Special issue: e-health innovations for global mental health

A staggering amount of 25% of people worldwide are estimated to be affected by mental in their lives (WHO, 2011). Although effective interventions to reducemental health symptoms exist, many sufferers do not receive mental health care. In particular, as much as 76–85% of people in need of treatment in lowand middle-income countries (LMICs) do not receive any treatment at all (Patel et al. 2011; WHO, 2013). Estimations may even be worse; Patel et al. (2016) revealed a treatment gap exceeding 90% for common mental disorders and alcohol use disorders in India and China, two relatively well-resourced middle-income countries (Fairburn & Patel, 2016). The lack of a mental health policy, mental health programmes and mental health legislation in many countries, aswell as limited resources (both financial and human), a limited infrastructure, stigma and shame are important reasons for low uptake and dissemination of mental health care (WHO, 2008; Munoz et al. 2016). While internet penetration and mobile phone ownership in particular is increasing globally (Pew Research Center, 2016), digital technologies offer a genuine opportunity to overcome several of these barriers. e-Health technologies have been extensively researched in the last few decades. Numerous systematic reviews and meta-analysis of randomized controlled trials have demonstrated the effectiveness of guided and unguided e-health interventions for, e.g. depression, anxiety, alcohol disorders and insomnia (Cuijpers et al. 2010; Richards & Richardson, 2012; Andersson & Titov, 2014; Riper et al. 2014; Karyotaki et al. 2017). Unguided digital treatments, especially, have the potential to reach millions of underserved people because of its scalable nature. For example, the online depression intervention ‘MoodGYM’ has been used by over three-quarters of million people since 2001 (Christensen et al. 2002; Fairburn & Patel, 2016). Although completion rates are low and effects are small as there is no therapist support, the public health impact may still be large. Recently, online clinics such as MindSpot for Australians with depression and anxiety (Titov et al. 2015) have emerged. Such clinics are likely to proliferate as they have many advantages for both users (e.g. ease of access) and healthcare systems (e.g. high patient throughput at low cost) (Fairburn & Patel, 2016). Digital treatment provided through mobile apps, virtual reality, serious gaming and artificial intelligence will furthermore become readily available in the nearby future to treat mental health problems (Fairburn & Patel, 2016). The adoption of e-health technologies has the potential to revolutionize the delivery of mental health education, training, care and advocacy in low resource settings. The goal of the current issue of Global Mental Health is to illuminate on current applications and promising new directions in e-mental health relevant to low resource settings. We present overview and review papers that summarize the research literature, as well as original research papers elaborating on recent innovations in the area. We therefore hope that * Address for correspondence: T. Donker, Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. (Email: [email protected])