Predictors of Perceived Need for and Prescribing of Digital Health Applications for Mental Disorders Among Psychotherapists in Germany: Cross-Sectional Survey Study

Abstract

Background: Since 2020, psychotherapists in Germany have been allowed to prescribe digital health applications for mental disorders (DHA-MDs). DHA-MDs were supposed to foster digitalization and improve access to mental health services. However, prescriptions of DHA-MDs are less frequent than expected. Objective: We aimed to investigate which characteristics of psychotherapists predicted perceived need for and prescribing of DHA-MDs among German psychotherapists. Methods: This study was a cross-sectional survey conducted in Germany. We contacted psychotherapists between January 2024 and April 2024 via professional associations, training institutes, or the social media platform X (formerly known as Twitter). We sent questionnaires to 1000 psychotherapy practices randomly selected from the registry of the National Association of Statutory Health Insurance Physicians. We assessed the characteristics of the psychotherapists, asked them to rate the perceived need for DHA-MDs on an 11-point scale, and documented their prescribing behavior. Linear and logistic regression analyses were performed to predict perceived need and prescribing, respectively. Results: A total of 321 psychotherapists participated. Perceived need was estimated as low (mean 2.1, SD 2.1). Among the 271 (84.4%) psychotherapists with valid data, 83 (30.6%) prescribed a DHA-MD to at least 1 patient in a regular quarter. As compared to a behavioral approach, a psychodynamic (b=–1.63; P