By Pramod Prabhakaran, International Business Development and Partnerships, Imperial College Health Partners
In the UK each year, around 70 million working days are lost due to anxiety, depression and stress-related conditions, making it the leading cause of sickness absence (Mental Health Foundation, 2015). Recognising the magnitude of the problem, the NHS now has a more national focus on mental health than ever before with NHS England establishing a ‘parity of esteem’ programme valuing mental health equally with physical health.
Mental health disorders constitute the single largest cause of disability in the UK with one in four adults and one in ten children estimated to experience mental illness during their lifetime. Furthermore, those suffering from severe mental disorders are at risk of premature death, dying on average 15 – 20 years earlier than the general population, mostly due to cardiovascular and respiratory disorders.
These are, however, global challenges and not unique to the UK. In developing countries such as China and India, there is a lack of access to decent mental health services for the vast majority of the population, especially in the non-urban regions.
Digital technology or e-health has the potential to transform mental healthcare by involving patients, services and health information in novel ways, yet the adoption of such innovations across mental health providers has been limited.
In recent years, there have been a number of digital innovations in this space, with web and mobile app-based solutions offering patients greater access to information and services and supporting clinical management through access to electronic health records.
These range from mental wellbeing apps such as Write Mynd, apps that help with sleep such as Pzizz to solutions such as Monsenso that support early intervention through predictive mood evaluation and Helios that offer accredited online psychological interventions.
One of the key challenges in adoption of these solutions is the substantial gap in the clinical and economic evidence base underlying these technologies.
This, however, also presents the opportunity for healthcare providers, innovators and policy makers to come together to address this challenge and develop innovative models of care.
Use of test bed programmes such as the RAIDplus integrated mental health urgent care programme is one such example that brings together academic, voluntary, provider and industry partners together.
Within the Imperial College Health Partnership, Central and Northwest London NHS Trust has begun implementation of the Monsenso solution within its early intervention services to support patients with Schizophrenia. This, however, has not been without its challenges, requiring executive leadership backing, a robust programme of clinician and mid-level management engagement and dedicated support from ICT colleagues.
Some solutions in developing countries such as the STEP programme, which provides tele-psychiatry through use of mobile clinics in rural India, demonstrate the clinical and cost-effectiveness of digital solutions with an average monthly cost of $12 per patient. Such programmes that improve access to vast underserved populations have the potential to transform mental health care, and are equally applicable to developed countries
For successful adoption and diffusion of these innovations, it is, however, important to ensure greater patient and clinician involvement in their evaluation so as to maintain public trust. In this context, the Executive Health Innovation Management Programme is best placed to provide the critical insights and leadership capabilities to deliver the key innovations required in these challenging times.