As the nation deals with enforced isolation and increased social distancing measures to reduce the risk of spreading COVID-19, concerns have been raised about the profound impact this could have on people’s mental health. Oliver Harrison looks at how digital technology can deliver high-quality mental health care.
Each day we find out more about the mental health effects of the pandemic. Early on, the Office for National Statistics found that one in five Britons1 reported symptoms of depression, compared with one in 10 before. And, according to a recent study2 led by the University of Nottingham and King’s College London, stress, anxiety and depression were all significantly higher in participants compared with ‘population norms’, with 64% of the participants reporting symptoms of depression and 57% reporting symptoms of anxiety.
Waiting lists can be long and the NHS is understandably struggling to meet the demand. Disadvantaged communities, such as ethnic minorities, older generations and younger people are particularly badly affected.
How digital solutions can deliver
Having worked as a doctor in NHS psychiatry services, it’s clear to me that the solution addressing this scale of challenge must involve technology. Provided such solutions are evidence-based and effective, this is the only way for us to provide the level of supply that will meet the widespread demand and improve mental health care.
“If we want to move towards a new era of effective mental healthcare, we must take steps to deliver accessible, evidence-based services that meet the highest standards of data and ethics”
Through simple force of necessity, COVID-19 has prompted many people to explore the benefits of telehealth and digital therapeutics, from the comfort of their home. In fact, it’s estimated3 that the number of people using digital therapeutics and wellness apps will grow from 627 million in 2020 to more than 1.4 billion in 2025. I believe that clinicians and the public have realised that digital solutions can deliver high-quality healthcare, with lower barriers to access, and significant benefits in cost and time effectiveness.
But there is progress to be made. Digital mental health solutions, and the companies that provide them, must overcome some important hurdles to ensure better user experience. At present, very few mental health apps have study data. It’s critical that these are grounded in science, with activities being evidence-based. For example, we use the principles of cognitive behavioural therapy (CBT), mindfulness and positive psychology – all based on in-depth research. In addition, ethical practices must be rigorous, with more being done to ensure companies store and utilise data ethically and responsibly. This needs to go beyond simply complying with GDPR; digital mental health companies need to develop and implement their own ethical frameworks and ideally have them externally audited.
If we want to move towards a new era of effective mental healthcare, we must take steps to deliver accessible, evidence-based services that meet the highest standards of data and ethics.
Putting the key questions across – Oliver Harrison answers Pf’s questions
How important is it to focus on mental health following 2020?
No year in recent times has been more taxing on our collective mental health than 2020. Students of previous pandemics will know that getting back to ‘normal’ and ongoing uncertainty mean that mental health will be a critical topic for driving recovery for years to come. For these reasons, it’s never been more important to focus on our mental wellbeing.
What effect is digital innovation in healthcare having on mental health?
Digital innovation is changing the way in which mental healthcare is delivered. Evidence-based, ethical and personalised digital solutions are the most accessible path to quality mental health care, especially given the ubiquity of hardware like smartphones. Clinical staff are in incredibly short supply in the UK, and therefore digital technology is the only practical solution capable of scaling quickly enough to meet the rapidly growing demand. It can also be scaled at a fraction of the cost of training new psychiatrists. Apps are needed now more than ever to form part of integrated care plans, complementing traditional practices such as counselling. People are recognising this, and that’s exactly why usage and investment is so high.
How important is personalised healthcare when it comes to mental health?
Traditional healthcare relies heavily on standardisation, where all patients are treated with the same set of procedures. This does not work for the ongoing care needed for mental health support. Mental health improvements depend on changes in a person’s behaviour, and overworked clinicians cannot always provide the immediate, individualised care needed to encourage patients to follow through for the long-term. Personalisation via mental health apps can help practitioners motivate patients to trust the process, ultimately increasing effectiveness and reducing the costs. With these tools, patients are also more likely to adhere to treatment and reach a wellbeing state faster.
What are the ethical challenges that come with digital personalisation and health?In order to deliver truly personalised products, data on the individual is required. This has been a stumbling block for so many companies. In fact, on ORCHA, the organisation that NHS Digital uses to evaluate apps, only 15% of mental health apps evaluated meet the minimum criteria for data privacy, clinical assurance and user experience. This is too low, and more digital health providers must build ethical practices into the very heart of their offerings. At Koa Health, we follow a rigorous ethical framework with all of our research and products.
How can digital healthcare help patients feel empowered to take control of their care?
When we put more control in the hands of the individual by giving them personalised mental health solutions, they’re empowered to be a part of delivering their own care and self-advocate for their own health. This gives them the greatest chance of improving their behaviours and health over the long-term.
Digital solutions also empower people to get help discreetly via an app, and as a result they’re much more likely to access support. It’s easier to build healthier long-term habits with practical tools that offer immediate help and advice that’s evidence-based and customised to the patient’s unique problem set.
Oliver Harrison is CEO at Koa Health. Go to www.koahealth.com