From pilot to practice: Fixing the mental health technology adoption gap
Updated: 2 days ago
MHDI is working towards clear national pathways for adoption, procurement and reimbursement.
Mental health services are under pressure that shows little sign of easing. Demand continues to outpace capacity, waiting times remain stubbornly high, and more staff and funding, while necessary, are unlikely to close the gap on their own.
Digital technologies are one of the few routes that could contribute meaningfully. They can begin support on the day of referral rather than at the first appointment, and stratify need at the point of entry so that those who do not require specialist assessment reach help sooner, shortening waiting lists from both ends. They also capture severity, functioning and outcome as a by-product of care, information currently recorded almost nowhere, which leaves services planning largely blind. Used well, they give clinicians more to work with and more time to do it.
Evidence is no longer the primary obstacle in digital mental health, and that is real progress. MindTech Bridge, a National Institute for Health and Care Research (NIHR) HealthTech Research Centre, has spent thirteen years developing, adopting, and evaluating mental health technology alongside more than 200 companies and 18,000 participants, and has supported six technologies into use in NHS services. That experience has been encouraging, but it has also made something clear. We have become better at demonstrating that these technologies work than at getting them used at scale, and the second problem is harder, and less well understood, than the first.
The reasons are structural rather than scientific. A product that satisfies regulatory and evidence requirements then encounters a health system that buys alone, organisation by organisation. Procurement routes are unclear, a NICE recommendation for a digital technology carries no funding duty equivalent to the one attached to medicines, and no reimbursement mechanism compares to a formulary. Each adopting Trust repeats information governance, clinical safety review, and evaluation in full. Demand signals are weak, so supply drifts away from what services actually need, and when a pilot ends, its funding often ends with it, with little transferring to the next site. The result is duplicated effort, stalled pilots, limited routes to national scale or sustainable revenue, and a market that gradually pushes innovators and investors away from the NHS.
"Evidence is no longer the primary obstacle in digital mental health"
MindTech Bridge was established to work on these structural problems. Hosted by MindTech HRC, it sits within the Mental Health Digital Innovation (MHDI) workstream of the Mental Health Goals programme, a partnership working towards clear national pathways for adoption, procurement and reimbursement, innovation aligned with the real needs of patients, carers, clinicians and services, and sustainable investment behind it. We lead the initiatives on adoption, demand signalling and scaling.
Our proposition is that the demand side must be organised at both ends: need-aggregated across organisations rather than expressed one service at a time, and the technologies that answer it selected, implemented and adopted collectively, giving the NHS the capacity to absorb what it has chosen. Our Mental Health Technology Demand Signalling system (M-TeDS) addresses the first, giving NHS staff a way to specify what they need while mapping what already exists and what is in development, so that demand and supply can be matched rather than each side guessing at the other.
The Mental Health Technology Adoption Collaborative (M-TAC) addresses the second: a standing consortium of providers that selects, implements and adopts validated technologies together, sharing risk and resources, with lived experience, carer and clinical voices in the selection itself. Alongside both, we are designing blended funding models that bring public, philanthropic and private capital together to finance the implementation and scaling that neither the NHS nor the market currently pays for, and building international partnerships so that UK innovations can scale beyond the domestic market.
None of this works as a single organisation's project. MindTech Bridge is working with Health Innovation Kent Surrey Sussex on implementation, and with partners across the Mental Health Goals programme who hold the procurement, regulatory, real-world data and lived experience expertise this requires. The barriers described here are systemic, and no one group will remove them. What makes the work worth doing is that the people who would have to live with the answer help design it.
Dr Aaron Kandola is the Programme Director for MindTech Bridge, a national innovation catalyst hosted by NIHR MindTech that helps commercialise, adopt, and scale digital mental health technologies.
Aaron has extensive experience across academia, government, investment, and industry, and has held roles at UCL, Wellcome Trust, the Department of Health and Social Care, Zinc VC, juli Health, and the Mental Health Foundation, giving him a system-wide view on developing and scaling evidence-based health and AI technologies and building cross-sector collaboration.
