Challenges and opportunities for e-mental health policy: an Estonian case study

ABSTRACT

Public administration of mental health policy is an area that raises issues about human rights and dignity, equality of access to high-quality mental health services and the adequacy of financial resources. Globally, most people with mental health problems lack access to care services due mainly to the limited number of trained specialists, the stigma and discrimination associated with mental illnesses, and fragmented service delivery models. A widespread response to the growing demand for integrated care is the establishment of e-mental health services engaging primary and secondary healthcare specialists from different disciplines. In Estonia, evidence-based e-mental health solutions are being introduced to improve access to mental healthcare and to reduce the costs associated with treatment. However, awareness of the benefits of e-mental health solutions remains limited among healthcare professionals and the wider population. This article draws on findings from EU-funded research projects to examine the challenges Estonia faces in adopting e-mental health solutions. The author shows how the lack of public investment in evidence-based e-mental health interventions and the reluctance of relevant professionals to engage with e-mental health technologies have resulted in legal uncertainty, hindering full implementation of e-mental health policy in mental health services.

KEYWORDS:

• e-Mental health policy
• internet delivered cognitive behavioural therapy (CBT)
• integrated mental healthcare
• digital awareness

Acknowledgements

The work reported in this article was supported by two EU projects: Preventing Depression and Improving Awareness through Networking in the EU (PREDI-NU, 2011–2014, http://www.eaad.net/mainmenu/research/predi-nu/); MAnagement of mental healthdiSorders Through advancEd technology and seRvices – telehealth for the MIND (MasterMIND, 2014–2017, https://mastermind-project.eu/).

Disclosure statement

No potential conflict of interest was reported by the author(s).

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Melita Sogomonjan

Melita Sogomonjan was a PhD student in the Faculty of Business and Governance, Ragnar Nurkse Department of Innovation and Governance, Tallinn University of Technology between 2016 and 2020. Her research is interdisciplinary and related to digital healthcare and governance, with a particular focus on mental health, data protection and the legal framework of e-health policy. She has worked with the Asian Development Bank as a health information system expert, and she gained practical experience at the Health Board and in the Ministry of Social Affairs in Estonia.