Nicky Main, UK & Europe Adult Clinical Lead for WYSA: Exploring the Benefits of Technology to Tackle Lack of Therapists

Wysa is a global leader in AI-driven mental health support, available both to individuals and through employer benefits programs and NHS IAPT services. Wysa supports people experiencing stress, depression, and anxiety throughan “emotionally intelligent” chatbotwhich embeds empathy and evidence-based cognitive-behavioral techniques (CBT) in conversation, as well as utilising meditation, breathing and mindfulness exercises and audios, to help users improve their wellbeing and build mental resilience skills. OWysa has facilitated over 100 million conversations in 65 countries across the globe. Wysa works with 20 enterprise partners to support 7 million employees worldwide, with partners that include the Ministry of Health in Singapore, Accenture Global, Aetna International and L’Oreal.

“The NHS may have given a commitment to mental health, citing in the Long Term Plan that “mental health services will grow faster than the overall NHS budget with a ringfenced investment worth at least £2.3 billion a year for mental health services by 2023/24. In 2021 NHS England shared plans of five new waiting times standards intended to give people much quicker access to mental health care. But how will that work, if the people to give care are already overstretched? Support for patients can only be delivered with an increase in the provision of trained psychotherapists – but there simply aren’t enough.

The British Medical Association has warned of chronic under-recruitment in psychiatric professions, with a year on year decline in the numbers joining. Therapists are leaving the NHS, citing workload, burnout, and too much time spent on admin as the reason. Whilst some go on to set up private practices, some leave the profession all together. The UK Council for Psychotherapy put out a statement saying that more psychotherapists are needed in NHS workforce to meet UK’s looming mental health crisis.

As a result of the pandemic, more people are open to the idea of digital treatment tools, and the NHS has pledged to provide ways to ensure that digital inclusion is accelerated. On demand healthcare, virtual reality, online treatment sessions, big data and predictive healthcare are all improving access and outcomes.

Online and digital health resources can help with prevention, self care, shared care and shared decision making, long term condition management and appropriate use of urgent and emergency care.

Releasing the burden

Effective etriage systems can release administrative burden on clinicians, meaning they have more capacity to focus on patients. During the waiting period patient data can be shared with clinicians during the waiting period, to help identify high risk responses and flag for crisis attention. The demands on administrative workload are reduced, freeing up time for therapists to work directly with patients.

It is not just about reducing workload on therapists of course. There are clear patient benefits to integrating technology into mental health care and the right digital tools can improve outcomes for patients, enhance patient engagement and increase service efficiency. It is not about making it quicker or easier by giving someone access to a chatbot or online tool. That is a false economy unless the digital intervention works. Effective solutions will create a safe environment for patients, provide faster access and deliver more personalised care.

Forming relationships

A recent peer-reviewed study in Frontiers shows people develop an emotional bond with AI driven chatbots in much the same way people bond with a human therapist. This ‘therapeutic alliance’ is crucial in helping people meet the goals of treatment, the study found. The therapeutic alliance is widely considered one of the most robust mechanisms of change in psychotherapy interventions and is defined as a collaboration between the patient and therapist on the tasks and goals of treatment, along with an emotional bond. The study of 1,205 people evaluated users who were experiencing measured symptoms of anxiety or depression. The results show that within five days the therapeutic alliance was comparable or better than scores found in traditional in-person cognitive behavioural therapy (CBT), in-person group therapy and internet-based tools for CBT.

There is a direct relationship between the length of time a patient waits, and how likely they are to complete their treatment and recover. This project means that when a person reaches out for help, they aren’t left waiting. Instead, they are proactively engaged which is key to improving clinical outcomes. When they start seeing the therapist, a relationship will already have been established, so the initial digital experience makes the entry into care much more human

Data sharing

The data sharing opportunities are also powerful. We cannot solve the UK’s growing mental health crisis without credible real-time data. The integration of innovative digital technology with records will create a safer environment where clinicians have real-time access to the information they need, which streamlines the system, ensuring that those who need treatment can access the professional support they need at the same time as allowing therapists and clinicians to effectively treat patients.
A better system

In systems that are complex and sometimes not well integrated, people presenting with mental health concerns can get lost in the process of referral, triage, and treatment. A well incorporated technological solution can help make sure that information and data that needs to be readily available is accessible to patients, clinicians and therapists at every stage of the process. They may feel lost at certain stages, and without the tools that they need to manage their conduction. The best technological solutions are readily available when patients need them, with a focus on personalisation and integration. Therapists want great outcomes for their clients. The NHS wants to improve health. And patients want good care. The right technology can achieve all of this, improving outcomes for all.”