My enthusiasm about the potential of digital technology in the mental health space, is always tempering by 4 factors that make these applications risky, potentially damaging. I call these the “Shadow Elements” of digital mental health and have written about this elsewhere in the past. See Samaritans Radar & Digital Mental Health’s Shadow Elements on Linkedin).

These Shadow Elements are:

1) stigma/discrimination, which causes many suffering to suffer in silence because they are too afraid or ashamed to take advantage of mentaltech (Ironically, here the very action we use to protect ourselves individually, damages us collectively as a society and economy),

2) privacy, which risks misuse of user’s private health information, and where too many mentaltech applications lack a sufficient level of rigor in this area. (John Torous, MD, Director of the Digital Psychiatry Division at Beth Israel Deaconess Medical Center, has lately newly opened my eyes further to this (and other) hazards.),

3) clinical efficacy, which risk harm from inaccurate diagnosis and tracking, and also risks delayed adoption of effective approaches where awareness of positive evidence is low. [Note: It is important to note that low awareness of clinical evidence in this space is as much a challenge as the presence of evidence itself. This is an important point called out to me by a few colleagues who have read this post, and I agree.]

4) the digital divide, related to financial and system access, requiring price points for the masses, improved health system adoption and reimbursement

As we look to expand the benefits of mentaltech around the globe, addressing these elements must be a key element of all our strategies. They are indeed chief rate limiting factors in this movement. The subject of what can and is being done about these by various ecosystem players will be the subject of posts in this space ongoing. Certainly also use the comments space in these posts to inform us about those who you think are doing good work in tearing down these barriers.

Postscript #1 — MentalTech’s Anonymous Upside: An interesting upside to mentaltech applications, related to stigma, is that some forms allow an anonymity which has potential to help those who will not or cannot get to a human treator. Examples include: WoeBotPacifica, etc., and there are many others.

Postscript #2 — Shadow Elements’ Healthcare Universality except…:Colleagues have called out to me that these factors are universally applicable to all disease states and I agree with exception that where there is greater stigma and greater burden of illness, there is greater risk that comes with lost anonymity and underserved suffering. As this risk is relatively greater in the mental health space, this benefit is correspondingly amplified.

Postscript #3: The Digital Stress Management Survey: Also, last week, I failed to mention that I have an ongoing Digital Stress Management Survey to help get a take on how people are aware of and using digital tech for mental health. It only takes about 7 minutes to complete. It can be found here: ( Thanks for participating and spreading the word on it. I will be reporting out on its initial (and ongoing) findings in future posts.

If you want to read more about the work of The Digital Mental Health Project, please read here: ( Also, please subscribe to receive our postings in your inbox.

Be (mentally & emotionally) well.

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