DIGITAL MENTAL HEALTH
Join Induction Health as they describe how their solution Attend Anywhere/Near Me has been used in NHS Scotland to support patients in safely accessing mental health care. In addition, HTN shares some of the top digital mental health solutions that have caught our eye in recent months.
Induction Healthcare and NHS Scotland: accessibility through remote care
Induction Healthcare aims to transform the interactions between patients and care teams through innovative technology solutions, helping people to take an active role in their own health and supporting the efficient delivery of care.
Working with healthcare providers like NHS Scotland has enabled the development of clinician-informed digital solutions that are transforming the healthcare delivery landscape, specifically in specialities such as: mental health (psychological and social wellbeing), diabetes, ophthalmology, oncology, midwifery, gastroenterology, and dentistry.
Scotland’s challenge
With a small population spread over a vast area, NHS Scotland needed a secure, reliable, accessible way to deliver care to remote communities and other groups who struggle to access care. The video conferencing tools that were in daily use in business lacked the security that would make them suitable for clinical use.
Our solution
In 2016, Induction Attend Anywhere was selected as the remote consultation platform that would give NHS Scotland the security, reliability, and accessibility required to ensure broad uptake by staff and patients.
Branded as ‘Near Me’ throughout Scotland, Induction Attend Anywhere replicates a physical healthcare environment by providing waiting areas for each specialist department, and associated administrative processes.
- When booking, patients are given the option of a remote consultation, where clinically appropriate.
- Service providers include a link to a specific waiting area or group of waiting areas when they send the patient their appointment letter.
- At the appointed time, the patient opens the link on their preferred device – mobile phone, tablet, laptop, or computer – completes the relevant fields, and enters their own secure waiting area. There are no downloads or software installations required.
- The service provider is notified when the patient arrives. They then join the patient’s waiting area and run the consultation as usual. If they’re running late, they can send a chat message via the platform to let the patient know.
The patient can have a support person join the call; the service provider can invite colleagues to join, where additional expertise is needed, and screen sharing allows the provider to show x-rays, test results, and other relevant information to the patient.
Post-pandemic business as usual
With Induction Attend Anywhere already well established in NHS Scotland when the pandemic hit, pivoting from face-to-face appointments to remote consultations was straightforward. Staff and patients came to value the benefits, which include:
- improved time keeping – it’s easier to keep things running on time, helping ease backlogs
- lower risk of exposure to infection – safer for both patients and staff
- better use of the physical space available – no need to find a free consulting room
- reduced waiting times – efficient triage allows clinicians to plan services better
- support for virtual wards – patients can be monitored at home after discharge, and some admissions can be avoided
- equality of service – less-mobile patients receive the same care as those able to travel
- sustainability and cost savings – less use of personal protective equipment, less need for travel
Around 20,000 remote consultations are held every week and the solution is now being rolled out across a range of public services.
Clinicians’ views
Clinicians from NHS Lanarkshire talk about their experiences of using Induction Attend Anywhere (Near Me) in the delivery of mental health services, including psychiatry, community outreach teams, psychology, child and adolescent mental health services, distress brief intervention, rehabilitation and recovery, and more.
The benefits of the technology mean that patients can engage with an evidence-based psychological intervention through attending one of our Digital Psychology Groups from the comfort of their own home. The flexibility and choice this provides to patients, along with the security of the platform, means clinicians can be confident we are offering a service which is safe, effective and person-centred.
Dr Emily Pathe, Counselling Psychologist and Digital Coordinator for Adult Mental Health
It is phenomenally useful to have visual contact with a patient in a mental health setting, because you can see things like eye contact, or whether or not somebody has washed and dressed appropriately. These things provide a huge amount of information about how that person is doing.
Dr Adam Daly, consultant psychiatrist
During any consultation, especially at assessment phase, being able to see patients is vital. The benefits are two-fold, as being able to see the clinician can also reassure and put the patient at ease.
Claire Stevenson, NHS Lanarkshire community psychiatric nurse
To learn more about Induction Attend Anywhere, please visit https://inductionhealthcare.com/attend-anywhere/
References:
https://www.nhslanarkshire.scot.nhs.uk/tec-podcast-with-ewan-summers-episode-two-matters-of-the-mind/
Dr Elizabeth Murphy (senior research clinical psychologist) and Kate Kelly (gameChange peer support worker) at Greater Manchester Mental Health NHS Foundation Trust discuss the role of virtual reality in treating mental health.
However, until recently, this was always on a small scale, as VR was used alongside in-person therapy. With recent advances in technology, this is changing and it is now possible for a virtual therapist to be built in. This means that treatment does not necessarily need to be overseen by a specialist therapist.
