The role of digital in preventing and treating poor mental health | Sean Duggan

Sean Duggan

Digital solutions for treating poor mental health has increased over time, but never more so than since COVID-19. Sean Duggan, chief executive of the Mental Health Network, brings us up to date, while highlighting that digital is part of a care pathway and traditional services are still relevant.  

Accessing mental health support via digital is now more important than ever. The scale of digital transformation within mental health settings has been significant. As the Mental Health Network set out in its recent report, Mental Health Services and COVID-19, we now need to think about how this can be maintained after the pandemic, but also recognise that accessing services via digital won’t be appropriate for everyone. Appropriate funding will be required to provide both digital and face-to-face interventions.

There had been an increase in the development and use of digital solutions even before the pandemic, but it has come into its own over the last year. Sussex Partnership NHS Foundation Trust, for example, provided more than 10,000 online appointments in two months, starting from a very low base.

There are ongoing concerns about the number of children and young people accessing mental health support and the waiting times for these services. Before the pandemic, apps such as Think Ninja from Healios have been used to support children and young people with mental health issues who are on waiting lists for specialist mental health services, and it has been used in schools to support mental health. Healios found that as the corona virus spread, daily use of the Think Ninja app increased by 168 per cent over five days. As a result, Think Ninja was updated to include content relevant to COVID-19 and was made freely available to all young people across the UK.

The lockdown earlier in the year saw schools being closed, which had an impact on many children and young people. Place2Be, a charity that provides mental health support in schools, teamed up with providers including Xenzone and Healios to ensure children and young people could still access support even when schools were closed. The importance of this can’t be underestimated, as the number of children and young people aged five to 16 with a probable mental disorder has increased to 1 in 6 or 16 per cent from 1 in 9 in 2017. This isn’t necessarily related to the pandemic of course, but we know that COVID-19 is having a significant impact on the mental health of our young people. 

The sector is also concerned about the sleep and mental health of adults. Research shows that 82 per cent of UK adults have experienced symptoms such as continuous low mood, anxiousness, low self-esteem or hopelessness while in lockdown, yet almost half (44 per cent) haven’t told anyone. In addition, a quarter (26 per cent) of UK adults say the coronavirus has negatively affected their sleep. Evidence shows that sleep problems can be both a symptom of, and a contributor to, mental health problems. Therefore, it is important to directly address poor sleep with effective, non-drug interventions.

The Thames Valley region and North Hampshire CCG have both adopted a digital solution to manage insomnia at scale. Sleepio, evidence-based digital Cognitive Behavioural Therapy (CBT) for insomnia, has been embedded in primary care and the community to open up access to treatment. In the Thames Valley, Sleepio has helped patients who began the programme in the clinical range for a probable insomnia diagnosis to achieve recovery rates of over 55 per cent, along with a reduction of c. 70 per cent in symptoms of anxiety and depression. An independent health economic evaluation has shown Sleepio delivers significant cost savings in primary care. Sleepio has also been made available to NHS and social care staff to support their wellbeing during the pandemic, with over 9,000 staff accessing CBT since April 2020.

Digital approaches should continue to form part of the care pathway for people with mental health issues, but we need to remember that it won’t be suitable for everyone. Some people will prefer digital options, but we know from service users that they are not always appropriate or easily accessible for various reasons. People may not have access to a digital device or may not be able to use it because of a disability. Sometimes a face-to-face assessment or intervention is necessary. Digital can’t replace traditional services but should be part of the local offer to patients. There needs to be sufficient funding available to ensure that patients are able to access services via their preferred route.

The Mental Health Network and NHS Clinical Commissioners are working with Big Health to host a webinar on 26 November, 12:00 – 13:00. The Role of Digital in Preventing and Treating Poor Mental Health in Primary Care and the Community - with a Focus on Managing Insomnia is aimed at commissioners and anyone interested in digital and mental health.

Join us to further the debate about digital and supporting mental health.

Sean Duggan is chief executive of the Mental Health Network. Follow the network on Twitter @NHSConfed_MHN

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