With mounting evidence that mental health problems have become even more prevalent since the pandemic, in the UK, the government has developed a Mental Health Recovery Action plan. Backed by £500 million, it aims to respond to escalating mental health issues, specifically targeting groups which have been most impacted including those with severe mental illness, young people, and frontline staff.
During lockdown, services turned to digital, switching from in-person help to a range of digital services, such as patient-to-clinician platforms, digitally-enabled treatments, mental health and wellbeing apps, chatbots and social support networks.
As services deliver against the mental health recovery action plan and COVID-19 restrictions lift, we ask what is the role for digital now?
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A partnership of health and social care organisations working together, Our Dorset holds the ambition for its 750,000 residents to lead healthier, fulfilling lives supported by sustainable health and care services. But the organisation faces real challenges. Dorset’s population is ageing, bringing more long-term conditions, which places a growing demand on services. Its funding cannot keep pace with this growth in demand and without changing its services, in five years it would face an annual shortage of £229 million a year(1).
To address its ambitions and challenges, the Integrated Care System has identified a clear plan, in which digital plays an enabling role. It established a ‘digitally-enabled Dorset programme’ to increase the use of technology in the health and care system, to support new approaches to service delivery.
The programme first researched and established the building blocks needed to establish public facing digital health. Alongside videos and the NHS choices website, apps were identified as a key building block to enable patients to better manage their own health.
To understand more about if and how health professionals could recommend the use health apps and what would be needed to support them, a pilot was run with 20 nurses. This revealed the team didn’t know where to find good health apps, how to know if they could trust them, if they met policy or who to ask for advice.
Without the expertise to establish a closed-loop quality assured programme, or capacity to be able to test health apps, let alone test them again when they are updated, the team recommended partnering with ORCHA. They selected ORCHA as they had seen how it had delivered testing at a national level and for other regional providers. With ORCHA, Our Dorset could build a programme to mitigate risk and assure clinical teams they are recommending safe apps.
ORCHA tested apps against 350 standards and measures and worked with Our Dorset to identify the best health apps across each priority health area. A dedicated app library was built to house the apps and enable patients and staff to search. It was also agreed that if an app doesn’t appear in the library it will not be recommended by any member of staff. If an app is ever nominated that isn’t in the library it will first be reviewed by ORCHA before being used by Our Dorset.
Our Dorset also opted to include a feature to enable staff to recommend apps via email or text message from the app library directly to residents and patients. This eliminated human error and enabled recommendations to be monitored.
Once ready, the team ran a series of 30 onboarding sessions across all ICS providers and governance leads, including all non-clinical teams, including link workers, health coaching and social prescribers. Over one or two sessions, teams were briefed on the value proposition of health apps, walked through the system and key apps were demonstrated. The health app programme also saw the emergence of a local Community of Practice which became a regular fixture on team meetings, prompting people to share learnings, tips and good practice including hearing about cohorts that are responding well to health apps.
Alongside training staff, the app library was launched to the public, forming part of its #HereForYou campaign which reassures Dorset residents that their health services are still available should they need them and that they should seek help and advice despite the Covid-19 pandemic. This included PR, social and paid digital activities.
Since introduction, the teams have actively embedded the app library and the practice of recommending health apps into their service offer. The teams drive home the concept of self-management and pick out effective tools that are available.
There have been almost 25,000 pages viewed on the site (up to the end of November 2020), and in one month alone, the app library achieved nearly 5,500 page views. Social prescribers are actively recommending apps to service users and vitally, this advice is being acted upon, with almost 1,500 apps recommended to date and 56% of recommended apps downloaded, which is a very good engagement rate, especially compared with other services.
The most popular search terms include Mental Health MSK, Dementia, Diabetes and Cancer. Some of the most popular apps to be viewed are Wysa: Stress, Depression & Anxiety Therapy, Sleepio, NHS Weight Loss Plan and Musculoskeletal (MSK) Self Care, providing a range of health interventions and show that apps are being selected to improve the physical and mental health of the population.
One of the most active recommenders of health apps is George Mitchell, Social Prescriber, Live Well Dorset. One app from the library he finds useful is Quit Now, as he shares that “it gives people support 24×7.” He regularly shares app tips with other prescribers, as he says “Don’t assume that just because you know about an app, everyone else does.”
Commenting on the programme Crystal Dennis, Interim Lead for Public Facing Digital Health Services, Our Dorset Digital said:
“ORCHA power our health app library. They help us to break down the barriers and mitigate issues around digital health. Previously our clinical leads didn’t recommend digital health technologies as they had no idea where to look, were concerned about implied liability and couldn’t tell if a technology was of a good standard. Thanks to ORCHA we are building the trust with clinical teams and have put in place the tools and governance they need.”
Source: (1) https://ourdorset.nhs.uk/wp-content/uploads/2018/07/Our_Dorset_STP.pdf
The coronavirus (COVID-19) pandemic has delivered a profound shock to the UK. Measures to control the spread of the virus have reached deep into our lives, significantly disrupting job security, social activity and family life, all of which essential to maintaining positive mental health. As health workforces and local governments reshape their work to contain infection and protect the most vulnerable, access to outpatient, preventive, and psychological services has also reduced significantly.
Given increasing difficulties in accessing face-to-face care, and with this, rising waiting times for psychological services, the potential role of mobile health (mHealth) has gained traction during the pandemic. While evidence demonstrating the real-world effectiveness of psychological mHealth solutions continues to grow, it remains uncertain whether a public appetite for psychological mHealth solutions exists.
ORCHA’s Health Economist, Simon Leigh, conducted research into the changing appetite for psychological mHealth solutions pre- and post-COVID-19. This research was presented at MindTech Symposium 2020, and can be viewed as a virtual poster presentation here.
The research found that is clear that an appetite for psychological mHealth solutions exists among members of the public, and that this appetite appears to have increased since the disruption of lockdown measures. This should provide confidence to commissioners and developers of such technologies that safe, trusted and evidence-based technologies are likely to provide significant value to those with unmet needs for high-quality psychological services.
Watch our free CPD webinar!
Last year Papyrus introduced an app library to offer instant, anonymous, help to those thinking about suicide. Papyrus staff are extending their services; using the website’s in-built functionality to recommend apps straight to service users’ phones by text or email where possible. Papyrus will share details of the programme, which apps they frequently share and where gaps in the mental health app ecosystem still exist.
Please click here to access the on-demand webinar.
15 minutes: Introduction to the digital health landscape – Liz Ashall-Payne, Founding CEO at ORCHA
25 minutes: Embedding digital health into suicide prevention services – Kelly Thorpe, Head of Helpline Services at Papyrus
15 minutes: Audience Q&A
The webinar recording is accessed through GoToWebinar. You will need to submit some basic details to access the webinar, and all you will need to watch the session is an internet browser.
Once you have finished watching the webinar, please use this feedback form to let us know what you thought and request your CPD certificate. Please be aware that it can take up to 28 days to receive your certificate.
