Opening up access to mental healthcare: another step in the digital journey
Our latest early intervention innovation, How Are Things? could have the potential to improve access rates, patient engagement, and outcomes according to early key opinion leader feedback. Read what health care professionals and patient advocates think of it, and where they see it fitting in the patient journey...
COVID-19 has highlighted the role of digital healthcare in opening up access to services, especially around mental health. With more and more people seeking support, market forces are responding with online questionnaires and apps that are at best poor and at worst dangerous. Partnering with Boots, we are trialling what we intend to become ‘the’ go to evidence-based, safest and most clinically appropriate tool out there. Early feedback from healthcare professionals indicates we’re on track.
What is ‘How Are Things?’?
“How Are Things? is an accessible, low-key service that does not pathologise feelings. It’s a very straight forward way to say to patients ‘here’s something trustworthy you can do right now with no fuss’.” Mental Health Patient Advocate.
How Are Things?, an online mood and symptom checker, is a class 1 medical device. It will be marketed as a service on Boots’ digital healthcare hub from August 10th 2021. For the price of a prescription, anyone aged over 18 can complete a questionnaire based on PHQ9, GAD7, and our own evidence-based free-form self-assessment questionnaire. Within two days, they receive a report and action plan suggesting evidence-based activities and treatments relating to their symptoms.
Designed as a conversational agent with sensitive content and framing throughout the user experience, How Are Things? neither dramatises nor diminishes struggles. Instead, it gives clear options for possible next steps in line with NICE guidance, including signposting support should any user score highly on questions relating to thoughts of harm or suicide.
What is in the How Are Things? report and action plan?
The How Are Things? report and action plan includes links to evidence-based CBT style exercises and articles relating to reported symptoms. Customers can begin these exercises and read the articles straight away. For some, this will be enough to help them improve their mental health. For others, it will help, but we will also signpost them to the next appropriate stage of their journey.
“How Are Things? gives patients a sense of freedom and the ability to feel anonymous enough to talk about how they are really feeling without the fear of stigma. It reduces stigma and people may engage better with services and support as a result of using it.” Mental Health Nurse & Patient Advocate .
So, is ‘How Are Things?’ a diagnostic tool?
No, How Are Things? is not a diagnostic tool. However, it can match and explain symptoms, flag severity, and highlight possible treatment paths. It is intended to be a fast, discreet way for people with concerns about their mental wellbeing to get a snapshot of how things are. Such a picture may kickstart their self-help journey or support them to seek further appropriate help. Think of it as an additional option for people who don't feel ready to see their GP, or who would like to receive support sooner or more discreetly.
“How Are Things? could come in really handy for people who are not sure if they need help or people who have not been able to access their GP or psychological services for different reasons.” NHS Psychiatrist.
Who is ‘How Are Things?’ designed to support?
How Are Things? is for people who are struggling with their mental health and at the start of their journey to getting help. It is designed to meet them where they are - often on their phones. This includes people who, for whatever reason, might not present at their GP, or might feel safer using a trusted family brand, such as Boots, in the first instance.
An early intervention online service, How Are Things? is designed to support and dovetail with IAPT services. It aims to improve patient motivation, manage patient expectations, lower therapy doses and improve access for and engagement with harder to reach patients.
“We have problems in my service relating to screening referrals and contacting people in a timely manner. How Are Things? could be really useful.” IAPT Service Development Lead
How Are Things? tentatively reassures patients who are experiencing mild symptoms which might respond well to Step 1, giving them clear advice for how to help themselves. It prompts those potentially at Step 2 or Step 3 to seek further help.
"For somebody who does not need an intervention, How Are Things? provides clarity, information, helpful tools and strategies. These may be enough for them to feel better and regain control. They may even be enough to prevent escalation and future interventions.” IAPT Service Development Lead.
As an early intervention service, How Are Things? provides an early warning system that may reduce therapy treatment doses. The self-knowledge and mental health literacy patients gain from their reports may speed up conversations with GPs and IAPT services too. These reports can also inform recommendations, helping GPs to quickly gauge severity and shape in-appointment conversations. And let’s not forget, people tend to be more committed to something they’ve paid for.
"How Are Things? has the potential to become a strategic planning solution to the massive problems of reducing waiting lists. Using it with patients at the beginning of the wait will divert, prevent escalation and improve long term outcomes.” NHS Clinical Manager.
Opening up access is on everyone’s agenda. We are already discussing how future iterations of How Are Things? can help NHS Trusts. Want to dig a bit deeper? Read our information page. Want to join the discussions? Please get in touch.
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