There is growing recognition of the scale of the challenge to society posed by mental ill-health. But while demand for mental health services has increased in recent years, services are still not equipped to meet the high levels of need among the population. Mental health services have a history of chronic underfunding compared to other parts of the NHS; services for children and young people lose out most of all, and account for just 0.7 per cent of the overall NHS budget.
Over the last year, momentum has undoubtedly grown behind the need to tackle the current crisis affecting mental health services in England. The government has pledged to invest £1.25 billion in children and young people’s services over the course of the parliament, and the recently published Five Year Forward View for Mental Health report set out the need to invest an additional £1 billion in adult mental health services. However, such is the scale of unmet demand (three quarters of people with a diagnosable condition currently receive no treatment whatsoever) that this investment will not be enough on its own: IPPR has calculated that at least 9 million people will still lack access to treatment, even once this additional funding is in place.
In order to ensure that all people who require access to services can actually access them, policymakers and practitioners must find new and innovative ways to deliver high-quality care. This means there is an urgent need to better understand the factors that contribute to mental ill-health, and also to ensure that services are made continually more efficient and effective.
The problems and solutions of technology
Digital technology, and how we interact with it, is intrinsically linked to the state of our mental health. It also affects how different conditions can be treated and how care can be organised. Despite this, our understanding of the threats and opportunities to our mental health posed by digital technologies lags behind where it ought to be. Compared to areas such as banking and higher education, the mental health world is still working out how to harness the potential benefits of new digital technologies, and to mitigate its threats.
In recognition of this, IPPR recently brought together leading figures from the worlds of mental health and technology at a public event – chaired by Mark Austin of ITV News – to explore these issues in more detail.
You can listen to a podcast of this event below.
The discussion explored the extent to which digital technologies can create stresses and pressures that grow in to mental health problems – and how they could help.
For children and young people, the digital age poses a number of relatively new challenges to mental health. Cyberbullying means that the pressures of the playground are now more difficult than ever to escape, even when at home. ChildLine reported an 87 per cent increase in the number of counselling sessions it provided that were related to online cyberbullying between 2013 and 2014. Similarly, up to 40 per cent of children and young people are thought to have engaged in sexting, with the dissemination of explicit images and videos among peer groups and social networks causing significant pressures on young people.
For adults, it is the pressures of the workplace that now pervade more and more of our everyday lives. The increased prevalence of smartphones and remote-access working means we live in an increasingly ‘never switch off’ culture. This has seen considerable change in the norms about how and when it is acceptable to work in some sectors – often with dangerous consequences for the health of employees. At our event, John Binns, founder of Fit4Success and a mental health adviser at Deloitte, told us of his own battle with work-induced depression, and urged both employees and line managers to prioritise mental health and wellbeing, and have the confidence to push back against invasive workplace practices.
Opportunities within and without the NHS
There, are, however real opportunities for utilising digital technology to organise mental health care in new and better ways. Perhaps the most exciting new approach is set to be piloted in Birmingham and Solihull, which has been selected as a new NHS ‘testbed’ site to pioneer the use of innovative technologies with a view to improving services across the local area. Dr Peter Lewis – medical director at Birmingham and Solihull NHS Mental Health Foundation Trust – described how the trust’s new approach would create opportunities for identifying and predicting patients most at risk, and transferring power to patients through the creation of ‘digital passports’.
Technology firms are also taking a growing interest in developing products that can monitor, diagnose and treat mental health, and are developing new apps and online digital platforms for self-management and peer support. For example, Big White Wall enables people to talk openly about their feelings with those going through similar experiences on a 24/7 online platform, while professionally trained ‘wall guides’ monitor content and so can intervene if they think a user might be in danger. Ieso Digital Health is another example, providing online cognitive behavioural therapy with a therapist via secure instant messaging. This can help people with conditions such as depression and anxiety who may be unable to travel to counselling sessions.
These products have the potential to ensure that more people have access to services at a very low cost – exactly what is needed given the scale of the challenge and tight budgets. But their success will depend on how well the NHS makes use of them: otherwise, there are risks that they could become available only to the rich, or that unregulated products could cause more harm than good. The NHS needs to ensure that it is leading, not following, this agenda.
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