“Digital mental health will be most successful when there’s good interplay between practitioners and academics” – Dr Martin Dechant on research in digital in mental health

As part of our focus on digital mental health, we spoke with University College London lecturer Dr Martin Dechant about his research around the use of digital interventions in mental health.

We first asked Martin to tell us a little bit about himself, and how he came to be lecturing in the field of digital mental health. He said: “I started my position at UCL in February, so I’m quite fresh! My background is computer science, sitting in the field of human-computer interaction – between the hardcore technology and making technology useful.”

On how he got into mixing technology and health, Martin explained:  “I did my PhD in Canada and my Masters and my undergrads at the University of Regensburg. We were working on eye tracking in the development of horror games, and using this data to make the games scarier. Next door to our eye tracking office, there was a clinical psychologist, and one day they asked what we were working on – they said it was similar to the work they were doing on exposure therapy. We started collaborating with them around interaction design, looking at how we could use games in the clinical context and therapies.

“I’ve also researched the potential use of games in the context of social anxiety, looking at social behaviours from the physical world and how they manifest in a digital space. Then I worked on a collaboration between (optical goods manufacturer) Zeiss and the University of Tübingen, focusing on human-computer interaction in eye health, as well as trust in AI. That led me to my interview with UCL, and now here I am.”

Detailing his role at UCL, Martin explained how he works with clinical experts on topics including game mechanics, stress reduction through gaming, prevention of maladaptive gaming behaviours, and how prevention and intervention techniques could be improved.

So what projects is Martin working on at the moment within the field of digital mental health?

“I’m working with my Master’s students on game mechanics, looking at the power of games in improving motivation,” he said. “We’ve looked at mundane harms – how games might damage your mental health unintentionally. For example, some games have things called battle passes, which present the players with reward tiers that you can access through earning experience. We’re looking into how these kind of social ratings can affect someone’s experience of social anxiety.

Martin elaborated on this link between gaming and social anxiety and interaction, explaining that during COVID, gaming could give people back the idea that they were in control of their life. Post-pandemic, he added, there have been people who have problems disengaging from games, so the question becomes how those people can be helped to get back into the real world.

When asked for his thoughts on where digital can lend the most value for mental health care, Martin said: “We have multiple levels where I think digital can help a lot, and also where it can be a negative, which is important to consider. On one side, through digital we have easy access to information; but on the other side, there is an incredible amount of information out there, so people start to have problems with figuring out what is trustworthy. Then you have concepts like doom-scrolling, and optimisation toward ‘I want to consume all of this negative information’. People can start to spiral. So it is a really good tool, but also, much of it can cause anxieties. Similarly, with digital tools; on one hand you can make things more accessible, like online therapy and consultations, but on the other hand, you can sometimes risk taking away the face-to-face interaction.”

Are there any areas of research across digital mental health that Martin feels have not yet been transferred very well into practice?

“I think we tend to stay very low with the capabilities of technologies, repeating evaluated systems rather than innovating,” he said. “The question for me is what can technology offer in terms of rethinking existing techniques and reinventing them, moving them forward? That doesn’t mean you want to dismantle them; you want to rethink them. But practitioners can’t use new innovations with patients without those evaluations, and that’s where academia comes in. That’s what I see as academia’s responsibilities – to deliver validations and guidelines to help with direction and how to design systems, like in AI and immersive media. I think that’s where digital mental health will be most successful, when there’s a good interplay between the practitioners and academic camps, learning from each other.”

Talking about the barriers to implementation, Martin noted the impact of bureaucracy and getting the acceptance of practitioners, as well as the time it can take to get approvals. In addition, he raised questions about the suitability of whoever is assigned with deploying solutions, the costs of interventions, and the ethical issues surrounding the collection or uses of personal data.

On the topic of virtual consultations, Martin said about how this was a good opportunity to increase accessibility to mental health services, but that there was a need to make sure that the technology being used was the right one. He used the example of patients with social anxiety, commenting on how it may be easier to use a text-based chatbot, rather than an immersive software, to ensure that patients feel comfortable. “If you build a technology which can mirror every little detail, but it’s too complex and too expensive to set up, then you waste time and waste the great opportunity.”

Finally, we asked Martin what he was most excited about that was developing in the realm of digital mental health. He noted he was excited about AI and how it could be used in smart devices, or smart homes, where people’s homes could be designed to participate in prevention for mental health issues. He also talked about how these types of solutions would need to be carefully developed, due to the sensitive nature of mental health and the potential for information to be misused or exploited. “There’s always two sides of the same coin, where on the one side it’s brilliant, and on the other it could backfire. That’s why the awareness of what is happening right now in the technology spaces is important.”

Martin concluded: “We are in an interesting time, where technology is changing not only due to climate change and conflicts, but also in acceptance of technology. Now, students grow up with all of this technology already here. I think it will be very interesting to see what they come up with in terms of the uses of these technologies. I gave the same lecture on the possibilities of digital in mental health to a group of computer science students and a group of psychology students, and their answers were completely different. I think that is the big opportunity which we have right now, learning from each other, and the knowledge exchange will be an important focus over the next few years.”

Many thanks to Martin for joining us.