How AI can give people back their autonomy when it comes to mental health care
By Dr Nicole Main, UK Clinical Lead, Wysa
Everyone deserves easy access to good quality mental health care where they are at the centre of decision making about treatment options and therapy. Unfortunately insufficient resources means that statutory services often operate in a world where support is either provided as a response to an immediate crisis, or is provided several weeks or months after symptoms first emerge, meaning that treatment can often take longer and/or is required at a higher level of intensity.
Although the national NHS Talking Therapies services have greatly improved the provision of psychological treatments for adults with mild and moderate mental health problems, waits remain long in some services, and are particularly notable in many CAMHS and CYP services. In addition the demographics of those reaching out for support rarely match the population demographics. For example, in my own experience working in the London Borough of Barnet for many years, it was very rare to receive referrals from Chinese people, even though Barnet has the highest number of Chinese communities in London.
We know though that early intervention, as well as patients having a choice of the type of therapy offered to them, improves outcomes. Autonomous digital mental health care can be a timely, personalised and affordable addition to existing treatment options, at a time when NHS resources are underfunded and stretched. Although the impact and effectiveness of self help for mental health problems such as anxiety or low mood requires further research, there is evidence for the effectiveness of exercise and relaxation for depression, and promising results for the effectiveness of bibliotherapy, internet based self help and meditation/mindfulness for anxiety (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418416/)
Good quality digital health technology that recommends and provides access to evidence based tools and techniques is one way of enabling more people to access help at the point at which symptoms first emerge, without the need to neccessarilyreach out to their GP or refer themselves to statutory services. It can also provide personalised care and be integrated into existing services as a first step following referral, whilst patients are waiting to be seen, or whilst they’re waiting for therapy or other treatments to begin. When used as an adjunct to therapy, apps which provide access to meditations, relaxations and psychoeducational material can remove the need for clinicians to send paper copies of psychoeducational material or email links to exercises which may be lost or forgotten about, and mean that patients can access helpful self help wherever and whenever is convenient for them.
With demand for services growing and capacity to meet this demand in short supply, we need to find alternative, less labour intensive ways of helping people to help themselves – this is one of the reasons why after 18 years in the NHS I decided myself to join a health tech start up – in my final years as a head of service, even with sufficient funding I was unable to source sufficient numbers of therapists to ensure waiting lists could reduce, or even remain stable.
Although digital technology will not and should not ever replace human therapists, AI-driven tools can analyse a person’s health data and provide personalised recommendations, such as when to schedule a check-up or tools to manage specific symptoms, which can aid in self-management and reduce dependency on statutory healthcare services. Some apps like Wysa can also provide 24/7 support in the form of crisis helplines, safety plans and exercises to reduce high levels of panic or agitation, which can help to mitigate the likelihood of deterioration when people are without or are waiting for professional support.
Anywhere, any time
Digital technology enables patients to receive remote support wherever they are. This is particularly empowering for individuals in remote or underserved areas, or for those with mobility issues, as it reduces the need to travel for face to face consultations or follow-ups. Digital health tools can also help bridge the gap in health disparities – although of course digital poverty exists, more of us in the UK have access to a phone than a car for example, making accessing support via our devices a more equitable playing field.
The care can also be longer lasting. Typical CBT cycles of treatment are between 6 and 12 weeks long and many services are unable to offer booster or follow up sessions following discharge, which can help to prevent deterioration and enable patients to feel supported for longer. Digital health tech can offer symptom management tools both before and after in person support, enabling people to continue to practise strategies and techniques used in therapy to improve their wellbeing in the longer term. AI and machine learning can help tailor health interventions to the individual’s unique health profile, preferences, and behaviours, making the care process more personal and relevant – and thus improving the likelihood of individuals remaining engaged and active in their own recovery.
Personally, integrating the use of digital health technologies within my clinical practice has improved the quality of care that I provide – it provides me and the patients I see with an easy, convenient and reliable way of communicating with each other, a way of sharing materials and tools which we talk about in therapy, and a way to provide additional out of session support that patients can continue to access even after discharge. It’s an invaluable tool that will never replace what therapists and psychologists can offer, but augment it and enhance it. Rather than running scared of technology and artificial intelligence we should think about how it can benefit us and the people we work with, and embrace clinically robust tools to enable us to do what we set out to in this profession – help people in a way that works for them.
Nicole Main – UK Clinical Lead
Dr. Nicky Main is a Consultant Clinical Psychologist and Health and Care Professions Council (HCPC) registered Practitioner Psychologist. She qualified in 2003 from the Institute of Psychiatry in London, and on qualifying spent 18 years working within NHS adult mental health services, most recently as Head of Barnet and Enfield Improving Access to Psychological Therapies (IAPT) Services. Nicky moved to Wysa in January 2022 as their UK and Europe Adult Clinical Lead. As well as completing her Doctorate in Clinical Psychology, Nicky also has a master’s in Research Methods and Statistics, and a postgraduate diploma in Cognitive Behaviour Therapy (CBT) from Oxford University. She is a member of the British Psychological Society, and an accredited member of the British Association of Behavioural and Cognitive Psychotherapies (BABCP). Alongside working for Wysa, Nicky has a private practice where she specialises in treating adults with anxiety, depression and low self-esteem. She also provides CBT-based coaching for Ph.D. students at University College London.
Wysa is a global leader in AI-driven mental health support, available both to individuals, through employer benefits programmes and healthcare services. We believe access to support should be available whenever people need it. Stigma prevails, so we take away the need for people to ask for help and eliminate the need for people to make a judgement call on when they should seek professional support. Proven to improve depression and anxiety scores by an average of 31%, Wysa’s AI-first approach enables employees to improve their mental health before symptoms become severe, by understanding an individual’s needs and guiding them through interactive cognitive behavioural therapy (CBT) exercises. Wysa’s clinically safe AI encourages users to take additional support, whenever it’s needed, by guiding them towards Wysa’s human coaching, employer benefits programmes (EAP) or national crisis lines. Wysa has helped over 6 million people through 550 million AI conversations across 95 countries.
