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The importance of choice in mental health care pathways for people with complex conditions

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    June 26, 2024

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    NHS, digital mental health, secondary care, talking therapies

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There is a widely held belief among mental health practitioners that digital mental health solutions are not an appropriate option for people with severe mental illness (SMI). But in answer to the frequently cited assumption that people with an SMI won't engage with digital channels there is a very straightforward answer: most of them probably already are.

Evolving mental health care for people with an SMI

With rates of smartphone ownership and usage by people with an SMI broadly in line with the general population, it shouldn't be surprising that this group is using their phones for activities such as accessing information about their condition, joining peer-to-peer support groups, setting reminders to take medication, and keeping track of appointments. Given all of this, providing these patients with a digital solution as part of their package of care is more of a natural evolution than some clinicians with hesitations might assume.

Of course, digital solutions are not for everybody, and in secondary care, digital is generally offered as an adjunct to therapy rather than an alternative, but when used effectively, clinically validated digital mental health solutions have the potential to make a significant difference to service users.

Creating a goal difference with digital programmes

With mental health services in such high demand, some degree of waiting is inevitable before patients begin treatment. A typical wait is 8 weeks but for some, it can be as long as 18 months.

Services who introduce a digital solution into the patient pathway at this early stage can help to prepare service users for when their active treatment begins. For example, the SilverCloud® Recovery programme can help to build an awareness of the basic psychological concepts, provide some stabilisation tools, and help a service user to start to identify their individual recovery goals. That means when they do begin their treatment, they have had an opportunity to think about what they want to get out of it.

Supporting service users during therapy

A lot of the work of therapy happens outside of therapy sessions. Digital programmes can be used to support patients in that space between sessions, providing valuable 24/7 access to therapeutic content. As well as reaffirming the work done during a face-to-face appointment, a digital programme enables a service user to return to a topic or tool whenever they like.

That's important because sometimes a piece of work may not feel relevant to a patient the first time they come across it. But ongoing access means they can self-pace, engaging with information and tools when they feel ready to.

Preventing potential recurrences

Continuous access to mental health tools via digital brings another benefit. Even after the person has been discharged or has finished an active period of treatment, they have ongoing access to digital content. This means they can easily return to things they found useful or review material if they need it. Having all the therapeutic content available on a patient's phone or device means that it is easily accessible whenever they need it and it's less likely to be misplaced or damaged.

Real-world use of digital solutions in secondary care

Following the successful implementation of the SilverCloud® by Amwell® digital mental health platform at Lincolnshire Partnership NHS Foundation Trust (LPFT) Talking Therapies, LPFT are now using SilverCloud® specialist programmes in their secondary care service. Steve Skinner, Service Development lead for the Adult Community Division at LPFT, is already seeing positive results. "The response has been good," he reports. "We're starting to see patients with some of the most severe and enduring illnesses, like schizophrenia and bipolar, engaging in digital, obviously not as the total aspect of their care package, but it's a really integrated part of it. And generally, we're finding that when people start, they follow it through.”

Read the full story about creating hybrid pathways in secondary care services by downloading our whitepaper.



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