The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality.

Journal: World psychiatry : official journal of the World Psychiatric Association (WPA)
Published Date: Jun 1, 2025

Abstract

The expanding domain of digital mental health is transitioning beyond traditional telehealth to incorporate smartphone apps, virtual reality, and generative artificial intelligence, including large language models. While industry setbacks and methodological critiques have highlighted gaps in evidence and challenges in scaling these technologies, emerging solutions rooted in co-design, rigorous evaluation, and implementation science offer promising pathways forward. This paper underscores the dual necessity of advancing the scientific foundations of digital mental health and increasing its real-world applicability through five themes. First, we discuss recent technological advances in digital phenotyping, virtual reality, and generative artificial intelligence. Progress in this latter area, specifically designed to create new outputs such as conversations and images, holds unique potential for the mental health field. Given the spread of smartphone apps, we then evaluate the evidence supporting their utility across various mental health contexts, including well-being, depression, anxiety, schizophrenia, eating disorders, and substance use disorders. This broad view of the field highlights the need for a new generation of more rigorous, placebo-controlled, and real-world studies. We subsequently explore engagement challenges that hamper all digital mental health tools, and propose solutions, including human support, digital navigators, just-in-time adaptive interventions, and personalized approaches. We then analyze implementation issues, emphasizing clinician engagement, service integration, and scalable delivery models. We finally consider the need to ensure that innovations work for all people and thus can bridge digital health disparities, reviewing the evidence on tailoring digital tools for historically marginalized populations and low- and middle-income countries. Regarding digital mental health innovations as tools to augment and extend care, we conclude that smartphone apps, virtual reality, and large language models can positively impact mental health care if deployed correctly.

Authors

  • John Torous
    Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
  • Jake Linardon
    School of Psychology, Deakin University, Geelong, Victoria, Australia.
  • Simon B Goldberg
    University of Wisconsin, Madison.
  • Shufang Sun
    Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
  • Imogen Bell
    Orygen, Parkville, VIC, Australia.
  • Jennifer Nicholas
    Northwestern University, USA.
  • Lamiece Hassan
    Centre for Health Informatics, University of Manchester, Manchester, UK.
  • Yining Hua
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Alyssa Milton
    Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
  • Joseph Firth
    Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences, The University of Manchester, Manchester, United Kingdom.

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