As a psychiatrist working for the NHS, Dr Andres Fonseca realised that he could only ever help around 400 people per year to improve their mental wellbeing, and he realised that wasn’t enough. He wanted to find something scalable that could help more people manage their mental health. Thrive, co-founded by Andres, is proven to train individuals in clinically proven techniques to manage their own mental health, screen for mental health conditions like anxiety and depression, and make prevention part of general wellbeing for all. It is one of a number of new mental health apps on the market today.
Increasing numbers of people are experiencing mental ill health and established mental health services are not coping. People who are already marginalised as a result of society’s economic and social structures are particularly affected by the rise in mental ill health. Suicide is increasing, self harm, substance abuse and domestic violence are all on the rise. In the face of these challenges, it is easy to despair but there are grounds for optimism.
The use of mobile healthtech has been on the increase, with research showing nearly half (48%) of healthcare consumers were using mobile apps to help manage their health in 2018, compared to just 16% in 2014, with mental health apps making up an increasingly large proportion.
At Nesta, we are at the forefront of innovation and are often seen as tech evangelists – and certainly, as an organisation, we are technology optimists – however we want to use the end of Mental Health Awareness Week to share some insights on mental health innovation: where we think more work is needed, and how it connects with our people-powered philosophy, where people have the knowledge and confidence to be at the centre of their health and care, are supported to build their own skills and networks, and where new data and solutions help people work together to solve complex problems. Innovation can often seem to be all about inventions – but sometimes innovation can be found in new ways of people being heard.
Nesta has written about tech in mental health several times over the last few years and has accurately predicted the rise of new technologies in supporting mental wellbeing, fuelled by some of the factors that inspired Andres to set up Thrive. We have supported a number of mental health innovations, including Thrive and [email protected], through programmes such as the Inclusive Economy Partnership (IEP) and Nesta’s Health Lab.
There is plenty to be optimistic about.
Technology can also facilitate the sharing of stories and lived experience, which in turn can help others feel less alone and better understand what they are going through. For example, This is Me, one of the IEP grantees, encourages organisations to share their employees’ mental health stories through blogs or videos, to help build mentally healthy cultures where people feel able to talk about their own experiences, or ask for help when they need it.
With NHS services stretched and private therapy unaffordable for many, technology can offer immediate information on the options and resources available, and some coping strategies that may help people to self-manage their conditions while waiting for treatment. This is particularly valuable for people experiencing mild to moderate mental ill health.
There are a variety of online resources for this, including peer-to-peer applications which have shown to be increasingly popular and effective, such as elefriends which is provided by Mind and Big White Wall which is on demand e-therapy.
There is evidence to show that mental health tech has been particularly popular with young people who may not want to access mental health services any other way.
Along with the work the NHS has been doing to assess and certify certain mental health tech products there is work being done by other organisations to standardise mental health tech to make it easier to measure and evaluate. For example, design agency Snook and the Public Policy Lab have created a set of design patterns to guide research and development in this area.
There is a lot that still needs to be done to ensure these innovations deliver for everyone. There is a huge risk that tech innovations can increase mental health inequalities because they are accessible (and marketed) to a specific part of the population and generally not the marginalised groups who often experience the highest levels of distress. Nesta believes there is more work to be done regarding evidence gathering and effectiveness by segmented communities and ensuring everyone gets the support they need.
Poor mental health is related to social determinants such as poverty, poor housing, racism, homophobia and other toxic stressors which cannot be solved by individualised tech solutions.
Three of the movements we are supporting in our new Social Movements for Health programme are taking people-powered action to demand the social causes of mental health inequalities are recognised and acknowledged in our public narratives and in our interventions.
Specifically, the Mental Health Rights Movement, hopes to challenge the underlying causes of mental health issues in Northern Ireland, where more people have died by suicide (4,500) since the signing of the Good Friday Agreement than the total killed during the conflict from 1969 to the 1990s (3,600).
BlackOut UK hopes to bring visibility to the sexual and mental health inequalities experienced by black queer men across the UK. Through creative collaborations and networks, they are creating a movement to counteract the marginalisation and exclusion of this community.
The ‘Movement for Social Approaches in Mental Health’, which brings together a broad range of people who have direct experience of mental ill health and the challenges facing current services, is building the case for the connection between social justice, structural inequalities and mental health and are fighting for this evidence to be built into our social and health policies.
We know the incredibly important role of social support, a sense of belonging and community in maintaining people’s wellbeing. A lack of social support is thought to have the same impact on mental health as smoking on physical health. Promising innovations in mental health will help build real-life community connections rather than rely on individual action only. The Cares Family and Shared Lives from our Accelerating Ideas programme are powerful stories of connection.
These social context issues are often overlooked by initiatives such as Mental Health Awareness Week. Solutions to these require changes to systems rather than just changes in individual people’s behaviour. Innovation needs to reach the people most in need of it.