Digital mental health has become an established part of mental health care, but the rapid arrival of large language models and other artificial intelligence tools has refocused attention on the evidence needed to guide the field. This editorial updates the research priorities articulated by JMIR Mental Health in 2023, while reaffirming their emphasis on equity, replicability, privacy, efficacy, and engagement. What has changed is not the importance of these priorities, but the urgency with which they must now be applied. As digital tools become more clinically consequential, research must move beyond demonstrating that a technology is feasible, usable, or novel. The field needs studies that clarify how these tools work, for whom they are beneficial, under what conditions they may cause harm, and how they can be responsibly integrated into care. We call for research that is transparent about the technologies being studied, grounded in meaningful clinical questions, attentive to safety and accountability, and designed to produce knowledge that remains useful as specific products and models change. The promise of digital mental health will depend less on the sophistication of emerging tools than on the quality of the evidence used to shape their role in care.
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Radically different