Published at a time of increased anxiety and impact on mental health from the COVID-19 pandemic, the research emphasises how digital cognitive behavioural therapy (iCBT) as part of wider psychological care can deliver strong clinical improvements and recovery. More than half of those with a diagnosis of anxiety and/or depression recovered after three months, according to the study published in npj Digital Medicine.
The findings, revealed in the largest ever study of its kind and involving more than 360 service users in England on the Improving Access to Psychological Therapies (IAPT) programme, strongly endorse the role that digital mental health can play in treating depression and anxiety disorders.
The study comes as mental health providers anticipate a significant increase in a range of disorders linked to anxiety and depression stemming from the pandemic and emerging as the lockdown continues to ease. The potential triggers include grief, job loss and insecurity, loneliness and isolation.
The findings underline the benefits from long-term outcomes and cost-effectiveness of including digital mental health interventions such as SilverCloud as part of clinical care, including stepped care models such as IAPT. Supporting economic analysis based on criteria suggested by the National Institute for Health and Care Excellence (NICE) indicated that over a 12 month period such health support could be cost-effective. Currently, iCBT accounts for just seven per cent of treatments completed within an IAPT programme.
The study participants were service users at Berkshire Healthcare NHS Foundation Trust, which is acknowledged as being at the forefront of developing new approaches to mental healthcare. It is one of NHS England's Global Digital Exemplars for transforming patient care and engagement through new technology.
Dr Derek Richards, Chief Science Officer at SilverCloud Health and Co-Director of the E-Mental Health Research Group, Trinity College, the University of Dublin, said: “This is important, large-scale research that demonstrates how digitally-provided cognitive behavioural therapy can enhance a wider mental health therapy programme calibrated to an individual's needs.
"Due to its results on long-term improvement, recovery and cost-effectiveness, at a time of increasing demand for psychological and behavioural healthcare, digital mental health care should be viewed as a standard part of psychological support and no longer simply as an innovative approach.
"As a result of the global pandemic, many individuals within communities are facing mental health challenges and iCBT can play an important part complementing current mental healthcare services, increasing their reach and capacity, and helping support and treat more people."
As part of the study an IAPT treatment group was given eight weeks of supported digital mental health intervention to treat depression and anxiety, compared with a waiting list control group that did not receive the treatment initially.
Psychiatric interviews of participants at three months after treatment found that, overall, 56.4% no longer had a diagnosis of anxiety, depression or a joint diagnosis. A further significant decrease in symptom scores was seen after 12 months, on average a 50% decrease.
The study report in npj Digital Medicine states: "In a society where the prevalence for depression and anxiety is rising and demand is outpacing what mental health services are able to offer, embedding digital interventions as treatment alternatives increases accessibility and service efficiency, which has the potential to be cost-effective for the health care system."
Judith Chapman, Development Director at Berkshire Healthcare, said: "By our joint working at Berkshire Healthcare Talking Therapies with SilverCloud Health in a long-term randomised controlled trial, we have been able to measure the effectiveness of iCBT within an IAPT setting.
The findings have proven the effectiveness of treating anxiety and depression using iCBT with excellent patient outcomes.
"The trial has demonstrated that digital treatment has a strong place alongside conventional face-to-face mental health therapy, which is not a second class treatment offer but a robust evidence-based and accessible treatment for the population, especially during the unprecedented and challenging times we are experiencing due to COVID-19."
About SilverCloud HealthSilverCloud Health is the world's leading digital mental health company, enabling healthcare organisations to deliver clinically validated digital health/therapeutic care that improves outcomes, increases access and scale while reducing costs. The company's multi-award-winning digital mental health platform is a result of over 16 years of clinical research with leading academic institutions. Today, SilverCloud is being used by over 250 organisations globally to meet their populations’ mental health needs. Global experts have deeply validated the platform through full randomised control trials and real-world data from over 300,000 SilverCloud users.
The platform continues to lead the industry with its effectiveness, engagement, and range of clinical programmes that encompass the spectrum of mental health needs.
About Berkshire Healthcare NHS Foundation TrustBerkshire Healthcare NHS Foundation Trust provides specialist mental health and community health services to a population of around 900,000 within Berkshire. They operate from more than 100 sites across the county but the vast majority of the people they care for are supported in their own homes. They have 216 mental health inpatient beds and 180 community hospital beds in five locations.