Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester

There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services | BMJ Open

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Results: Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive and Sleepio  groups. Promising improvements in mental health scores were found within all three groups, as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties. Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online.

Conclusion: Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services.

Full reference: Elison, S. et al. (2017) Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of ‘Living Life to the Full Interactive’, ‘Sleepio’ and ‘Breaking Free Online’ at ‘Self Help Services’. BMJ Open. 7:e016392

New programme will assess how digital therapies can help treat anxiety and depression

NICE is to start assessing new digital therapies that will help treat more people with anxiety and depression.

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Guided self-help, which can track people’s mood or advise on breathing exercises for example, is recommended by NICE guidance to help treat mild to moderate anxiety and depression.

As part of NHS England’s Improving Access to Psychological Therapies (IAPT) programme, NICE has been asked to assess digital applications or computer programmes, which will sit alongside face-to-face, phone and online therapy.

Developers of therapy applications are being invited to submit their product to NICE to see if it meets the criteria to be entered into the new programme. An eligible product will be assessed by NICE for its content, how effective it is at treating anxiety and depression, how cost effective it is and whether it complies with technical NHS standards. NICE will then produce an IAPT assessment briefing (IAB) on the product which will be looked at by an expert panel, made up of mental health clinicians, statisticians, an economist and a patient representative. They will look at NICE’s briefing and make a decision on whether the product can be recommended for real-life testing in selected IAPT services, where further evidence can be collected on its effectiveness.

Over the next two years, NICE’s expert panel will review data from this evaluation in practice and decide if the digital therapy should be adopted for use across the whole of NHS England’s IAPT service. Funding will also be made available from NHS England for digital therapies that are identified by the expert panel as promising, but need further development.

 

Digital technology and adolescent conduct problems

Adolescents spend an unprecedented amount of time using digital technology to access the Internet and engage with social media. There is concern that this continuous connectivity could increase their mental health symptoms, especially for at-risk adolescents. | Journal of Pediatric Nursing

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A new US study has reported that on days that at-risk adolescents used technology more, they experienced more conduct problems and higher attention-deficit hyperactivity disorder (ADHD) symptoms compared to days when they used digital technologies less.

However, the study also found that on days when adolescents spent more time using digital technologies they were less likely to report symptoms of depression and anxiety.

Key findings:

•Daily digital technology use by at-risk adolescents is associated with worse mental health symptoms.
•Higher levels of digital technology use were associated with increases in next-day conduct problems.
•Attention-deficit hyperactivity disorder symptoms increased with increased digital technology use.
•When adolescents spent more time using digital technologies they reported fewer symptoms of depression and anxiety.

Full reference: McBride, Deborah L. Daily Digital Technology Use Linked to Mental Health Symptoms for High-risk Adolescents. Journal of Pediatric Nursing: Nursing Care of Children and Families. Published online 7th June 2017

Ethics of digital technology for mental health

The potential of digital technology to make the lives of people with mental health difficulties better has never been greater | The Mental Elf

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The advent of the smartphone and mobile internet access has created the conditions for an ever-expanding range of opportunities for the use of technology to influence outcomes in health. However, ethical considerations remain for professionals in suggesting the use of such technologies.

Bauer et al.’s (2017) open access paper Ethical perspectives on recommending digital technology for patients with mental illness reviews some of the major ethical concerns presented to medical professionals by this explosion of technological possibilities and explores some of the ways in which new technologies challenge the boundaries between health, commerce and the private and public uses of data.

Read the full blog post here

Mental health patients to benefit from new digital services

Seven areas across England are set to trail-blaze digital services for mental health patients, which will include innovative apps to improve care and online access to ‘real-time’ patient records. | NHS England

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NHS England has announced funding for seven mental health trusts to enable them to pioneer digital services for mental health patients.  It is intended that all key professionals involved in a patient’s care have access to real-time records – from triage and initial assessment, through to admissions or referrals, as well as transfer between services and follow up care.

The trusts will also develop remote, mobile and assistive technologies to empower patients to manage their conditions and enable family and carers to provide the best possible support.

The trusts will have up to £70m to invest in digital services – consisting £35m with additional match funding from themselves of £35m – in order to become ‘Global Digital Exemplars for Mental Health’ helping the organisations become world-leading in the use of IT, providing knowledge and expertise to the wider NHS in order to reduce time and costs for others.

This is all part of the NHS’ plan to harness technology to improve services and become more efficient.

Web-Based Mindfulness Intervention for Families Living With Mental Health Problems

Stjernswärd, S. et al. (2017) Health & Social Care in the Community. 25(2) pp.700-709.

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The aim of this study was to explore the participants’ experiences of using an 8-week web-based mindfulness programme in terms of user value and usability.

The programme’s usability was satisfactory and largely corroborated by the surveys. The programme was experienced as a valuable tool to cope with stress in both private and professional contexts, making it a viable option to support families living with mental health problems. Time for self-care, a widened perspective, a less judgmental and more accepting attitude, deterring automatic reactions and setting limits helped the participants to deal with their situation and health. The programme’s ease and flexibility of use were major advantages, although the training requires discipline.

Motivators and barriers to use were illuminated, which should be considered in the development of further online services and study designs.

Read the full abstract here

Digital-first public health: Public Health England’s digital strategy

This document explains how Public Health England (PHE) will make best use of digital to meet the needs of our users and fulfill our remit to protect and promote health and reduce inequalities.

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PHE will take a digital-first approach to lead the development of new models of public health within the public health system, working with partners including national government, local government, the NHS, the voluntary and community sector, industry, the scientific and academic community and global public health partners.

The strategy sets a common approach for our digital work including principles, clear roles and responsibilities, and standards for digital development. It describes the current state of digital within PHE and what we plan to do in 2017 to 2018.

Read the full strategy here