NICE backs digital therapies for depression in draft guidance

Eight ‘digitally enabled’ therapies for depression and anxiety disorders in adults have been recommended by NICE, while further evidence is being gathered. 

The draft guidance published today describes eight therapies which use CBT techniques and must start with a formal assessment by an NHS Talking Therapies clinician.

NICE said the therapies could potentially help more than 40,000 people, with one in six people in England experiencing a common mental health problem such as anxiety and depression in any given week according to data from NHS Digital.

The therapies could also offer more flexibility for patients and use up less practitioner or therapist time.

NICE launched a two-week consultation on the guidance, which was based on its ‘rapid assessment process’ to identify medical technology for the NHS, using evidence on its clinical effectiveness and value for money. 

As part of this process, NICE heard from clinical and patient experts about the positive impact of CBT on anxiety and depression disorders, including PTSD and body dysmorphia, and how these technologies can improve access. 

Mark Chapman, interim director of medical technology and digital evaluation at NICE, said: ‘Our rapid assessment of these eight technologies has shown they have promise.

‘Developed using tried and tested CBT methods, each one [of the therapies] has demonstrated it has the potential to provide effective treatment to the many thousands of people who live with these conditions.’

These digital therapies, some of which are already in use, are the sixth and seventh early value assessments for medical technology which use the new NICE rapid assessment process.

One of the therapies is ‘Beating the Blues’ by 365 Health Solutions, an online computerised CBT programme with eight sessions for people with mild to moderate depression and anxiety. 

All of the eight therapies must be delivered with regular monitoring and formal assessment by an NHS Talking Therapies therapist, as ‘they may not be the right choice for everyone.’ 

Dr Roman Raczka, chair of the British Psychological Society’s division of clinical psychology, said the division welcomed the NICE medical technology advisory committee’s conditional recommendation. 

He added: ‘Clinically evaluated digital therapy developments for anxiety and depression offer new opportunities to reshape mental health pathways benefiting patients, professionals and systems alike.

‘It is, however, really important that the digital therapy is delivered with practitioner or therapist support to monitor patient safety and manage progress.’

Elizabeth Mullenger, lay specialist member on the NICE committee, said: ‘These technologies will allow us to be in charge of our treatment, gaining a sense of autonomy as we navigate our own journey towards positive mental health.’

NICE’s consultation on the conditional recommendation is open to comments until 15 March. 

At the beginning of the year, NICE said that GPs should support patients with depression from minority ethnic backgrounds to access help in languages that they can understand.

Last summer, NICE finalised guidance on depression which advised GPs to discuss the full range of treatments with patients and move away from antidepressants in people whose condition is less severe. 

A Pulse survey last year found that NHS pressures mean two thirds of GPs are having to provide specialist mental health support beyond their competence.