Providing Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-Review

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Providing Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-Review

Werntz, A., Amado, S., Jasman, M., Ervin, A, & Rhodes, J. Journal of Medical Internet Research. (2023-03-01)


Digital mental health interventions (DMHIs) have demonstrated efficacy across various evaluations for improving mental health symptoms. However, user retention rates are low, minimizing DMHIs’ full impact. In this paper, the authors aimed to evaluate the effects of providing human support for digital mental health intervention (DMHI) use.


The researchers qualitatively summarized and compared previous study's meta-analytic data from human-supported DMHIs and nonhuman-supported DMHIs. They searched electronic databases to find previous meta-analyses that compared effects of DMHIs when there was human support present, versus having no human support. Outcome variables included mental health symptoms such as anxiety, depression, stress, and PTSD.


The study analyzed 31 meta-analyses comprising 505 unique primary studies. The results indicated that almost half (48%) of the effect sizes showed that human-supported DMHIs were significantly more effective than unsupported DMHIs. However, 9% of effect sizes showed that unsupported DMHIs were more effective. No significant results emerged across training types for those providing DMHI support. Also, findings suggested that human support for DMHI use might be most helpful for those with elevated mental health symptoms.


The findings suggest that human support has the potential to improve the effects of DMHIs as a way of increasing access to evidence-based mental health tools. Results also suggest that DMHIs do not need to be supported by individuals with extensive mental health training, and those with elevated mental health symptoms may benefit from human support the most. However, the study also highlights the need for more detailed research to understand the circumstances under which human support is most effective.