Reconsidering the ethics of exclusion criteria in research on digital mental health interventions

ABSTRACT

Digital mental health interventions (DMHIs) have emerged as a promising means of expanding access to mental healthcare. Prospective participants reporting severe symptoms or suicidal ideation are often excluded from DMHI trials and may struggle to access alternative treatments. However, evidence suggests that DMHIs are efficacious for people reporting these characteristics. We suggest that there are risks to both including and excluding people from DMHI trials, and we urge researchers to ensure that their eligibility criteria are designed in an evidence-based and ethically conscious manner. We also make specific recommendations for those working in various other capacities within the academic community.

KEYWORDS:

• digital mental health interventions
• ethics
• ICBT
• Internet interventions
• eligibility criteria

Acknowledgments

All contributions to this work were made by the authors. Dr. Jeffrey Barnett was action editor for this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Canadian Institutes of HealthResearch [152917], the Saskatchewan Health ResearchFoundation, the Rx & D Health Research Foundation, and the Social Sciences and Humanities Research Council of Canada.