Webwatch: Apps and online therapy recommended to help treat anxiety and depression

Around 40,000 people could be offered apps and other digital tools to help them combat anxiety and depression, health officials have announced.

The National Institute for Health and Care Excellence (Nice) has conditionally recommended eight “digitally enabled therapies” for NHS use.

The tools range from apps to web-based courses which aim to help people on the road to recovery for a number of different anxiety and depression disorders.

It is hoped that offering online services will speed up access to treatment.

The new tools will also offer patients more flexibility on when and where they receive their care, Nice said.

The therapies, which help to treat a range of conditions including anxiety, depression, post-traumatic stress disorder and body dysmorphia, have all been conditionally recommended in new Nice draft guidance.

A consultation has begun to gather views before a final recommendation is made and the technologies must achieve regulatory approval prior to their NHS use.

The tools all include the involvement of an NHS talking therapist and all use CBT (cognitive behavioural therapy) techniques.

People will only be able to access the services after a formal assessment with an NHS therapist, as they may not be the right choice for some, Nice added.

“Our rapid assessment of these eight technologies has shown they have promise,” said Nice’s interim director of medical technology and digital evaluation Mark Chapman.

“Developed using tried and tested CBT methods, each one has demonstrated it has the potential to provide effective treatment to the many thousands of people who live with these conditions.

“We want these new treatment options to be available for people to use as quickly as possible and we also want to make sure they are clinically effective and represent good value for the NHS.

“The additional evidence collected during this period will help us do that.

“We also want to hear what people involved in this area think – both clinicians and the people who will be using these digital technologies. We know CBT can work well for many people and we know that digitally enabled technology can help the NHS get support to people faster.”

Professor Dame Til Wykes, head of the School of Mental Health and Psychological Sciences at King’s College London, who helped advise Nice’s committee’s decision, added: “Digital therapies may offer welcome additional help for people with a diagnosis of anxiety or depression.

“They may help enough to reduce the need for face-to-face contact be that in person or virtually. But we don’t know enough about who will improve and who will need extra help.

Elizabeth Mullenger, lay specialist member who helped advise the committee, said: “Digital technology could transform the experience of people living with mental illnesses.

“It can be incredibly isolating to be on a long waiting list for in-person treatment. You might know that help is coming, you just don’t know when.

“Having access to a digital therapy could help prevent this lonely feeling. Sometimes people need support most in the middle of the night, or after a busy day at work, and it’s hard to know where to turn. Having access to digital therapy can give people the help they need when they need it.

“These technologies will allow us to be in charge of our treatment, gaining a sense of autonomy as we navigate our own journey towards positive mental health.”

Commenting on the announcement, Lucy Schonegevel, associate director of policy and practice at the charity Rethink Mental Illness, said: “As the NHS grapples with rising demand for mental health services in the wake of the pandemic and the cost-of-living crisis, it’s encouraging to see new technologies recommended that can potentially add to the range of evidence-based treatments on offer.

“Digital technologies stand to help make therapy more accessible and can prove to fit more conveniently into people’s everyday lives, plus they can help improve efficiency in stretched organisations like the NHS.

“But we must ensure that no-one is locked out of vital mental health support as some services move online and it’s crucial people continue to be presented with a choice of treatments appropriate to their needs.

“While thousands of people stand to benefit from the introduction of new, digitally enabled therapies, the number of people accessing such support will be a drop in the ocean considering the 1.24 million referrals for NHS talking therapies received in 2021/22.

“As much as digitally enabled therapies are a welcome innovation and we hope to see further evidence gathered on their effectiveness, they are far from a magic bullet to address rising demand for NHS services.

“This is why it’s critical that the Government keeps its promise to deliver a specific, cross-department 10-year plan for mental health and wellbeing that tackles the drivers of mental illness.”

Jessica D’Cruz, information content manager at Mind, added: “We’re always pleased to see innovation in mental health therapies that can help people have greater choice in how they are supported, and allow all of us to find a therapy that works for ourselves.

“But online support isn’t right or accessible for everyone, so it’s important that we all have a range of support offered to us.

“It’s also important to remember that with the ongoing underfunding of NHS mental health services, and the issues many services are experiencing in the wake of pressures from the pandemic and cost-of-living crisis, the majority of people in need of mental health support will struggle to benefit from this.

“The UK Government must urgently give mental health services the financial support they need to be able to expand the availability of new treatment options such as these.”

The treatments recommended by Nice include:

• For depression, Nice has conditionally recommended the use of three online CBT programmes: Beating the Blues, Deprexis, and Space from Depression (SilverCloud).
• For generalised anxiety symptoms or unspecified anxiety disorder, Nice has conditionally recommended Beating the Blues and Space from Anxiety (SilverCloud) with support provided by a psychological wellbeing practitioner or high intensity therapist.
• For body dysmorphic disorder, an online CBT called Perspectives has been conditionally recommended, alongside support provided by a high intensity therapist trained in treating BDD. The programme is delivered through a mobile app.
• For post-traumatic stress disorder (PTSD), Nice has conditionally recommended two treatments: an internet version of CBT called iCT-PTSD and an online guided self-help programme called Spring – both to be delivered with support from a high intensity therapist trained in treating PTSD.
• For social anxiety disorder, people can access an internet-based programme delivered in a series of modules alongside therapist support.

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