Berardi C, Antonini M, Jordan Z, Wechtler H, Paolucci F, Hinwood M. Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework. BMC Health Serv Res. 2024;24(1):243. doi:10.1186/s12913-023-10536-1
This systematic synthesis of qualitative evidence aimed to identify and categorize barriers and facilitators of the systemic integration of digital technologies for mental health. This article summarized the barriers and facilitators for implementing digital mental health interventions as reported by patients and providers. Barriers and facilitators were assessed at the nano, micro, meso, and macro levels and across six domains: cognitive, behavioral, attitudinal, and emotional (sixty-six papers), patient (forty-four papers), professional and interpersonal (fifty-eight papers), guidelines and evidence (fifty-seven papers), support and resources (fifty-one papers), and system and process (sixty-six papers). The complexity of the interaction between barriers and facilitators by domains and levels that impact the implementation of digital interventions cannot be overstated. Generally, patient-centered care, co-creation, empirical evidence, health equity considerations, and extensive patient and provider education are critical for successful implementation. Themes concerning personal adaptability, privacy, data security, and user efficacy were found at all levels. Digital health interventions should adapt to specific attributes of the end user, be backed by several efficacy trials, and complement, rather than replace face-to-face mental health care. The article calls for improved databases for available digital mental health interventions and urges policymakers to create tailored implementation plans that address the varied needs across different domains and levels of the healthcare system.