At Greater Manchester Mental Health NHS Foundation Trust (GMMH), we are currently delivering gameChange VR therapy to people with psychosis through five mental health teams across Manchester. This rollout builds on the results of a randomised control trial (RCT), published in the Lancet Psychiatry (Freeman et al, 2022), which involved 346 participants across nine NHS trusts, was delivered in collaboration with the University of Oxford and its spinout company, Oxford VR.
The RCT found that VR therapy could reduce symptoms of agoraphobia and distress in everyday situations compared with usual care alone. We are now investigating how the technology can be used as part of our routine clinical services.
Many people with psychosis suffer debilitating levels of agoraphobia, and it is common for everyday situations such as getting a bus or going to the shop to induce extreme stress and anxiety. As such, they often struggle to leave their homes.
Using the gameChange headsets, our service users can try out everyday situations through digital simulations from the comfort of their home. During the VR sessions, they’re guided by a virtual therapist who helps them practice being in everyday situations, such as at a café, a shop, or a doctor’s surgery. In this way, people who experience severe anxiety and distress at the thought of leaving the house are able to access therapy without having to leave the house and go into a clinic.
The therapy is based on Cognitive Behavioural Therapy (CBT) and works by reducing anxious thoughts and feelings that patients have about the simulated situations. As patients progress through the therapy, which is typically delivered over six sessions, they gradually encounter more complex tasks. Throughout the sessions, the virtual therapist prompts patients to practise noticing their thoughts, feelings and defences, replacing them with more positive beliefs and behaviours. Following the VR therapy, service users are then supported by a wide range of staff to apply this learning in real world situations. The result is that people who were previously paralysed by their fears and unable to leave their homes on their own, are able to take part in everyday activities that they had previously found unthinkable.
One of the key ingredients for success for technology like gameChange is involving people with lived experience throughout the development of the technology, through to the delivery of the therapy. With gameChange, the different scenarios within the headset were co-designed by a Lived Experience Advisory Panel, comprised of people with personal experience of psychosis. Similarly, peer support workers who have experienced psychosis themselves, work with people who are undergoing VR therapy to help them apply their learnings in the real world. Peer support workers offer a role model for recovery, and this combined with the virtual therapist, can help create meaningful change for people who may be unable to access in-person therapy.
VR offers tremendous promise and technology like gameChange has the potential to have huge benefits in the lives of service users experiencing extreme distress in managing everyday situations. By automating certain aspects of mental health treatment, VR could also help treat more patients more quickly, as well as provide greater choice for patients. While we’re still some way off technology like gameChange being available in mental health services as standard, we hope this is going to change soon, and that we will see VR therapy being more widely available across GMMH and beyond.
NHS England launches extended reality training to support perinatal mental health learners
NHS England has launched a new immersive method of training to support healthcare learners to expand their skills when interacting with people with perinatal mental health problems.
Using extended reality (XR) technology, learners are taken through a series of instructor-driven simulations, to interact with a virtual patient.
The patient avatar Stacey was developed by Health Education England and Fracture Reality to support learners practice in their own clinical setting as well as virtual reality, offering students the chance to experience interacting with the patient avatar in their own home or other clinical settings.
NHS England said that the development is being introduced to support learners in building their skills to “engage and communicate effectively with patients to determine the severity of their condition and make appropriate interventions” and because there are “limited opportunities for learners to practice these skills in a safe learning environment”.
The project is said to provide learners with an immersive simulated experience that allows them to have “realistic and natural conversations”.
The Centre for Immersive Technologies at the University of Leeds has evaluated the training experience, with over 100 participants supporting their study. The study has shown the method of training is highly usable and useful for learners and educators, with participants showing significant improvements in cognitive and emotional understanding. Across all participants almost four out of five (79 percent) learners said they preferred this simulation training over traditional approaches.
Rebecca Burgess-Dawson, national clinical lead for mental health at Health Education England, said: “Stacey provides students and learners with a wealth of scenarios that they may encounter while they are working in a clinical setting, all in a natural and realistic way. The potential impact that she has on perinatal mental health training is enormous and she will have a real benefit for learners in gaining the practice and skills they need for future patients they treat.”
Dr Faisal Mushtaq, director of the centre for immersive technologies, added: “This project is significant because it demonstrates how these technologies can help people deal with difficult emotionally challenging conversations that can arise in mental health consultations. This is a big step forward for using XR to support learning and skill acquisition.”
The training simulations have been built in and delivered via Fracture Reality’s JoinXR platform for use with Microsoft Hololens2, HTC Focus 3, Meta Quest 2 & Pro and Windows 10.
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