NICE has approved the use of nine digital tools for use in treating depression and anxiety disorders in adults to help speed up access to NHS services.
It includes apps or websites that use cognitive behaviour therapy techniques with the support of an NHS Talking Therapies clinician or psychological wellbeing practitioner, NICE said.
The digital therapies can offer an alternative way for people to access help that may be more suited to their needs or flexible on time or location, the recommendations stated.
And because treatment provided in this way needs less therapist time, it could free up clinical resources to reduce waiting times and increase access, NICE added.
Three of the tools were approved for depression after a health technology evaluation found that digital tools meant 90 minutes spent with a therapist compared with eight hours with standard care.
For anxiety, where six digital therapies were approved, it reduced clinician time from ten to four hours, NICE said.
Further evidence for their clinical and cost-effectiveness is still being gathered and will be published at a later date, NICE said. This will include rates of recovery, improvement and deterioration as well as adverse effects and stepping up of care.
Some of the tools are already in use and all nine listed by NICE will also need to undergo Digital Technology Assessment Criteria (DTAC) approval, assessment for use on the NHS Talking Therapies programme from NHS England, or to have a CE or UKCA mark before they can be implemented.
Figures from NHS Digital suggest in any given week in England, one in six people experience a common mental health problem such as depression and anxiety.
In 2021/22 this led to more than 520,000 referrals. For any digital tool, a formal assessment with an NHS Talking Therapies clinician or practitioner will take place before starting treatment to ensure the approach is matched to both clinical needs and the person’s preferences, NICE said.
A Pulse survey in 2022 revealed that pressure on counselling services mean two thirds of GPs are having to provide specialist mental health support beyond their competence.
Mark Chapman, interim director of medical technology and digital evaluation, at NICE, said: ‘We know NHS Talking Therapies services are in demand and people are facing waits of several weeks.
‘A part of the solution could be the use of digitally enabled therapies recommended by our committee which could increase the number of people receiving the treatment they need sooner.
‘One of our priorities is to get the best care to people fast while at the same time ensuring value for money for the taxpayer – these digitally enabled therapies do both.’
Professor Tony Kendrick, professor of primary care at the University of Southampton, who has been trialling a digital programme to help people come off antidepressants, said there is good evidence for the effectiveness of some of the apps, but not all, which NICE had specified in the reviews it had published.
‘The point is well made that further evidence of effectiveness and cost-effectiveness needs to be gathered, and the relevant metrics for evaluation are listed.’
He added: ‘We also need more evidence however on the possible risk of widening inequality of access to treatments.
‘The risk is that people who are less Internet savvy will miss out, although if therapies become more available as a result of the wider adoption of digital therapies then it may help everyone.
‘Information needs to be examined on the effects on the demographic profile of people accessing the therapies, as indicated in the document, but also on the effects on waiting times and broader measures of access beyond the people who access the apps.’
New mental health digital tools approved by NICE
- Beating the Blues (365 Health Solutions)
- Deprexis (Ethypharm Digital Therapy)
- Space from Depression (SilverCloud)
- Beating the Blues (365 Health Solutions) for generalised anxiety symptoms or unspecified anxiety disorder
- Space from Anxiety (SilverCloud)
- iCT-PTSD (OxCADAT) for post-traumatic stress disorder
- Spring (Cardiff University) for PTSD
- iCT-SAD (OxCADAT) for social anxiety disorder
- Perspectives (Koa Health) for body dysmorphic disorder