Are digital CBT apps the answer to reducing the mental health backlog?


Digital CBT apps are coming into their own due to built up demand for mental health services


The pandemic has worsened an existing mental health crisis, with nearly one in two people (49%) saying it has impacted negatively on their mental health, according to research from Public Health England (1).


Loneliness, missing friends and family, employment worries and uncertainty about the future are just some of the reasons causing significant numbers of people to experience more anxiety (46%), stress (44%), sleep problems (34%) and low mood (46%).


Yet research published in the Lancet shows that reduced primary care contact for mental health during the pandemic means there is now a substantial burden of unmet needs for mental health conditions (2). This has prompted researchers to warn healthcare authorities to take steps to prepare for increasing demand in the coming months and years, not least by leveraging digital mental health solutions, such as digital CBT apps, to increase access to NHS approved treatments.


Digital CBT apps as a means of meeting demand


Despite the additional funding now being pledged for mental health services, the reality remains that there are only a limited number of human counsellors and the waiting lists to see them are very long. By leveraging technology we all have on our phones, digital CBT apps increase access to therapies that can be successfully delivered online, such as cognitive behavioural therapy (CBT).


The benefits of this are two-fold. In the first instance, it allows those who are comfortable using digital mental health services to start accessing support immediately, instead of having to wait 6-18 weeks to see a human therapist. Secondly, it frees up human therapists to focus on those people who aren’t comfortable using digital CBT apps, or for whom digital CBT is inappropriate.


Either way, it means many more people can get help sooner, meaning their mental health has less chance to deteriorate into a longer-term condition. Not only is this good for them, reducing the distress and suffering caused by having to struggle unsupported with their mental health, but it also reduces the amount of therapy they will eventually need. All of which reduces pressure on the NHS.


Digital mental health apps for reducing stigma


Another major benefit of digital CBT apps is that they empower people to work on their mental health in their own time and in their own home, without having to open up about their feelings to a counsellor.


This can be very liberating for many individuals, who realise all is not well with their mental health but are reluctant to see a counsellor and might feel like they should be able to help themselves recover. This is a view typically reinforced by the current Increasing Access to Psychological Therapies (IAPT) stepped care model, which requires individuals to be at least moderately depressed (with a score above nine on a PHQ-9 mental health assessment) or close to being moderately anxious (with a score above seven on a GAD-7 assessment) before they meet the criteria for counselling (3).


By instead giving the GPs the option to prescribe people with mild anxiety or mild depression access to a mental health app, you can start supporting them the moment they reach out for help. This makes them feel more comfortable seeking timely support.


Digital mental health apps for monitoring recovery


Until someone meets the IAPT criteria for treatment, there is very little GPs can currently offer, other than lifestyle advice, to try and get more rest and exercise and reduce their stress levels, or ‘watchful waiting’. The reality is that GPs are often too overloaded to check in with people who were displaying mild anxiety or depression symptoms and are dependent on them coming back if things get worse.


Another major benefit of digital CBT apps like CBT with Skip [LINK TO HOME PAGE], which have inbuilt weekly mental health assessments, is that they enable GPs to conduct proper ‘watchful waiting’, with automatic alerts if their patient’s condition worsens, encouraging the patient to revisit their GP.


At the same time, digital CBT apps also allow the patient to monitor their own progress and assess which exercises and tools are working for them. CBT apps such as CBT with Skip even include an element of artificial intelligence (AI) to guide individuals to complete exercises based on their unique needs. They also enable healthcare authorities to measure overall improvements in the mental health of entire populations using the app.


In this sense, digital CBT apps now have a vital role to play in transforming mental health support, by giving those who are keen to support themselves while their issues are still mild, immediate access to NHS-approved online CBT therapy. This takes pressure off front-line mental health services, helping to reduce the prevalence of the mental health crisis now facing the UK.


Digital mental health apps sources


(1) Impact of coronavirus on mental wellbeing, Public Health England, Jan 2021

(2) Indirect acute effects of the COVID-19 pandemic on physical and mental health in the UK, The Lancet, Feb 2021

(3) IAPT stepped care model NICE Guidelines, Healthy Mind Bucks, 2021


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