Jaime Essed, Founder and CEO of Oh My Mood sheds light on how mental healthcare provision in the UK can be improved with new models of care
Approximately one in four people in the UK will experience a mental health problem each year, but it is getting harder for people to access the treatment they need. A ‘potent mix’ of rising demand and cuts to the workforce have caused waiting lists to get longer. NHS Providers found that 80% of NHS trusts in England fear they cannot provide timely, high-quality care to the growing number of people seeking mental health support.
To prevent the system from coming to a standstill, NHS mental health trusts, clinicians and care professionals need to explore new ways of delivering high-quality mental healthcare.
Steps are being taken to improve the situation. For example, the NHS Long Term Plan includes ‘a renewed commitment to growing investment in mental health services faster than the NHS budget overall for each of the next five years’.
However, the delivery of efficient, cost-effective mental healthcare requires a fundamentally different approach. Indeed, the Five Year Forward View for Mental Health report identified the development of new models of care as a priority. Such a new model should explore other, more efficient solutions to the long-term benefit of mental health patients.
The role of eHealth
eHealth is increasingly put forward as an alternative solution to cope with the increased levels of mental healthcare demands. But is it the new model of care that will transform the mental healthcare delivery?
There is evidence that eHealth can reduce psychiatric complaints, such as depression, anxiety and alcohol dependency. But besides these areas, the number of evidence-based eHealth interventions is limited. There is also evidence that eHealth promotes autonomy and self-determination, which will be to the benefit of the service user even after treatment has ended. However, most eHealth interventions are standalone and highly standardised, with clinicians having no or just a marginal role.
In comparison, during face-to-face sessions clinicians can make adjustments to meet the individual needs of a service user. Not being able to make adaptations to the eHealth intervention prevents clinicians from offering eHealth-based treatment plans to most of their patients.
Another, equally important issue is that it has been unclear what the government’s vision is for eHealth, that is how it will be incorporated into the mental healthcare system, and how providers will be financially compensated? This leaves the healthcare provider uncertain of eHealth’s return on investment. As long as this barrier has not been removed, eHealth as a new model of care is unlikely to be the panacea for the problems we are facing.
Blended care is the best of both worlds
eHealth has a transformative role to play if it is a viable component of the care model – not a stand-alone solution. When eHealth methods are combined with traditional therapies, we talk about blended care. Blended care can be conceptualised as a new model of care in which traditional face-to-face health services and eHealth are integrated into the care procedure to make for a rational and personalised mental healthcare plan.
An important prerequisite of blended care is the notion that treatment methods:
- Should complement each other;
- Should be tailored to the specific needs of the service user;
- Should be cost-saving.
Because of its Internet-based facilities, a blended care treatment programme can be representative of a mix of treatment services provided by a range of healthcare providers. It supports a change in how traditional medicine is practised, as the knowledge and skills of different disciplines are blended into one integrated healthcare process. Blended care enables an integrated treatment of service users.
Modern society has made it clear that it is no longer considered appropriate to dictate a mental healthcare plan to a service user. Shared decision making should be applied to personalise the care pathway and focus on patient outcomes. It is known that blended care encourages the participation of service users in their own healthcare. Not only because they can access a wealth of care information on the Internet, but also because of the possibility of easy access to a therapist to help them sort things out and apply learnings to their daily lives. Collaboration between the two increases programme fidelity and patient outcomes.
Although a relatively new concept, blended care could well be the most promising new model of care for patients and therapists alike. It is supportive of the delivery of personalised care – one of five major, practical changes that the NHS Long Term Plan aims to deliver over the next five years – and ensures a more efficient delivery of mental healthcare, which eases the strain on care practitioners without adding pressure on NHS budgets. It is value-based because it encourages the continuous improvement of the quality of care while delivering more value for money. A blended care approach can prove to be a win-win situation for everyone involved.
Jaime Essed is the Founder of mental health interventions provider Oh My Mood, which is on a mission to shake up mental health provision with its proprietary blended care method that makes support more effective and accessible to service users.
The Guardian, NHS bosses warn of mental health crisis with long waits for treatment, 7 July 2017, https://www.theguardian.com/society/2017/jul/07/nhs-bosses-warn-of-mental-health-crisis-with-long-waits-for-treatment
NHS, NHS Long Term Plan, January 2019, https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/nhs-long-term-plan.pdf
Mental Health Taskforce, The Five Year Forward View for Mental Health, February 2016, https://www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf
University of Washington, The Collaborative Care Model, https://aims.uw.edu/collaborative-care
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Founder and CEO
Oh My Mood
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