Following the Digital Showcase 2023: Tech solutions for Children and Young People’s Mental Health Services partnership event, facilitated by Mayden, Fiona Dawson, gives her view on the vital role that digital support plays in Children and Young People’s Mental Health Service (CYPMHS) pathways, and why a collaborative approach is so important.
There have been significant challenges for children and young people’s mental health in the last five years, notably the interruptions to education and home life caused by the Covid pandemic. According to NHS data, the mental health of children and young people in England has worsened since 2017. In almost every year since 2017-18 there have been steady increases in the number and rate of children being referred to specialist mental health services and, in many areas, waiting times between referral to CYPMHS and treatment are rising. Access to timely treatment is vital, without it a child’s mental health condition is likely to become more significant and have a greater impact on their life.
The role digital interventions can play
One of the key themes we explored at the Digital Showcase event alongside Oxford AHSN and University of Oxford’s TOPIC Research Group was the potential for digital interventions to support young people’s mental health. These can provide access to support in a timely way, not just for children and young people, but for their parents or guardians too. There is growing evidence to suggest that digital therapies can have positive effects for adolescents and young people with depression and anxiety. For example, four digital mental health tech solutions based on CBT principles for children and young people were recommended by NICE earlier this year.
Over the last five years, there has been significant growth in the range of digital therapeutic interventions and apps available to support children and young people, across the mental health care pathway. Digital presents what we call ‘just in time’ advantages – it can provide evidence-based support, quickly, for those people who are assessed as suitable for it. It means CYPMHS can offer choice to young people and their parents, helping them to access services more easily when they need them and feel more engaged in their care. Take for example a child who is experiencing anxiety – an app which is readily available on their phone might be offered as part of a pathway to provide the child with immediate help while they wait for an appointment with a therapist.
Young people have a digital-first attitude and data shows that the traditional models of mental health support don’t always provide what young people need. A recent survey carried out by Wysa, an AI-driven mental health support app, found that services are inaccessible for over half of teenagers because they’re not offered at the right time, it is not the right support, or because of the associated stigma. It also found that young people are turning to online information and social media platforms for tips and advice on their mental health with 25% of 13-15 year-olds and 33% of 16-17 year-olds saying they would consult TikTok.
How services can maximise digital interventions
When faced with such worrying trends, it is understandable why healthcare professionals might be cautious about including digital interventions in mental health care pathways. However, service structures can be adapted to maximise the benefits of digital interventions. Whether it be digital only, blended or adjunct tools, it requires services to have an open mindset and understand how to manage digital pathways and integrate them with traditional interventions.
There are a plethora of digital therapeutic interventions and apps available, with different levels of clinical rigour and evidence base, which we know can be intimidating to navigate for mental health teams and commissioners. This is why resources such as Oxford AHSN’s report Scoping Digital Support for Children and Young People’s Mental Health are so important. ORCHA’s digital health app library, The Best for You, provides a comprehensive guide to mental health apps that are digitally and clinically assured. Together, they can help service providers to select assured and evidence-based digital therapies to include in their care pathways.
Incorporating the patient voice in services
It is vital that children and young people themselves are part of reimagining the future landscape of mental health provision, which is why co-production is so important. This process involves service providers, service users, and their families all working together to design, deliver and evaluate services.
We need this collaborative approach to ensure services, and the digital options they offer, are user-led and meet the needs of those who use them. This co-production also helps to build trust between service users and mental health providers which ultimately leads to better outcomes.
Where interoperability comes in
Systems and services don’t exist in isolation. Patients often engage with many different services across health and social care during their diagnosis, treatment, and recovery from mental health conditions. At Mayden, we recognise the need for interoperability between clinical systems across the NHS and the range of digital therapeutic interventions that are in use in services. That’s why our iaptus patient management system offers interoperability with over 20 providers of digitally enabled interventions. This ensures therapists can refer patients to digital options and that secure data flow with the patient record supports continuity and quality of care for patients.
Another key point made at our Digital Showcase event was that digital technology – whether it’s patient facing health apps or electronic patient record systems and specialist clinical software – needs to work together to deliver the most value. This provides care that is not fragmented. Interoperability is not a nice to have, it is critical to safe and effective mental health care for people of all ages.
Reimagining the future landscape of mental health provision
Digital solutions have the potential to improve the efficiency, accessibility and effectiveness of mental health services for children and young people, but ultimately the future of mental health provision must be collaborative and joined up. In order to deliver the best possible outcomes we need to embrace both digital solutions and traditional support, with a focus on early intervention, co-production, and integration with patient records.
Supporting continuity and quality of care for children and young people means we can hopefully provide the right support at the right time. If we can leverage digital technology to improve and support mental health at this early stage of life, we may even change the outlook for many individuals who would be likely to face further difficulties in adulthood.
