Mental health help at the click of a mouse

The increasing numbers of those seeking treatment for mental health is reaching epidemic levels, with a large proportion asking their GPs for help. The NHS website is supporting practices, providing a digital lifeline to the millions who log on every week. In this article Martine Gallie, NHS.UK content designer, describes the impact that the website is having on the mental health of the population

This is an edited version of an article which first appeared on the NHS website.

What would you do if you were feeling stressed, anxious or down and decided it was time to do something about it? Chances are you’d start Googling to see what kind of support might be out there.

At the NHS website – NHS.UK – we know that growing numbers of people are turning to Google to find help with stress, depression and anxiety. We also know that most of these people end up on NHS.UK. More than five million people visit our, clinically approved, mental health pages each year – three times more visits than the next highest ranking website – the ‘wild west’ that is YouTube.

More than five million people visit our, clinically approved, mental health pages each year.

One of our key roles at NHS.UK is to help patients take more control of their health, including their mental health. We have a responsibility to help the thousands of people who visit our mental health pages to either manage their mental health themselves or to find the right support. In 2018 we examined how we could improve people’s digital journey towards better mental health, in particular taking a closer look at a fantastic service that provides psychological therapies.

The Improving Access to Psychological Therapies, or IAPT, service provides support – such as cognitive behavioural therapies (CBT) – for people who need non-urgent support with their mental health; to access it, you just need to be registered with a GP in England.

A key goal laid out in the Five Year Forward View is to increase the number of referrals to IAPT services from 15% of people with mild-to-moderate depression or anxiety to 25% by 2020. And yet, during our user research, we discovered that very few people knew about these services; if they did, it was because their GPs told them about it.

Not one person we spoke to knew that you could refer yourself to an IAPT service directly – and this included people who had previously used an IAPT service (they had all been referred by their GPs). So, we asked ourselves three questions:

  1. How can we make it clear that you can refer yourself to an IAPT service without seeing a GP?
  2. How can we make it easy for people to self-refer?
  3. How can we let people know what to expect once they get there?

After six months we had created a brand new IAPT service finder supported by a new dataset painstakingly compiled from scratch. Within a few weeks 10 times more people (69% compared with 7%) were managing to locate their local IAPT service compared with our old finder –  that’s 12,000 more people across England per month. We also refreshed all our relevant mental health content to make it clear:

  • what IAPT services offer;
  • who they’re for;
  • how to access them.

These changes led to an amazing 382% increase in the number of people clicking through to the new IAPT service finder.

The response to our new finder has far exceeded our expectations. It tells us that there’s a huge appetite out there for non-urgent, evidence-based treatment for the kind of mental and emotional problems many of us experience. The success of the new finder also takes us one step closer to increasing the number of referrals to IAPT services as laid out in the Five Year Forward View.

IAPT services have welcomed the new finder too. iCope (Camden and Islington Psychological Therapies and Wellbeing Service) says, “Our admin team are the ones most pleased with this as it means they can send it to the many patients who try to self-refer to our service but don’t have a GP in our area.”

New challenges

Now we’re looking at other aspects of the IAPT self-referral process, including the forms that people need to complete in order to refer themselves. We’ve seen that these vary hugely in their ease of use. The number of questions on the forms ranges from just five up to 82. In user research we have seen people struggle to complete the forms, with none of the participants able to successfully complete them at the first attempt. As one user put it, “I’m trying to get some help here and I’m having to faff about with this bloody form. You’re already feeling rubbish as it is, without divulging all this info.”

Half of the IAPT services we spoke to (10 in total) had already moved to shorter self-referral forms, or were in the process of doing so. One service had started this process after discovering that 57% of people trying to refer themselves online were not managing to complete their online form. As one service manager told us, “The simpler you can make it for people, the better.”

Following on from the success of our new IAPT service finder we now hope to support IAPT services and their users by working together to find ways to make the online self-referral process as simple and accessible as possible. Removing any final barriers would mean that many more people could benefit from the expert, evidence-based help they offer.

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