Published in: BMJ Evidence-based mental health
With a consistent decline in mental health professionals, and ever increasing demand on NHS services, waiting lists for psychological services have been increasing for some time. In fact, in some CCGs, waiting times as long as 140 days (from seeing a GP to a first appointment with a psychologist) have been reported.
While waiting lists continue to grow, unmet needs grow in parallel with conditions often worsening. The charity MIND determined that one in 6 of those on waiting lists for mental health services are expected to attempt suicide, 4 in 10 are expected to self-harm and two-thirds are likely to see their condition deteriorate before having the opportunity to see a mental health professional.
Health-apps are one solution the NHS has recommended to fill the gap between patient need and he capacity of incumbent NHS psychological services. While some apps may be brilliant, not all apps are equal, and some can even be dangerous.
In 2015 the NHS recommended 14 health-apps within the NHS apps library for the treatment of depression or anxiety, only 4 of which provided any evidence of effectiveness, furthermore, only 2/14 used validated outcome measures.
As such, over 85% of health-apps recommended by the NHS for the treatment of depression or anxiety had no solid evidence to back up their effectiveness.
During a time of unprecedented NHS efficiency savings, the opportunity afforded by health-apps should be welcomed by NHS commissioners looking to extend the provision of high quality mental health services within existing budgets. However, this should not be done so without first guaranteeing the quality of these technologies, as this may result in a worsening of symptoms.
During the summer we surveyed 2000 consumers to find out more about how they were using health apps.
The research revealed that doctors, nurses and care staff are hardly ever recommending health apps to the over 55s – yet many in the older age categories consider themselves tech savvy.
Our research found that 55% of over 55s and 52% of the over 65s are actually willing to embrace health tech.
And a striking 90% of over 55s and 81% of the over 65s who have already used a health app have been satisfied or very satisfied with the end result.
Additionally, the research found that the older the patient, the less likely the healthcare professional to recommend a digital solution. For example, out of the research sample, GPs had recommended apps to 7% of over 45s, 4% of over 55s and just 2% of over 65s. This pattern also played out when it came to pharmacists, nurses and care professionals.
Our thanks to the Daily Telegraph for exploring these findings in more detail.
Read the full article here
“When we’re questioning whether GPs should revert to face-to-face appointments, we should reflect on the massive success of tele-health during COVID-19.”
Research scientists led by Simon Leigh, head of research at ORCHA (the Organisation for the Review of Health and Care Applications), have examined web-based internet searches for digital health products before and during the COVID-19 pandemic.
This first-of-its-kind public health paper, just published by BMJ Open, shows beyond doubt that the pressures put on the routine delivery of healthcare during the pandemic lead to ‘significant increases’ in searches for digital health products.
Examining two years of collated data (from January 2019 to December 2020), the team found that:
Commenting on the paper, Simon Leigh said: “We set out to explore whether demand for digital health products changed following the COVID-19 pandemic and the lockdown measures… it did! And these increases weren’t a flash in the pan at the start of lockdown – they were sustained in the nine months following the first lockdown, with 84% of condition areas still experiencing demand at least 50% greater than pre-lockdown levels.
“When we’re questioning whether GPs should revert to face-to-face appointments, perhaps we should reflect on the massive success of tele-health during COVID-19. Whilst a video or telephone call won’t work for everyone, for many patients it works brilliantly. This could be the start of increased acceptance of a whole new generation of medical technology and we should be encouraging GPs to use a range of approaches, including digital health products, to match the needs of patients and provide the choice they are wanting.”
The full paper, Web-based internet searches for digital health products in the United Kingdom before and during the COVID-19 pandemic: a time-series analysis using app libraries from the Organisation for the Review of Care and Health Applications (ORCHA), is available for free here or by clicking the PDF download icon below.
About ORCHA
Founded by NHS clinicians, ORCHA is the world’s leading digital health evaluation and distribution organisation. We provide services to national health bodies across three continents, including the NHS in 50% of UK regions, delivering national accreditation frameworks, bespoke Digital Health Libraries, and professional recommendation tools, specific to the needs of our clients. ORCHA’s unique Review Engine assesses digital health solutions against more than 350 measures across Clinical/Professional Assurance, Data & Privacy, and Usability & Accessibility, plus additional criteria depending on needs.
Since the start of the COVID-19 pandemic, ORCHA’s researchers have been watching trends in the use of digital health for mental health support.
ORCHA is the Organisation for the Review of Care and Health Apps. It is the world’s leading app review and distribution organisation and in the UK has created libraries of safe, top-quality apps in 70% of NHS regions.
