Comprehensive model for mental health access and service use (CoMMA): A process model for technology-enhanced mental healthcare

Over recent decades, mental healthcare reforms have been proposed to facilitate deinstitutionalization, integration into primary care, task-sharing to non-specialist providers and, more recently, digital interventions. All are aimed at improving the accessibility, acceptability and effectiveness of care. However, many healthcare systems still suffer from complexity, rigidity and inequity in access. New and more integrated models of service delivery are needed to fully harness the potential of evidence-based approaches in mental healthcare, including digital or community-based interventions. The current contribution provides an overview of recent developments - in the organization of care, allocation of healthcare services, and the digital transformation of care - and presents the Comprehensive Model for Mental health Access and service use (CoMMA). The process model includes both informal support (e.g., self-help and community care) as well as formal services (e.g., diagnostics and interventions delivered by healthcare professionals). In line with the increasing digital transformation of care, CoMMA also addressed how technology can play a role in the different model components. The purpose of the model is to provide guidance to healthcare systems, professionals and trainees in shaping the provision of evidence-based psychological services and implementing interventions. It hereby aims to complement ongoing societal, regulatory, and economic changes in the healthcare field by providing a conceptual and substantive narrative. The model shows how mental health services can be organized based on current scientific frameworks, policy perspectives, and clinical practice.