E-therapies in England for stress, anxiety or depression: what is being used in the NHS? A survey of mental health services

M R Bennion, G Hardy, R K Moore, A Millings, M R Bennion, G Hardy, R K Moore, A Millings

Abstract

Objective: To document the range of web and smartphone apps used and recommended for stress, anxiety or depression by the National Health Service (NHS) in England.

Design: The study was conducted using Freedom of Information (FOI) requests and systematic website searches.

Data sources: Data were collected via FOI requests to NHS services between 13 February 2015 and 31 March 2015, and searches conducted on NHS apps library websites between 26 March 2015 and 2 November 2015.

Data collection/extraction methods: Data were compiled from responses to: (1) FOI requests sent to all Improving Access to Psychological Therapies (IAPT) services and NHS Mental Health Trusts in England and (2) NHS apps library search results.

Results: A total of 61 (54.95%) out of the then 111 IAPT service providers responded, accounting for 191 IAPT services, and all 51 of the then NHS Mental Health Trusts responded. The results were that 13 different web apps and 35 different smartphone apps for depression, anxiety or stress were available through either referral services or the online NHS Apps Libraries. The apps used and recommended vary by area and by point of access (online library/IAPT/trust).

Conclusions: Future research is required to establish the evidence base for the apps that are being used in the NHS in England. There is a need for service provision to be based on evidence and established guidelines.

Keywords: England; NHS; anxiety; depression; e-therapies; stress.

Conflict of interest statement

The last author was formerly an employee (2010-2012) and minor shareholder of Ultrasis UK (makers of "Beating the Blues"), which went into administration in October 2015.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Figures

Figure 1
Figure 1
PRISMA flow diagram of app data collection. PRISMA, Preferred Reporting Items for Systematic review and Meta-Analysis.

References

    1. Dutton P. Australia's first digital hospital 2014. (accessed 9 Sep 2016).
    1. Andersen AJW, Svensson T. Internet-based mental health services in Norway and Sweden: characteristics and consequences. Adm Policy Ment Heal Ment Heal Serv Res 2013;40:145–53. 10.1007/s10488-011-0388-2
    1. National Information Board. Personalised health and care 2020, using data and technology to transform outcomes for patients and citizens, a framework for action 2014.
    1. NHS England. Five year forward view 2014. (accessed 9 Sep 2016).
    1. We Need to Talk coalition. We still need to talk: a report on access to talking therapies 2013.
    1. Mental Health Network. The future's digital mental health and technology 2014.
    1. Marks IM, Mataix-Cols D, Kenwright M et al. . Pragmatic evaluation of computer-aided self-help for anxiety and depression. Br J Psychiatry 2003;183:57–65. 10.1192/bjp.183.1.57
    1. Cuijpers P, Riper H. Internet interventions for depressive disorders: an overview. Rev Psicopatología y Psicol Clínica 2014;19:209–16. 10.5944/rppc.vol.19.num.3.2014.13902
    1. Titov N. Status of computerized cognitive behavioural therapy for adults. Aust N Z J Psychiatry 2007;41:95–114. 10.1080/00048670601109873
    1. Spurgeon JA, Wright JH. Computer-assisted cognitive-behavioral therapy. Curr Psychiatry Rep 2010;12:547–52. 10.1007/s11920-010-0152-4
    1. Riper H, Andersson G, Christensen H et al. . Theme issue on e-mental health: a growing field in internet research. J Med Internet Res 2010;12:e74 10.2196/jmir.1713
    1. Newman MG, Szkodny LE, Llera SJ et al. . A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: Is human contact necessary for therapeutic efficacy? Clin Psychol Rev 2011;31:178–86. 10.1016/j.cpr.2010.10.002
    1. Barak A, Klein B, Proudfoot JG. Defining internet-supported therapeutic interventions. Ann Behav Med 2009;38:4–17. 10.1007/s12160-009-9130-7
    1. National Institute for Health and Care Excellence. Depression in adults: recognition and management. CG90 2009:63 (accessed 9 Sep 2016).
    1. NICE. Depression in adults with chronic physical health problem: recognition and management. CG91 2009.
    1. National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management. CG113 2011. (accessed 9 Sep 2016).
    1. National Institute for Health and Care Excellence. Social anxiety disorder: Recognition, assessment and treatment. CG159 2013. (accessed 9 Sep 2016).
    1. European Commission. Guidance document medical devices—scope, field of application, definition—qualification and classification of stand-alone software—MEDDEV 2.1/6 2016.
    1. Medicines & Healthcare products Regulatory Agency. Medical device stand-alone software including apps 2014. (accessed 9 Sep 2016).
    1. McCartney M. How do we know whether medical apps work? BMJ 2013;346:f1811 10.1136/bmj.f1811
    1. Clark DM. Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience. Int Rev Psychiatry 2011;23:318–27. 10.3109/09540261.2011.606803
    1. NHS Choices. Authorities and trusts—The NHS in England—NHS Choices 2015. (accessed 9 Sep 2016).
    1. NHS England. NHS Commissioning Board launches library of NHS-reviewed phone apps to help keep people healthy 2013. (accessed 9 Sep 2016).
    1. Huckvale K, Prieto JT, Tilney M et al. . Unaddressed privacy risks in accredited health and wellness apps: a cross-sectional systematic assessment. BMC Med 2015;13:214 10.1186/s12916-015-0444-y
    1. Leigh S, Flatt S. App-based psychological interventions: friend or foe ? Evid Based Ment Health 2015;18:97–9.
    1. NHS Choices. Online mental health services 2015. (accessed 9 Sep 2016).
    1. National Institute for Health and Care Excellence. Computerised cognitive behaviour therapy for depression and anxiety. TA97 2006. (accessed 9 Sep 2016).
    1. National Institute for Health and Care Excellence. Computerised cognitive behaviour therapy for depression and anxiety: review of technology appraisal 51 2008. (accessed 10 Dec 2014).
    1. NHS Digital. Improving access to psychological therapies data set 2016. (accessed 9 Sep 2016).
    1. Health and Social Care Information Centre. Psychological therapies: annual report on the use of IAPT services England, 2014/15 2015.
    1. MindTech. Digital mental health toolkit—MindTech 2014. (accessed 20 Oct 2015).
    1. Stoyanov SR, Hides L, Kavanagh DJ et al. . Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR mHealth uHealth 2015;3:e27 10.2196/mhealth.3422
    1. Mani M, Kavanagh DJ, Hides L et al. . Review and evaluation of mindfulness-based iPhone apps. JMIR mHealth uHealth 2015;3:e82 10.2196/mhealth.4328
    1. National Information Board. WORK STREAM 1.2 ROADMAP. Enable me to make the right health and care choices. Providing citizens with access to an assessed set of NHS and social care ‘apps’ Work 2015. (accessed 24 Nov 2016).

Source: PubMed

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