App-based psychological interventions: friend or foe?

THE NEED In a time of increasing demand for psychological services and continually decreasing resources, unmet need with respect to National Health Service (NHS) mental health services is reaching an unprecedented level. While monthly referrals to community mental health teams increased 13% in 2013, and 16% in the case of crisis services, investment in mental health services has fallen in real terms for three successive years, not helped by the government’s £22 billion target for efficiency savings. As such, the resulting loss of over 200 full-time mental health doctors and 3600 nurses has meant that despite a £450 million investment in reducing waiting times and increasing access to psychological therapies (IAPT), 1 in 10 patients experience waiting lists of over a year before receiving any form of treatment, with 1 in 2 waiting over 3 months. One in 6 of those on waiting lists for mental health services are expected to attempt suicide, 4 in 10 are expected to self-harm and two-thirds are likely to see their condition deteriorate before having the opportunity to see a mental health professional. 5 As such, approximately 70 million sick days and 170 000 self-harm related accident and emergency attendances can be attributed to underlying mental health issues in the UK every year; with these individuals also exhibiting double the rate of both inpatient and outpatient hospital attendances compared to the UK general population. Unfortunately long-term prospects for those with mental health issues are not much better. Those suffering from serious mental illness face twice the risk of diabetes and death from heart disease, three times the risk of hypertension and a fourfold increase in all-cause premature mortality when compared with the UK general population; all of which contributing to the £105billion that mental distress costs the English economy each year.