Wild West eHealth: Time to hold our horses? (2015)
March 5th, 2015
In reviews of the eMental health field, the Netherlands are often hailed as a forerunner nation, a shining example for the rest of the European Union. All that glitters, however, may not be gold. Dutch eMental health upscaling efforts are currently characterized by one of the most dubious mottos of the old Wild West, ‘Shoot first, ask questions later’. Pressed into action by financial incentives from health insurance companies, mental health organisations hastily implement untested e-health interventions on an increasing scale. On introduction, the efficacy and cost-effectiveness of these interventions is simply asserted or assumed. Efficacy trials start after implementation, if ever at all. Arguments do exist for this disconcerting twist in the preferred order of things, but we argue that these do not hold up to closer scrutiny. Large-scale dissemination of unvalidated e-health may kick-start a quality-sacrificing, cost-driven downward spiral in mental health care. It is time to hold our horses.