The welcome increased willingness of children and young people (CYP) to talk more openly about their mental health has led to a spike in demand for existing health and wellbeing services. This in turn has led providers, including CYP therapists, child psychologists, paediatricians, school counsellors and GPs, to look for additional tools and ways of helping the children and young people they support.
In seeking to meet the needs of these children and young people, large numbers of whom are very comfortable with technology and like the convenience and privacy that online solutions offer, attention has often turned to digital options.
However, often the biggest barrier to putting in place the right digital tools are myths and concerns about this type of support, which may be unfamiliar to many health professionals.
In the face of the huge surge in demand for children and young people mental health support - the number of children and young people aged 5-19 with a probable mental health disorder has risen from one in nine in 2017 to one in six in 2020, fuelled in part by the Covid-19 pandemic - it is clear that doing nothing is not an option. This is something that National Institute for Health and Clinical Excellence (NICE) recognised when they formally recommended digital options for children and young people.
NICE were clear that digital therapy is effective, especially if it is based on cognitive behaviour therapy (CBT) like the SilverCloud® by Amwell® platform. NICE recommend computerised cognitive-behavioural therapy (CCBT) as an evidence-based approach that is suitable as a mode of delivery of interventions for adults with mild to moderate anxiety and depression. They were equally clear in their guidance specifically in relation to children and young people, saying:
“The evidence showed digital CBT and group therapy were most effective at reducing depressive symptoms and we have recommend these as first-line options for children and young people with mild depression”.
So, despite increased overall demand from children and young people, their desire to have digital options available to them and the clear recommendation from NICE for the provision of digital mental health support, especially for anxiety and depression, what is holding decision-makers back? What are those top myths that need debunking?
1. Digital therapy doesn’t work as effectively for children and young people as face-to-face support in school, college, university or within the NHS
The outcomes that we see in our work, based on 20 years of clinical research, show that digital mental health support – behaviour therapy delivered through digital CBT as recommended by NICE – produces results comparable to traditional face-to-face counselling therapy:
- More than half of those with a diagnosis of anxiety and/or depression recovered after three months when using SilverCloud programmes.
- up to 80% of participants show improvement in depression and anxiety symptoms1.
- up to 65% of users achieve clinically significant improvement when they use SilverCloud programmes1.
- 56% with a clinical diagnosis of depression or anxiety were diagnosis-free at three months when using SilverCloud programmes1.
Digital support also provides health and education professionals with a different option that often meets the needs and demands of children and young people and is used to complement, not replace face-to-face support. The SilverCloud programmes can be used to allow health and education professionals to target their face-to-face time to those with the most acute conditions and help children and young people with milder depression or anxiety to access more self-help support through the online platform.
2. Demonstrating value for money and tracking results with CYP digital support cannot be done
There are many different digital solutions available to children and young people but not all offer the same level of outcome tracking and value for money. Some act as an outsourcing tool, in which the clinician referring the patient loses contact with them and in effect hands them over to another service. With SilverCloud, the clinician stays in contact with the patient and is able to track their progress, provide ongoing online and/or face-to-face support, conduct follow up discussions and can work alongside the child or young person as they go through the programmes, highlighting specific tools, exercises or advice.
Using SilverCloud allows clinicians to measure outcomes for their patients and see how the investment made leads to clinical results by tracking the cost and benefit of the intervention. They stay in touch with the patients throughout their journey and can offer ongoing online access to the programmes for six months after treatment ends to help prevent a relapse.
3. Parents/carers are not involved in the support
With SilverCloud there is a key role for parents/carers. Alongside a dedicated programme for anxious teenagers, Anxiety (CYP), SilverCloud has developed two programmes for parents, carers and teachers: Supporting an Anxious Child and Supporting an Anxious Teen.
These programmes, aim to provide psychological strategies to support parents/carers of teens or children experiencing anxiety. They are an invaluable tool in helping the adult support their child or young person, but also can provide vital help to the adult themselves, who could be experiencing significant personal mental health challenges. As with the CYP programmes, they are available 24/7, allowing users to access the materials at any time, from their own devices, how and when it suits them.
4. Integrating a new digital solution will take lots of time and money
The SilverCloud platform can be quickly integrated into current IT systems or sit alongside them – this is done in a seamless and straightforward way. There is a team of dedicated technology experts within SilverCloud who work with our clients through every step of the process, to make the implementation smooth and successful.
Our customer success team ensures that SilverCloud is tailored to the organisation’s needs, guiding them through the integration into existing care pathways and then helping to drive uptake, usage and engagement to get the most out of the platform.
We believe it's important to deal in facts not myths when talking about children and young people’s mental health. We also believe that being able to access help for mental health in a convenient way, 24/7, when and where suits children and young people is vital. We don't believe that myths about digital health should stop patients from getting the help they need, especially at a time when existing services are under such demand and pressure.
1 – Data from SilverCloud Platform IAPT services