Prior to COVID-19, mental and behavioral health was gaining momentum as a healthcare priority. Funding was starting to flow into mental health services and the technologies to support it. One of those technologies was telehealth – an effective way for patients to “visit” with their Psychiatrist. Another was digital cognitive behavior therapy solutions (digital therapeutics) which allow providers to treat more patients more effectively. Then the pandemic arrived and mental health became even more important.
Dr. Derek Richards, Chief Science Officer at SilverCloud Health, a company that creates internet-delivered cognitive behavioral therapy programs, was kind enough to answer a battery of questions in an email interview on the topic of digital mental health, cognitive therapy and digital therapeutics.
What is digital cognitive behavior therapy?
Generally speaking, digital therapy offers three benefits that are of high interest to healthcare providers who operate on the one-to-one therapy model: scalability, accessibility and affordability. Simply put, it allows them to increase the number of patients they see; the platform circumvents traditional barriers that prevent access to mental health therapy, and it dramatically decreases care delivery costs (91% reduction compared to face-to-face therapy). In the U.S., as many as 43.8 million adults will experience some form of behavioral or mental illness in a given year. In 2018, 56 percent of those wrestling with these mental difficulties did not receive care because of treatment barriers, including stigma, limited or exhausted budgets, and geographic remoteness – that’s over half the mental illness population. Mental therapy is in need of a transformation, and digital therapeutics are a proven alternative.
Is digital therapy as effective as face-to-face?
SilverCloud’s platform is built on an extensive research base with over 30 peer reviewed clinical studies over nearly two decades. Through several randomized control trials (RCT), we have demonstrated that our programs are extremely effective and provide clinical outcomes that are equivalent to similar interventions delivered in face-to-face therapy. SilverCloud delivers structured brief interventions for the treatment of common mental health disorders including depression and anxiety. They also have a suite of programs that address personal wellbeing and functioning such as stress management, sleep management, and resilience. These interventions are reflective of many types of interventions delivered in face-to-face services either in 1:1 formats or groups. We have demonstrated equal effectiveness with similar evidence-based interventions delivered 1-to-1 and in group settings.
Is there any difference in the treatment received digitally?
The treatments that are delivered online are identical to those that would be delivered in person. Essentially as clinicians, we have a repertoire of empirically supported treatments that have been developed through research and practice over many decades. They describe the treatment components and what works best for whom giving the presenting issues and difficulties. It is from this repertoire that the active ingredients of treatment are composed and delivered for effective clinical outcomes. Therefore, apart from the mode of dissemination, we are delivering standard evidence-based psychological treatments.
What mental health services are most in-demand right now because of COVID-19?
At this current time, we are experiencing a pandemic like most have never witnessed before. That alone raises the levels of distress and stress in the population. The various community initiatives to support the effective management of the COVID-19, including cocooning, social distancing, and the closure of many places of businesses and leisure pursuits will inevitably have its impact on people’s general wellbeing and their mental health. These initiatives, while important and necessary, have a direct impact on our sense of selves, who we are, our social lives and also whether we are employed in meaningful and purposeful pursuits.
Stress management, resilience and sleep management have all been in high demand.
What is SilverCloud experiencing during this pandemic?
Due to the closure of mental health services, SilverCloud is being deployed more than ever before to maintain continuity of service provision. This continuity helps to support those with serious and long-term mental health conditions that require ongoing management. However, in addition and with the prospect of service doors remaining closed for the coming months, many health systems are leveraging SilverCloud to provide for the treatment of common mental health concerns such as depression and anxiety disorders. It is likely that these concerns will become more prevalent in the coming months as people face the ongoing consequences of loss and dislocation that we are experiencing.
One of the main advantages of digital is the ability to rapidly develop new content and deploy that at scale. To that end, we have built new content specific to COVID-19. The content is underpinned by the latest research in emergency psycho-social response that implicates the principles of mental health first aid. The content builds on Hobfoll et al. (2007) 5 principles for intervention development during emergencies and mass violence: A sense of safety, a sense of calming, a sense of self-efficacy and collective efficacy, connectedness and hope. We have delivered this globally, across our partnerships and networks, with particular emphasis on supporting frontline health care workers.
Is the growth that we are seeing in digital therapeutics and mental health services a blip or is it a sustained trend?
As it relates to COVID-19, we believe the heightened need for mental health therapy will sustain for quite some time for a variety of reasons. It is likely that the worsened socioeconomic conditions that will follow the crisis will have lasting effects on society, and consequently, it will be imperative that we have treatment options available to everyone who is in need. Digital therapeutics scales treatment beyond traditional one-to-one therapy models and bridges the gaps that healthcare providers and patients experience when trying to access mental health care. We believe the power and clinical outcomes of these programs will be realized even further after the COVID-19 dust settles, and we hope that those who are struggling with mental difficulties will continue to turn to digital therapeutics for treatment. We have 20+ years of research supporting the effective and safe delivery of digital therapy for mental health, and the current circumstances only highlights how important it is that we have digital mental health solutions like SilverCloud available as part our treatment initiatives.
To learn more about SilverCloud Health, visit their website at https://www.silvercloudhealth.com/
This article is part of the #HealthIT100in100
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