A push for digital in mental health

Source: NHE Sept/Oct 2018

Sean Duggan, chief executive of NHS Confederation’s Mental Health Network, argues that mental health services could hugely benefit from digitisation.

Matt Hancock has made no secret of his enthusiasm for new technology. This could represent a big opportunity for mental health providers to embrace the transformative power digital technology represents – but there are significant challenges to overcome.

The new health secretary brings a fresh pair of eyes and an opportunity to start some conversations on how to embrace the future, building on his predecessor Jeremy Hunt securing a 3.4% a year five-year funding settlement for the NHS’s 70th birthday.

In particular, the new secretary of state’s enthusiasm for all things digital, as outlined in his maiden speech, is good news for the NHS, and mental health services especially. However, if his ambition to prioritise technology within the health service is to become a reality, there will need to be serious investment across the board.

Whilst there are excellent examples of innovation taking place in the mental health sector, as a whole, many people will perceive that the NHS is lagging behind when it comes to digital technology. We know what we can achieve by improving our use of technology – it will give us opportunities to reach more people and to do so efficiently – but we need to make up for what we currently lack in digital expertise and infrastructure first.

Despite the challenges, our members are making some great strides with digital innovation.

There are seven Global Digital Exemplars for mental health in England; organisations that lead the way by delivering exceptional care, efficiently, through the use of world-class digital technology and information. One of these is Berkshire Healthcare NHS FT, whose work encompasses shared access to digital records, appointments and follow-ups arranged online, and therapies and consultations taking place over the web.

The changes have been well received by clinicians and patients: 80-90% of people using online computerised cognitive behavioural therapies for mild to moderate anxiety and depression said they got help that mattered to them. For 3,200 users, it also cut clinical time in half and delivered opportunities for savings.

Much has been written about the dangers of social media, but XenZone has taken the best aspects of social media to inform its Kooth project, which gives young people immediate, safe and anonymous access to professional therapists.

The fact young people self-refer is proof they want to get help and are open to early support. Over 4,000 young people achieved or took positive steps towards achieving their therapeutic goals last year. Research in Bracknell Forest found that the introduction of Kooth was associated with a 7% reduction in referrals to specialist services.

Our members are doing some sterling work to improve access to services through the use of digital technology, but we also acknowledge there is a lot more we can do. We have a long way to go before everyone with a mental health problem is getting the treatment and support they require – and it will not happen overnight.

NHS England chief executive Simon Stevens recently named mental health, especially services for children and young people and potentially ‘core crisis care,’ as the first of his five long-term priorities which will form the heart of the 10-year plan.

However, he also cautioned that major improvements could take more than five years because of a lack of staff, even if efforts to address emerging mental health problems earlier working with schools, and employing more non-psychiatrists, proved successful.

The truth is that digital tech will form part of the solution for workforce shortages; increased risk detection, above-average recovery rates and fewer missed appointments are just some examples of what is possible when the latest technology is used to enhance – not replace – human interaction. There is no substitute for highly skilled staff delivering direct patient care.

The University of Birmingham’s Mental Health Policy Commission said access to appropriate support and treatment remains a lottery for young people, with long waiting lists and services that do not address the range of challenges that they are facing.

The bottom line is, even with cutting-edge technology expanding the capabilities of our services, we need more staff and more funding. The long-term NHS plan is a chance to put that right, and it is vital that decision-makers step up and make it a reality.


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