The past year has been tough on our mental health. A Mind survey showed 68% of young people and 60% of adults felt their mental health got worse at the beginning of the first national lockdown. A further Mental Health Foundation study highlighted the key issues impacting mental health, including lockdown isolation, health anxiety, and worries about finances.
The way we address healthcare has also shifted dramatically in this time. Many healthcare appointments went remote, pushing us towards digital healthcare. NHS Digital data shows that the use of its digital services increased throughout 2020. The number of people using the NHS App increased by 912% between December 2019 and December 2020. Patients also used the NHS 111 online service to get healthcare advice more often, with sessions increasing by 257%.
The NHS also invested in digital mental health provision in order to provide support to people who needed it despite the pandemic restrictions. In-person therapy sessions were held via video consultations, while some mental health apps including ThinkNinja have been made free during the pandemic.
However, while digital healthcare has provided a safety net during these difficult times, it is not without its shortcomings. For patients seeking mental health support, these shortcomings could be frustrating at best and damaging at worst. In this article, we take a look at the positive and negative impact of digital healthcare on mental health.
Improving access to mental health support
One of the most widely recognised benefits of digital mental health support is that it improves access to mental health services. Waiting lists for in-person therapy are higher than for remote consultations, even beyond the coronavirus pandemic. The University of Manchester found that usage of digital mental health services rose steeply during the coronavirus pandemic because it was more accessible.
Remote appointments offer a number of benefits to both practitioners and patients. In the same way remote working has improved work-life balance for many, remote healthcare appointments can do the same, eliminating travel time. If patients have busy work schedules or family commitments, they could be more motivated to book and attend remote appointments, free from the additional travelling and waiting times.
Digital support provides options for the early stages of care
While perceptions of mental illness are improving, there still unfortunately exists a stigma. This is especially true of men and older people who struggle with their mental health but can affect anyone. This can prevent people from seeking help when they need it; recent research shows stigma and embarrassment are some of the main barriers to young people with mental health conditions seeking support.
The online self-referral option offered by the NHS allows patients to seek help in a low-pressure pressure environment. This is helpful for people who may not want to speak to their GP or another professional in the first instance. Assessments are carried out over the phone before the patient is offered therapy, and digital-only options are available.
Equally, NHS-approved apps are available to those who feel like they need help but who aren’t ready to speak to someone. They range from apps that offer guided meditation and mindfulness sessions to breathing exercises and informational content. Some options also allow people to confidentially message therapists, again providing low-pressure access to talking therapies.
Digital methods could impact diagnosis
According to Professor Martin Marshall, RCGP chair, digital GP appointments could make diagnosing and managing mental health problems more difficult. In some cases, patients could receive a medical misdiagnosis and therefore not receive the right care. He stresses that patients suffering from mental health conditions may have experienced difficulties adapting to remote appointments during the coronavirus pandemic.
Many have also raised concerns about the legitimacy of mental health apps. Popular mindfulness app Headspace has recently come under fire for a weak evidence base. A number of academics carried out studies with mixed results, highlighting the lack of scientific evidence behind the platform. Psychologist Chris Noone comments that these apps could prevent people from seeking scientifically backed treatment like cognitive behavioural therapy.
Patients report a lower quality of care during COVID-19
A recent UCL study has found that those receiving digital mental health support reported a lower quality of care. Many patients said their care felt less personal than speaking to someone face-to-face, increasing their feelings of isolation and loneliness further. For some, digital appointments created further anxiety, while patients with limited access to technology struggled.
One patient reported that in addition to her sessions moving from in-person to remote, her sessions were less frequent, moving from weekly to every three weeks. Others were offered support via text but said this wasn’t sufficient. The loss of group therapy also heavily impacted users, who felt supported and socially connected to their fellow attendees.
Is technology the answer to mental health?
As we can see, the switch to digital mental health support during the coronavirus pandemic has had both positive and negative effects. Digital mental health services are more accessible than in-person therapy and, while waiting lists are still a concern, more people can access support. The ability to self-refer or informally treat our own mental health conditions with digital apps and services creates a low-pressure environment where we can seek help without needing to speak to someone. This is useful if people are initially reluctant to seek formal support.
On the other hand, we’ve witnessed issues with digital inclusion and the quality of support people are receiving. Many people feel that remote appointments in particular are less personal than in-person treatment, with many reporting that it can exacerbate their symptoms. Those who don’t have easy access to technology are being left behind. Additionally, the scientific evidence of leading apps that present themselves as mental health therapies is being brought into question.
The coronavirus pandemic has not only had a monumental impact on our mental health, but it has also changed the way we receive support. The positive elements of digital mental health support cannot be ignored, but neither can the downsides – especially as some patients report that this can exacerbate their symptoms. Going forward, it’s important to blend in-person and digital mental health support, which gives patients the option to choose the most suitable treatment.