Oliver Harrison, founder and CEO of Koa Health, explores how 2020 hit our mental health hard and the barriers we must break down in 2021 to deal with the mental health repercussions of the previous year.
It’s hard to think of a recent year that’s been more taxing on our collective mental health. Events across the world including record breaking wildfires, shocking scenes of police brutality and a deadly pandemic have challenged us in ways we never hoped to be.
As a result, there has been a huge spike in mental health problems. Early into the pandemic, the Office for National Statistics reported that one in five Britons reported symptoms of depression, compared with one in ten before. A different study by The Health Foundation placed the figure closer to 70%, with stress, anxiety and boredom driving mental health issues. As the pandemic rumbles on, it’s hard to say how much further this could rise.
While it’s easy to look at the negatives of 2020, in many ways we must also be thankful that it has exposed the barriers to accessing mental healthcare. Perhaps the biggest exposed shortfall in the UK is a lack of mental healthcare professionals. Over the past 10 years, the workforce has not significantly grown despite demand rising an average of 21% year on year. As a result, two-fifths of patients waiting for mental health treatment are forced to contact emergency or crisis services.
Another barrier to care is continued stigma and discrimination. Nine in ten people with mental health problems still experience discrimination, and, despite the success of campaigns such as Time for Change, there is still some way to go in changing public attitudes. Far too many sufferers still struggle to reach out for help when it’s most needed.
Although I welcome the government’s £500 million investment as part of the 2020 spending review, there is still much more to be done. The package is targeted towards those with severe depression and anxiety, leaving out growing masses of people who are suffering in silence. In 2021, breaking down barriers to care for everybody must be our collective priority.
I do believe that technology is our biggest asset and hope here. Evidence-based, ethical and personalised digital solutions present the most accessible path to quality mental health care, especially given the ubiquity of hardware like smartphones. Without enough clinical staff to go round, mental health apps are the only solution capable of scaling quickly enough to meet the ever-growing demand for support at a fraction of the cost of training new psychiatrists. Apps are also one of the most discreet solutions, and provide a route to care for those who feel unable to talk to others about their mental health issues. In short, apps are needed now more than ever to form integrated care plans, complementing traditional practices such as counselling.
Digital solutions do face their own challenges though. At present, only 2% of apps available have study data, which is far too low. With a vast amount of the 10,000 apps available lacking clinical assurance, commentators were perhaps justified in labelling the digital health sector as a Wild West. ORCHA, the organisation that NHS Digital uses to evaluate apps, reports that only 15% of those evaluated meet the minimum criteria for data privacy, clinical assurance and user experience. If mental health apps are to be taken seriously as a solution to a spiralling crisis, this must be solved as a matter of urgency.
Even once technology is recognised as a vital tool to access mental healthcare, there is still perhaps the greatest hurdle to overcome before it can be prescribed. At present, there is a lack of willingness in the NHS to take risks with new digital solutions. Each area of the NHS is committed to doing its own pilot before investing in new technology, resulting in a sluggish pace of change.
COVID-19 forced the NHS to undertake decades of progress in a matter of weeks, and patients reacted positively to tech based solutions, such as telehealth. Despite the success of these solutions (as well as their continued use) there is a real risk that once the pandemic is beaten we’ll revert to the old ways of doing things. It’s well documented that the mental health impacts will lag long after the infectious disease. Therefore we must push the NHS to implement policies which increase the impetus for technology adoption, particularly in this area.
We simply cannot allow barriers to mental health care access to stand for any longer. The digital health sector must strive to demonstrate consistent standards of efficacy, ethics and privacy to be taken seriously by healthcare providers, and continue to push them hard for implementation. COVID-19, and the weaknesses it has exposed in mental healthcare provision, has provided a golden opportunity. The stakes are too high not to capitalise.
