NHS to trial online CBT services as part of £67.7m investment in digital mental health

The prime minister Theresa May has announced plans to improve online advice and information on mental health and increase the use of digitally assisted therapies.

Prime minister Theresa May allocated £67.7m for digital mental health services – Photo credit: PA

Giving the annual Charity Commission speech, May yesterday pledged to “reform” mental healthcare in the UK, with a focus on early intervention and prevention and a commitment to offer more support to schools and employers.

One of the main strands of the announcement was to allocate £67.7m to digital mental health services.

The majority of this cash – £60m – will go to six mental health trusts to improve digital technology, informatics and data and share these innovations with other trusts, by acting as digital exemplars.

This will be in addition to the funding promised by the government in September last year, following the Wachter review of NHS IT, for a set of 12 digital exemplars to help other trusts build up their digital expertise.

Of the remaining £7.7m, £3m will fund a trial of digitally assisted Cognitive Behavioural Therapy services for up to seven common conditions, including depression, generalized anxiety disorder and obsessive-compulsive disorder. Products that pass evaluation by the National Institute for Health and Care Excellence will be rolled out to the whole service.

Simon Leigh, principal consultant and senior health economist at company Lifecode Solutions, told PublicTechnology that the funding for the digital side of mental health treatment “had been a long time coming” but was a positive step.

“Mental health is a very hard thing to tackle,” he said. “Having digital options makes perfect sense – not only for those who are in active therapy, but also for those who are might not be ready to see a GP or other professional.”

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There will also be £300,000 funding to improve the mental health content on the NHS website, which is part of the £4.2bn funding to create a paperless NHS by 2020 that was first announced by the Department of Health last year.

The aim is to offer people up-to-date information, properly signpost people to other services, such as the Improving Access to Psychological Therapies programme, and help them better understand their symptoms.

As well as acting as an online triage system for people with mental health problems, the move would also offer people immediate access to digital therapies that they can use if they have to wait for a face-to-face therapies, which is on average 28 days, but can run to 32 days.

Leigh said that this was crucial. “Two-thirds of people on waiting lists are likely to see their condition deteriorate during that wait, so if you can offer them something in the interim that will potentially do some good – or even help reverse their problem – that has huge potential.”

He added, however, that they should be seen as an “adjunct, not a replacement” for face-to-face treatment, and that it was important to remember that some people might not be able to access apps or other online treatments.

Welcoming the government’s commitment to increasing its focus on online therapies, Jenny Edwards, chief executive of the Mental Health Foundation, said that this was an opportunity for the government to champion better mental health through digital interventions.

However, she noted that the UK is “well behind other countries in Europe and Australia in digital mental health” and that the next challenge is being able “to move away from a single offer of cognitive behavioural therapy online”.

Edwards said: “In future, we need to offer people a range of effective interventions that give patients choice depending on their experience and preference. 80% of young people have smartphones and they naturally seek information and support online.”

Five Year Forward View

The government also published its response to the Five Year Forward View on mental health – which was published by the independent Mental Health Taskforce in February 2016 – to coincide with May’s speech.

In it, the government said that efforts to make best use of digital technologies in mental healthcare included “an expanding set of NHS accredited health apps”, which will be included in an online app library that is expected to launch in April this year.

The announcement also allocated £500,000 to develop six digital tools that will focus on children’s and young people, £900,000 for an app to improve communication between police forces and mental health services and £3m for a mental health triage system for the NHS 111 line. All of this funding will come from the £4.2bn that was announced last year.

The Five Year Forward View also noted the importance of improving the use, publication and sharing of mental health data.

The government response committed health bodies including NHS Digital to drawing up plans to improve availability and transparency of such data, adding that they were developing a five-year data plan “to address the need for substantially improved data on prevalence and incidence, access, quality, outcomes, prevention and spend across mental health services”, with an update expected early this year.

Paul Farmer, chief executive of Mind, who led the taskforce that drafted the Five Year Forward View, said that he was pleased that the recommendations had been expected, but that “the key now is in the delivery”.

He said: “We know that things won’t change overnight but we do need to see urgent progress and a sustained commitment to making mental health a priority across all government departments if we are to address the damaging impact of decades of neglect and underinvestment.

“We will be keeping a close eye on the delivery of the Five Year Forward View and holding government to account on the promises made today.”


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