Digitisation key to improving mental health services in England; report

Personalising digital mental health treatment

Faced with a looming mental health crisis, the UK government has been urged to invest in the digitisation of service provision across the NHS in England in a new report from think tank Future Care Capital.

The study's author – FCC's head of policy and research Dr Peter Bloomfield, argues that there has been a lack of support for mental health services for many years in the UK, and the pathways for accessing them are  "convoluted, waiting lists are extensive, and outcomes are poor over the long term."

He recommends  "a complementary approach, including face-to-face care and digital support," coupled with research into digital tools that can prevent mental health as well as complementing acute care.

There is a real opportunity for digital technologies to deliver new interventions in mental healthcare, according to the report, although it added more research is needed to understand what types of technologies would be  "effective, needed, and scalable."

The recommendations come as services in the UK have been stretched to the limit with an estimated 10 million citizens needing help with their mental health as a result of the coronavirus pandemic and the disruption to social networks and livelihoods.

That has been accompanied by a  "staggering rise" in in mental health issues amongst NHS staff during the coronavirus pandemic, with a survey suggesting almost one in four (22%) met the criteria for post-traumatic stress disorder (PTSD).

At the moment though there is only a small, niche sector of companies working on apps and other digital technologies for mental health applications – 56 in total according to the report – compared to other areas of healthcare.

The majority are working on mobile apps, which are most accessible to the general population, and are clustered around facilitating talking therapy – for example providing video calls with therapists -  and behavioural assistants focusing on activities like breathing regulation, stress management and gamified treatments.

Within care settings there is also work on Internet of Things (IoT) devices and platforms technologies, in areas like patient monitoring, data collection and tools for improving productivity.

Among the recommendations are that more public money should be made available to mental health tech start-ups to encourage the sector to grow, and efforts should be made to build consortia between companies, the NHS digital innovation agency NHSX, medical charities, and government, according to the document.

At the R&D end, there is a need to foster partnerships between academics, commercial partners, charities, and end-users to develop mental health tools that are better suited to use within the health service.

Finally, new assessment pathways need to be developed for digital mental health tools, building on the work being undertaken by NICE with its digital health technology pilot and NHSX' digital technology assessment criteria (DTAC).

A  "bespoke assessment mechanism at a national level" for mental health technologies would be a driver for developing the sector, says the report.

There are some gaps in the market that need to be filled, including platforms that can educate people about mental health terminology, signpost appropriate resources and support mechanisms, and help with self-referrals.

Diagnostic technologies or screening programmes that can identify people at risk of developing problems, as well as tailored digital interventions to aid treatment, are also needed.

From a policy perspective, FCC said that the Health and Care Bill currently at the second reading stage in parliament  "will have an impact on future mental health care provision," and it welcomed  the £500 million in non-recurrent funding the government announced last year, plus an additional £38 million for NHS psychological services for conditions such as anxiety, depression and PTSD.

However,  "with so many competing demands we must ensure mental healthcare does not fall through the gaps. If we are to achieve true parity between mental and physical health services, we must include access to relevant new technology in this ambition," it argues.

FCC is hosting a webinar to explore the technology being developed for mental health care next week, with details available here.