November marked the launch of the first assessment framework for the rapidly growing number of e-mental health and addiction tools available and in development in Aotearoa New Zealand.




Commissioned by the Ministry of Health and developed by the Health Navigator Charitable Trust, the assessment framework – known as the Digital Mental Health & Addiction Tool (DMHAT) – will help anyone involved in the design, development and use of e-mental health tools to ensure the products meet acceptable quality standards.




Health Navigator CEO Dr Janine Bycroft says an assessment framework was needed to assist with identifying the quality, safety, effectiveness, security, usability, cultural fit and relevance of current mental health digital tools for use by New Zealanders and prior to inclusion in clinical pathways and any commissioning decisions.




E-mental health tools are apps and tools that are digitally delivered and aim to support mental health in some way, eg, mobile apps and online programmes. This can include wellness-orientated apps if there is a clear health-related focus and benefit.




Framework development began with a Deloitte-commissioned draft evaluation tool known as DMHAS. Health Navigator Charitable Trust was asked to road test the toolkit on three existing mental health applications.




“Following the trust’s wide consultation with stakeholders and health consumers, recommendations were provided for the next phase of development for DMHAS. This resulted in the production of the Digital Mental Health and Addiction Tool (DHMAT) Assessment Framework,” Dr Bycroft says.





DMHAT uses a range of international and NZ relevant criteria




Also an Auckland GP, Dr Bycroft says the framework is timely.




“The use of trusted e-mental Health solutions has increasingly been accepted world-wide as a realistic option for augmenting traditional mental healthcare services and improving access to psychological interventions and mental health care.




“The uptake of these solutions has further been accelerated by the COVID-19 pandemic, which has highlighted how digital approaches can offer some level of care where access to in-person services is precluded,” she says.




In addition, she adds that DMHAT has really benefited from a collaboration  between Health Navigator and ORCHA, a UK company “unlocking the power of digital health”.




“ORCHA is an international leader in digital health assessment and activation. With their guidance we’ve been able to incorporate international best practice into a baseline assessment and then develop an additional Aotearoa enhanced review process. Their experience working with numerous jurisdictions globally presented an opportunity for us to work on a well-informed and truly homegrown, culturally relevant and appropriate version of digital tool assessment, which we brought across into the e-mental health mahi (work),” Dr Bycroft says.




The framework assesses these tools against a range of criteria including clinical safety and quality and data privacy and security.




“A unique feature of DMHAT is that it assesses a number of criteria unique to Aotearoa New Zealand such as social responsibility and equity, cultural safety, user experience responsiveness and data sovereignty.”




As of this month, the framework is available as a beta version and has two components: an introductory guide that sets out baseline standards expected of e-mental health tools to help developers both before and during tool development; and a self-assessment process available either online or as a downloadable document. Developers also have access to a user manual to assist them in the process.


Pathway and collaboration forum will follow


In due course, once funding is confirmed, it is hoped a third DMHAT component will be developed that will offer a formal accreditation pathway – similar to a warrant of fitness – for developers to be able to apply for accreditation.




Dr Bycroft likens the pathway to the Social Services accreditation process, Te Kāhui Kāhu,



“This would add significant value to the sector by providing assurance that digital tools and online programmes can safely deliver e-mental health support and e-therapy for our communities,“ she says.




Formal accreditation would put in place a check for digital tools to ensure key safety, usability, relevance, cultural safety, technical security, privacy and data sovereignty standards have been met. Accreditation would also support safer, faster procurement and commissioning of trustworthy, reliable e-mental health solutions.




A national collaborative and online forum is also planned. Digital health is constantly evolving, and Health Navigator is calling on whānau (family) with lived experience, clinicians and health providers, vendors, researchers, academics and agencies at all levels to register to participate in the ongoing development of digital tool assessment, with a particular focus on the mental health and hauora (wellbeing) space.




To register for the collaborative or to access the DMHAT self-assessment process, visit the DMHAT website, which is generously hosted by eMHIC.


Dr Janine Bycroft, founder and CEO Health Navigator Charitable Trust with Health Navigator senior writer and pharmacist Sandra Ponen at the NZ Primary Healthcare Awards ceremony in March 2021.