in this space is some of the assessments such as Organisation for the Review of Care and Health Apps (ORCHA), which provides an independent assessment of services, NICE’s early value assessments and NHS England’s digital technology assessment criteria (DTAC).

Making progress

We heard a desire for minimum standards, co-designed by the mental health sector and public, for quality, safety and privacy of applications being used as part of a public service around mental health. This would include defining what is or isn’t a clinical device, and setting out which interventions or innovations would require greater or less regulatory rigour.

We also heard that this should be evenly split between protection of data and cyber security, and patient safety. Currently, regulation feels heavily weighted to data and cyber security as opposed to safeguarding and risk management.

While it shouldn’t be ignored, there are significant challenges in regulating what has been termed the ‘wellbeing market’. The public as consumers can and will decide what and how they consume in this space. It’s important to recognise that innovations happen alongside the continuing development of traditional services. In theory there is nothing wrong with open access to a range of digital services. The issue becomes sharpened when taxpayers’ money is being used to purchase services in this arena. It is here where commissioners need to be satisfied with the evidence, impact and safety of broader wellbeing offers. What can help in this space is some of the assessments such as Organisation for the Review of Care and Health Apps (ORCHA), which provides an independent assessment of services, NICE’s early value assessments and NHS England’s digital technology assessment criteria (DTAC).

Suggested discussion points for future exploration

There is a significant amount of work taking place looking to utilise digital to improve mental health services and meet population mental health needs. However, we know we need to go further to truly maximise the potential of digital. Through the discussions we have had during this project, we have seen great potential and a willing range of partners and stakeholders ready to seize the opportunities provided.

This now requires greater national and local co-ordination; clarity about the direction of travel and the purpose and evidence for digital; and greater collaboration across a range of sectors and disciplines. With clear national leadership from NHSE and DHSC and a focus on greater co-ordination of effort, collaboration and clarity on future direction, digital can be a key component in the mental health ecosystem. There is an opportunity in England to make progress at scale and pace, open up greater access to care and support, and play a part as a leading force in international digital mental health.

From the principles and building blocks identified from our conversations and discussions, and building on the work that has taken digital mental health to this point, we have developed a set of discussion points for further exploration with system players that may help move things to the next stage. 

1. Create further opportunities for a wider and deeper national conversation on digital mental health and its future. Biulding on existing forums led by DHSC and NHSE, and with support from local government and the national voluntary sector, a singular national conversation would enable all stakeholders to come together and consider what is needed to move forward and how to achieve NHSE’s digital priorities for mental health. Involving the public and people with lived experience in this would be essential. This would also be a good opportunity to look at what other countries are doing in this space, to gather learning from a global perspective.
    
2. Consider clarifying digital’s place in the overall mental health ecosystem of care and population health. We see this as a key role for NHSE to consider including digital mental health in existing guidance and planning. This could include co-designing specific guidance for ICSs. This would build on the aims and priorities of the long-term plan, but going wider to embrace digital as a key embedded part of the future local systems.
    
3. To drive collaboration in innovation, NHSE to continue establishing a national innovation working group, bringing together all interested stakeholders. This group could then work in a similar way to the Scottish Government’s National Mental Health Digital Innovation Cluster, which brings together cross-sector organisations for sharing, learning and development.  
    
4. Bring together the leading research and development funding agencies to agree a programme of research and innovation priorities for digital mental health. As part of this, it would be helpful to include the development of a central portal of information on digital mental health; current, past and future research; and innovation opportunities. This could be explored by AHSN’s and UKRI alongside NHSE and DHSC.
    
5. Provide clarity on existing regulatory processes, in alignment with a centrally designed policy framework in development by NHSE and NICE, and agree a national process for establishing a modern and proportionate regulatory system with the main bodies engaged and involved, including the MHRA. 
    
6. Consider how to develop an effective way of scaling digital mental health solutions in local and national solutions. This would also add value by focusing on culture change and supporting adoption, implementation and change management of innovations. We see NHSE and AHSNs with a key role to play in taking this forward.

The Mental Health Network is keen to play a supportive role in maximising the potential of digital mental health to make a real difference to people, families and communities, including through further exploration of the topics in this report and the recommendations made. We remain committed to supporting our members in exploring how digital services and innovations have impact and improve outcomes for population mental health, people with mental health problems and serious mental illness.

We see this report as a step in a longer-term collaborative journey. The next step is to bring stakeholders and partners together again with national policymakers, NHSE transformation directorate and mental health leaders in a second roundtable discussion to explore in more detail the findings and suggestions and develop more specific plans for taking the building blocks forward collectively.

Annexes