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Prevention with digital technologies: expanding the possibilities for better mental health

Co-production, knowledge exchange and inclusion....asking the difficult digital questions at the eMEN London Conference

On Thursday 24 January PCMIS attended the eMEN London Conference ‘Prevention with digital technologies’.

A joint enterprise by the Mental Health Foundation and University of York, the event brought together a range of experienced researchers and industry figures to discuss how digital interventions might allow us to ‘expand the possibilities for better mental health’.

Coming hot on the heels of the news that NICE have recommended digital CBT for children with depression, we thought you might like a summary of the key points from this event.

Throughout the day, the Beyond the Room team, led by André Tomlin (National Elf Service) were facilitating wider discussions on social media and with attendees. This added an interesting extra dimension, increasing engagement with the topics being addressed and expanding the reach of the event.

"The progress we've made in preventing physical health problems is stunning. It's time to make the same progress in mental Health"

Mark Rowland, Chief Executive, Mental Health Foundation

After an introduction from Mark Rowland, CEO of the Mental Health Foundation, in which he challenged attendees to consider the potentially positive and negative impacts of digital health, the University of York’s Dr Lina Gega started the day by focussing on the importance of ‘knowledge exchange’ when developing digital mental health interventions.

Lina used examples from a project implemented in children’s mental health services, and stressed the importance of co-design at every stage of development. She shared the below slide with some key markers for defining a digital intervention as ‘fit for purpose’.

'Getting Digital into Practice'

The morning continued with an update from Tracy Parr of the Healthy London Partnership. Tracy provided an insight into the ongoing work being done in London to improve access to psychological therapies using the Good Thinking website, launched in late 2018.

A key goal of Good Thinking is to ensure the population are directed to the most relevant intervention for their individual needs, as well as the best fit for their location. IAPT services can be found using postcode and GP searches, with online referral forms available via Good Thinking.

Tracy stated that, so far, 700 Londoners have completed an online referral via Good Thinking and then continued into IAPT treatment.

The project is funded by London CCGs and local authorities but Public Health England are looking at the possibility of rolling out a similar approach nationally.

Tracy concluded by stating that the Good Thinking project leads are liaising with PHE to ensure that any further work is complimentary rather than competitive. Good Thinking is currently undergoing an evaluation around whether the project has successfully included ‘hard to reach’ groups within the London population.

Efficacy vs Efficiency

Happy to play devil’s advocate in a room full of digital evangelists, Prof Simon Gilbody (University of York) described himself as the ‘honest evaluator’ as he discussed what we can learn from trials of CCBT (Computerised Cognitive Behavioural Therapy).

Simon presented the findings of the REEACT trial, which suggested that there was no real benefit to computerised CBT, but did demonstrate through feedback from participants, the importance of human support for those using digital interventions. He stressed the need for clarity around definitions of efficacy (does this do what we require/expect?) versus efficiency (does this do what we require/expect in real life over a sustained period of time?) and the limitations of trials done so far in this area.

Prof Gilbody finished by reiterating his commitment to the continued scrutiny of digital interventions, due to the sheer pace of innovation and change.

His talk included some guiding principles about how to proceed with digital technology:

After a break, the afternoon started with three different presentations all aimed at addressing the questions…

‘How far have we come? How far can we go?’

First up was Mark Brown, serial tweeter and mental health writer, who presented a stream of conscious ‘ideas dump’ based around the current state of play and possible future landscape of mental health care as the NHS begin to place all their eggs in the digital health basket.

Mark threw out some difficult questions that we often forget to ask about technology and our mental health, including a reminder that a 'business approach' continues to dominate the conversation on the possibilities of digital.

He finished by asking how we can balance the fact that prevention and recovery are things measured at population level, when they are experienced on an individual level.

The rest of the afternoon featured talks on harnessing digital interventions for workplace mental health, plus lessons learnt and hard fought insight from experts working in mental health innovation for over a decade, and was brought to a close by an insightful panel discussion featuring representatives from a range of sectors.

PCMIS would encourage you all to check out the recent blog by speaker Victoria Betton (mHabitat) - Standards and principles for evaluating mental health apps which covers recommendations made in World Psychiatry (the Official Journal of the World Psychiatric Association).

But don't stop there, this being a conference that focussed on the possibilities of digital, there is a lot of content available online for those that didn’t attend the event.

Follow the day’s key ideas and conversations via #eMENprevention on Twitter

Check out audio interviews with speakers recorded on the day

Watch the panel discussion ‘Tech for good? The benefits and challenges of digital technologies for mental health’ 

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