Mental health is regularly referred to as the 'Cinderella of all NHS Cinderella services'. In recognition of this, the coalition Government's 2011 outcomes strategy No Health Without Mental Health, set out plans to improve people's mental health and wellbeing.
However the rhetoric has not been matched with resources and the reality is that just 11 per cent of the NHS budget goes towards treating mental health, even though it accounts for around 23 per cent of all health problems. Indeed since 2011 mental health services have experienced real term funding cuts. We have looked at the potential for technology to provide an effective solution in the delivery of early intervention mental health services.
Research shows that those who suffer from mental health issues are more likely to be isolated, live in deprived areas, experience financial difficulties and struggle to stay in employment. Mental health is both the cause and effect of this. Additionally, mental health issues often impact on lifestyle and lead to higher mortality rates (3.6 times higher than the general population). Patients with mental health issues aged 30-39 have the highest mortality rates.[i]
In 2013, mental health issues, in particular stress, depression and anxiety were responsible for nine per cent of all sickness absence.[ii]The financial impact of mental-health-related absenteeism, presenteeism and staff turnover is estimated at £26 billion a year.[iii]In 2013-14 over one million people were referred to Improving Access to Psychological Therapies (IAPT) services with 70 per cent of people referred to IAPT services between the ages of 20 and 49.[iv]
The NHS is struggling to deal with demand. The last two years has seen a 10 per cent reduction in hospital beds, wards operating at full capacity and waiting lists for talking therapy struggling to achieve its targets (recovery rates are dipping and patients in some areas are waiting over a year for treatment). Only 45 per cent of referrals recover and although 48.4 per cent of patients are employed at the start of the therapy, only 45.9 per cent are still employed upon completion of treatment.[v] Organisations and charities such as the 'We Need to Talk' coalition highlight that waiting times are too long and courses of therapy too short, due to the financial constraints.
The Government's 2011 strategy recognises that information technology and telecommunications have the potential to provide new ways of working with people at risk of, or suffering from, mental health problems. Furthermore that technology can support innovation, increase choice and make services more accessible. More importantly, new technologies have the potential to play a central role in improving the delivery and quality of care and in changing the way people deal with mental health issues.
This is one area where the rhetoric is starting to match the reality. Recent data on smartphone penetration show that 85 per cent of 18-24 year olds and 84 per cent of 25-34 year olds own or have access to a smartphone.[vi] Given that the under 50 age group accounts for the vast majority of mental health referrals, and that the same age group owns the majority of smartphones, the scope for using technology to support people with mental health problems is evident.
The number of technology-enhanced mental health devices has increased rapidly in the past few years. Twenty-eight per cent of all available medical apps are mental health apps (in particular autism, anxiety and depression).[vii] The NHS's 'health apps library' (http://apps.nhs.uk/apps/) showcases a number of apps that have been sanctioned by teams of clinicians and technicians as relevant and underpinned by rigorous scientific evidence, as well as complying with all data protection laws. App uses include monitoring medication compliance; delivering cognitive behavioural therapy online; keeping track of personal health records online; and helping to manage daily life. In addition to these, there are also platforms and forums to share experience. There is also a growing evidence base demonstrating improved patient outcomes. For instance 80 per cent of users of www.bigwhitewall.com, an online mental health support tool, report that they have found ways manage their daily lives more effectively, and 95 per cent feel better after using it.
There remains a stigma attached to mental health: although people find it easy to talk about their broken limbs, they are not so comfortable talking about their broken limbic systems. Technology can help overcome this stigma by providing access to online mental health services privately and anonymously.
Given, one in four people in Britain will suffer from some form of mental illness during their life time, ranging from severe psychosis to mild depression, the impact on both the individuals affected and society as a whole is significant. Wellbeing well from a psychological point of view is just as important as from a physical point of view. Indeed, it is starting to look increasingly odd that we arbitrarily divorce these two aspects of our health and wellbeing especially given the increasing evidence of the effect that each has upon the other. The financial and social consequences of mental health are serious and pervasive and we are at an important cross-road in the delivery of services and in the promotion of good mental wellbeing. One way of tackling this is for the NHS to embrace technology to help staff to work differently so that they intervene early and change services for people with mental health issues for the better.
[i] Health & Social Care Information Centre. http://www.hscic.gov.uk/article/2543/Mortality-rate-three-times-as-high-among-mental-health-service-users-than-in-general-population
[ii] Statista, http://www.statista.com/
[iii] Parliamentary Office of Science & Technology, Number 422, October 2012
[iv] Statista, http://www.statista.com/
[v] Psychological Therapies, Annual Report on the use of IAPT services
[vi] TMT Predictions 2014, Deloitte
[vii] Patient Apps for Improved Healthcare, IMS Institute for Healthcare Informatics, October 2013
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