Now, six months on from the launch of the government’s COVID-19 MENTAL HEALTH AND WELLBEING RECOVERY ACTION PLAN, ORCHA reports that:
The COVID-19 pandemic and subsequent lockdowns saw a 200% increase in the use of mental health apps. But far from falling away to pre-pandemic levels, the use of mental health apps has continued to grow at an average rate of 55%.
Founding CEO of ORCHA, Liz Ashall-Payne, said
“High quality mental health apps have more than proved their worth during the pandemic and beyond. We’re working with some superb NHS trusts and CAMHS teams around the UK to create bespoke libraries of accredited mental health apps to support their clinicians, including trusts in South West Yorkshire, Greater Manchester and Surrey.”
ORCHA is also now working with partners Chelsea and Westminster Hospital NHS Foundation Trust, its charity CW+, Central and North West London NHS Foundation Trust and West London NHS Trust to develop an app library that will form part of the youth-focussed Best for You programme, which is officially launching in November.
Liz added:
“Studies, including one in The Lancet*, have shown that e-therapy can actually be more effective than face-to-face therapy – and less costly. Clinicians are increasingly looking at patients holistically and including mental health support as part of wider care pathways supporting stroke recovery or weight management, for example. Health apps are a perfect way to provide this extra support.”
Anxiety
7 Cups: Anxiety & Stress Chat
Founded by a licensed psychologist, 7 Cups is 100% CONFIDENTIAL and offers over 160,000 trained listeners and licensed therapists to choose from. Listeners provide support across 189 countries and in 140 languages. Each listener has a profile with reviews and a list of categories that they specialise in, ranging from panic attacks and bullying to eating disorders, surviving a breakup, and more. An app user said, “I got undivided attention from someone who cared for the first time in a really, really long time.” Another said, “Talking anonymously with a listener made me feel safe enough to really open up.”
ORCHA score: 79%
Available for iOS and Android
Free chat 24/7 or paid upgrades available for further features
Depression
Feeling Good: Positive Mindset.
This app uses relaxation, cognitive behavioural therapy and resilience building techniques from sport to help improve positive feelings, self-esteem and self-confidence. The main offering is a 12-track positive mental programme which is available as an in-app purchase. The programme has been used by the NHS in Edinburgh for the last 12 years to help those recovering from stress, anxiety and depression. One user said, “This is the best thing that ever came into my life. My mental health nurse recommended it to me.”
ORCHA score: 79%
Available for iOS and Android
Free with additional in app purchases
Teen mental health
MeeToo
MeeToo makes it easy to talk about difficult things and is for anyone aged 11+. Age banding means you chat with people who are a similar age to you, so you can get advice from people of a similar age. And every single post is checked by a moderator before it goes live, so there is no bullying, grooming or harassment. A user said, “MeeToo really turned my life around, no exaggeration! 2020 had been a really crap year for me, then my social worker and crisis worker introduced me to MeeToo. The atmosphere of this community is just amazing! The members are so sweet and the advice is really helpful.”
ORCHA score: 81%
Available for iOS and Android
Free
Sleep
Pzizz – Sleep, Nap, Focus
Pzizz helps you quickly quiet your mind, fall asleep, stay asleep, and wake up refreshed. It uses “dreamscapes” — a mix of music, voiceovers and sound effects designed using the latest clinical research — to help you sleep better at night or take power naps during the day. Users said: “I love Pzizz… Best I’ve used by a mile” – J.K. Rowling, Author
“Give Pzizz a try! Love that app and it helps me fall asleep or nap on command.” – Daniel Weinard, Co-founder of Shopify
ORCHA score: 73%
Available for iOS and Android
Classic Pzizz is free. Pzizz Pro requites a subscription after a trial period
Self-harm and suicide
distrACT
This app provides easy, quick and discreet access to general health information and advice about self-harm and suicidal thoughts. It helps you understand urges to self-harm and encourages you to monitor and manage your symptoms. There’s advice and support information, including emergency contact numbers, how best to work with healthcare professionals and safer alternatives to self-harming. The app has been created by UK health professionals together with people with lived experience of self-harm and experts in self-harm and suicide prevention.
ORCHA score: 81%
Available for iOS and Android
Free
*The Lancet, July 2020 – EClinicalMedicine: A comparison of electronically-delivered and face to face CBT in depressive disorders
For more information on Best For You, visit cwplus.org.uk/best-for-you/
