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Increasing Access to Mental Health Therapies

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    April 30, 2024

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    NHS, access, secondary care, clinician burnout, stepped care model, waiting lists, access to healthcare

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Mental health problems in the UK are growing at an alarming rate. In 2023, Digital NHS found that 1.83 million people were in contact with secondary mental health services by the end of October. The survey also found that 1 in 5 children and young people in England aged eight to 25 had a probable mental disorder This is causing unprecedented strain not just on mental health services but on all healthcare throughout the UK (NHS Confederation, 2021).  
The number of referrals to both NHS Talking Therapies and for starting treatment has increased. In 2011/12, there were 887,452 referrals, which nearly doubled to 1,676,985 by 2019/20. This has led to a sharp increase in demand for mental health services. As a result, the NHS and other healthcare providers have found it almost impossible to meet this growing demand (NHS Confederation, 2021). 

Challenges in Accessing Mental Health Care

The situation is further exacerbated by the challenges many people face in accessing quality mental health care. The Care Quality Commission sought patient feedback between April and December 2020; they found many people sought help for their mental health from primary care services but often felt ignored or dismissed by their GP. People with mental health needs also felt that due to a lack of capacity within the community mental health services, they could not get a referral to a specialist from their GP. Not being able to access the proper care and support when it is needed increases the risk of individuals’ mental health deteriorating.
The Department and NHSE acknowledged further concerns around the lack of data on patient outcomes and experiences within mental health services. Of 29 integrated care boards surveyed, only four said they had all or most of the data they needed to assess patient and user experiences, and none of them felt they had adequate information about their patient's outcomes.

The Stepped Care Model in the NHS

The stepped care model is an organising framework of treatment and with varying levels of intensity recommended by the National Institute for Health and Clinical Excellence (NICE). The existing literature regarding stepped care defines it as a service delivery system recommending the least intrusive intervention first, starting with low-intensity treatment, with step-up if there is no progress. 
Step 2 of the model focuses on increasing capacity and choice through digital therapy. Online Cognitive Behavioural Therapy (CBT) is offered as a treatment alternative, supported by a qualified clinical practitioner called a Psychological Wellbeing Practitioner (PWP). Internet-based CBT is successful at reducing symptoms of depression and anxiety, with over half of the participants no longer meeting the diagnostic criteria for any mental health disorder after treatment.

The Role of Digital Therapy in Increasing Access

It is now apparent how crucial it is to find innovative solutions to increase access to mental health therapies. A recent study by the National Institute for Health and Care Excellence found that digital therapy “has demonstrated it has the potential to provide effective treatment to the many thousands of people who live with mental health conditions” (NICE, 2023). The flexibility of digital therapy allows individuals to access support at their own pace and convenience.
Digital therapy looks to understand problems, overcome current difficulties and achieve identified goals. By working with SilverCloud® by Amwell®, NHS England  is now providing accessible mental health support that can be accessed anywhere and anytime (NHS England, 2023). It can also help promote access to treatment for people who may be less likely to engage in face-to-face therapy appointments. This increases capacity, choice, and ease of access, allowing more individuals to receive timely support.  
To learn more about the potential of digital interventions through the NHS Stepped Care Model, download our comprehensive whitepaper today.


Bower P., & Gilbody S. (2005). Stepped care in psychological therapies: access, effectiveness and efficiency: narrative literature review. The British Journal of Psychiatry, 186(1), 11–17. 10.1192/bjp.186.1.11 [PubMed] [CrossRef] [Google Scholar] 

Care Quality Commission. (2021, October 21).State of Care 2020/21. Retrieved from www.cqc.org.uk: https://www.cqc.org.uk/publications/major-reports/soc202021_01d_mh-care-demand

Mind. (2020, June 30). Mental health facts and statistics. Retrieved from www.mind.org.uk: https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/

National Collaborating Centre for Mental Health UK. (2011). Common Mental Health Disorders: Identification and Pathways to Care. Retrieved from British Psychological Society: https://www.ncbi.nlm.nih.gov/books/NBK92265/
NHS Confederation. (2021, October 25). An increase in demand for mental health support is being felt across the system. Retrieved fromwww.nhsconfed.org: https://www.nhsconfed.org/articles/increase-demand-mental-health-support-being-felt-across-system

NHS England. (2023). NHS Talking Therapies for anxiety and depression. Retrieved from www.england.nhs.uk: https://www.england.nhs.uk/mental-health/adults/nhs-talking-therapies/

NICE. (2023, March 1). Eight digitally enabled therapies to treat depression and anxiety in adults conditionally recommended by NICE. Retrieved from National Institute for Health and Care Excellence: https://www.nice.org.uk/news/article/eight-digitally-enabled-therapies-to-treat-depression-and-anxiety-in-adults-conditionally-recommended-by-nice

Young Minds. (2021, October 1). The impact of Covid-19 on young people with mental health needs. Retrieved fromwww.youngminds.org.uk: https://www.youngminds.org.uk/media/xq2dnc0d/youngminds-coronavirus-report-march2020.pdf

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