The pressure on mental health services in the UK has been well-documented, with demand steadily rising. In 2023 alone, community mental health services saw 625,000 referrals, an 11% increase over the previous year. This surge has stretched resources thin, leading to longer waiting times. On average, the wait for treatment initiation (the second contact after the initial assessment) stands at eight weeks, but for more than 19,000 adults with severe mental illness (SMI), this can extend to 18 months.
This blog aims to share some of the promises, challenges and benefits of integrating digital therapeutics into secondary care services. It aims to give an overview of the discussion outlined in our new whitepaper: Creating Hybrid Pathways in Secondary Care: How digital mental health solutions can help services to support patients with complex needs
Stepped Care Model and Digital Interventions
In the stepped care model, internet-delivered Cognitive Behavioural Therapy (iCBT) is typically offered to those with mild to moderate depression or anxiety at Step 2. This form of therapy, supported by a therapist who monitors progress and provides guidance, is as effective as face-to-face treatments but less resource-intensive. iCBT allows patients to access therapy on their own schedules, reducing the need for travel, childcare, or taking time off work.
However, secondary care presents a different challenge. Patients here are often more complex and require multi-professional support. This complexity means that remote-only options are not always viable or safe. Instead, digital products are integrated with regular face-to-face interactions, forming a core part of the care strategy.
The Promise of Digital Therapy in Secondary Care
While digital tools can't entirely replace the personalised and intensive care needed for patients with complex mental health issues, they hold significant promise in enhancing patient experience and service efficiency. Digital therapy offers an adjunctive support mechanism that can alleviate some of the pressures on overburdened services.
Steve Skinner, who now focuses on developing adult community services, previously served as Clinical Lead for NHS Talking Therapies at Lincolnshire Partnership NHS Foundation Trust (LPFT) shares his experience in our new whitepaper of implementing SilverCloud® by Amwell® in his secondary care service.
“"In Talking Therapies, we've seen digital products improve both efficiencies and the quality of care. There's a strong case for extending these benefits to secondary care," says Skinner.
Digital tools can replace outdated paper-based resources with evidence-based content accessible during therapy sessions. Programmes like Tools for Therapy from SilverCloud® by Amwell® offer a flexible, shared space for synchronous use, enhancing the efficiency and quality of therapy and allowing clinicians to support patients with more complex needs in secondary care services.
Skinner adds, "Digital programs provide up-to-date, evidence-based approaches, moving practice forward and replacing outdated methods."
Enhancing Accessibility for secondary care patients
In today's digital age, using online channels for mental health interventions can significantly reduce barriers to accessing support. Remote therapy eliminates the need for travel and can reduce missed appointments, which are notably high in mental health settings compared to other healthcare areas. Moreover, digital access can help mitigate the stigma associated with seeking mental health support by providing a private, virtual space for therapy.
Since the rapid shift to virtual therapy during the pandemic, the quality of online mental health support has improved significantly. Tools like SilverCloud® by Amwell® facilitate real-time collaboration between practitioners and service users during remote video sessions.
Operational Efficiencies and supporting Integrated Care
Digital can support secondary care services in their pursuit of delivering an integrated care system within the NHS between primary and secondary care.
Digital solutions also offer considerable potential for improving operational efficiencies in mental health care. Historically, divisions between primary and secondary care services led to patients falling through gaps as their needs changed and their care needs developed. Digital can support a focus to widen access to mental health therapies, remove thresholds, and offer increased flexibility and choice. Skinner advocates for incorporating digital tools within these integrated services to support continuity of care and relapse prevention.
Nick Harwood of LPFT explains, "Traditional pathways involve multiple stages of triage and appointment booking. Digital solutions can speed up this process, improving waiting times."
Digital tools also simplify the capture and sharing of post-session data, creating a secure environment for clinicians to communicate with patients. These tools, integrated with electronic patient record systems, reduce administrative burdens, allowing practitioners to focus on clinical care.
Digital therapy is not a panacea for the challenges facing secondary mental health care, but it offers valuable tools that can enhance patient experience, support care delivery, and improve service efficiency. Integrating digital solutions into secondary care pathways ensures they become a core component of modern mental health services, meeting the evolving needs of patients and practitioners alike.
In the words of Steve Skinner, "It's crucial that digital tools are integrated into our services to ensure they are a fundamental part of our care offerings." As mental health care continues to evolve, the role of digital therapy will undoubtedly expand, providing innovative solutions to meet the growing demands of the sector.
To learn more about integrating digital solutions into secondary care services, read our whitepaper and review our case study with Lincolnshire Partnership NHS Foundation Trust.
