Mental health solutions: how data is changing the use of digital technology 

Context

More people than ever before are seeking help for mental health issues, and digital technology opens up seemingly infinite opportunities to help those in need. The pandemic served to increase both the need for such services and the digital support available to those who need them.

The problem

In a field where the establishment of rapport and trust between those seeking and providing support is so essential, the idea of remote, virtual services that lose in-person face-to-face connection potentially comes with challenges. But when done well, digital services, particularly ‘blended’ with in-person support where allowable, provide an accessible and scalable route to support individuals when they need it.

“We are seeing a rise in emotional disorders, distress and self-harm,” says Dr Emma Lawrance of Mental Health Innovations and Fellow at Imperial’s Institute of Global Health Innovation (IGHI). “Digital offers exciting opportunities to support people in a scalable, timely and tailored way, but not all digital services are alike, and a lot of people don’t maintain engagement with tools like mental health apps. Different things work for different people at different times, and for digital mental health services to work most effectively we need to understand those nuances.”

An innovative cross-sector approach

Lawrance’s research combines real-world experience and data from mental health charities, including Shout 85258, the UK’s first 24/7 mental health text support service, and Imperial’s own technology experts. The result is a unique, interdisciplinary, cross-sector perspective on how digital mental health services are being used and can be made more accessible.

“Shout has a huge dataset of anonymised text conversations, which we can use to better understand mental health needs and the impact of services, with help from Shout experts and Imperial’s mathematicians, neuroscientists, psychologists, machine learning and natural language processing experts.”

The result, she hopes, will set a standard for policymakers and other organisations to ensure the digital mental health space is as open and accessible as possible, and crucially that it can reach people in need who might otherwise have nowhere else to turn.

“Previously we’ve seen academic organisations develop evidence-based interventions which fail when put into real-world scenarios – or vice versa, digital tools such as apps that have no evidence base or robust evaluation. Our team’s research brings all these things together, putting frontline organisations together with an innovative academic partner.

“We’ve done work with patient and public involvement and engagement experts at IGHI’s Helix Centre, and run workshops with Shout users. That experience gives invaluable context to the data, enabling Imperial teams to ask the right questions of the data, and develop insights that then feed back into the charities to provide even better services. We also ran an Imperial Lates event, and a NIHR People’s Research Café, that both asked: ‘What does the public want to know? How do they feel about this data being used? What are their hopes and fears around this?’ Collaboration is essential.”

A shared vision

As with any technology, data privacy is key. “Shout has an extremely high standard of data protection,” says Lawrance. “Anonymity is taken extremely seriously. But when we spoke with Shout texters we found there is very much a shared vision: most people want their (anonymised) data to be used positively, with insights fed back to the entire sector and the service users themselves, to make digital engagement in mental health services as accessible as possible. There’s a real appetite for how the results and impacts of this research can be rolled out to help others.

“We want our work to help inform policy across the mental health sector, to help everyone understand what it means when people seeking support move to an online space, and we’re trying to make those messages as accessible and understandable as possible.”

Lawrance was part of the team that published a report and framework for the World Innovation Summit for Health to improve the development and implementation of digital mental health services. “Ultimately, it’s about how we help individuals with mental health issues, and understanding what’s going on for people, many of whom are not accessing other services and could slip through the net. If we can understand the issues they face and listen to them, we can develop evidence-based interventions and the most suitable, appropriate support to help them as individuals.”

Dr Emma Lawrance leads the mental health strategy for the Institute of Global Health Innovation, and founded the youth mental health charity It Gets Brighter.