Over the past two decades, advances in digital technologies have begun to transform three aspects of mental health care. The use of sensors and artificial intelligence (AI) have provided new, objective measures of how we think, feel, and behave. The ease of connecting and communicating remotely has transformed the brick-and-mortar practice of mental health care into a telehealth service, increasing access and convenience for both patients and providers. And the advent of digital therapeutics, from virtual reality for treating phobias to conversational agents for delivering structured therapies, promises to alter how treatments will be delivered in the future. These digital transformations can help to solve many of the key challenges facing mental health care, including access, quality, and accountability. But digital technology introduces a new set of challenges around trust, privacy, and equity. Despite high levels of investment and promotion, there remain profound questions about efficacy and safety of digital mental health technologies. We share our experiences from the front lines creating digital innovations for mental health, with a focus on what a digital transformation of care could deliver for millions with a serious mental illness.