Digital Mental Health and Neurodevelopmental Services: Case-Based Realist Evaluation

Area of Science:

• Digital Mental Health
• Neurodevelopmental Services
• Pediatric Healthcare Technology

Background:

• The COVID-19 pandemic accelerated the adoption of internet-based mental health services.
• Prepandemic digital services offer valuable insights for current online healthcare delivery.
• There is a need to understand the components of successful digital mental health provision.

Purpose of the Study:

• To explore elements of interconnected digital mental health and neurodevelopmental services.
• To assess how web-based delivery improves access to assessments and interventions for young people and families.
• To compare the timeliness, flexibility, and person-centeredness of digital versus in-person care.

Main Methods:

• A realist evaluation using a multiple case-study design.
• Analysis of 9 pediatric cases (ages 8-15) with conditions including autism, ADHD, and anxiety.
• Program theory defined by research literature and six context-mechanism-outcome (CMO) statements.

Main Results:

• Identified 10 key elements of effective web-based services, including flexible delivery, personalized care, and multi-agency integration.
• Young people and families valued the responsiveness, flexibility, and speed of digital mental health services.
• Evidence suggests good therapeutic alliances, client satisfaction, and positive clinical outcomes, facilitated by digital tools and family involvement.

Conclusions:

• Interconnected digital mental health services are effective for young people and families.
• Web-based delivery provides more timely, flexible, and person-centered access to care compared to in-person services.
• The 10 identified elements of web-based service delivery can guide future research and enhance digital mental health provision.