Children’s mental health services have reached a crisis point. Increasingly, technology is stepping in to shorten waiting lists and address the postcode lottery.
Access to mental health care for children and young people has become a critical issue.
In the wake of the pandemic, traditional models of care – which were already proving inadequate pre-Covid – are no longer fit for purpose.
Waiting lists are soaring and an understaffed and underresourced workforce is facing a 76 per cent increase in referrals of children and young people to NHS mental health services since 2019.
Meanwhile, new research suggests that the pandemic has “disproportionately and adversely” affected children with ADHD.
In the UK, healthcare providers have been seeing an increase in diagnoses over the last two decades, rising from 1,4 per cent in 2000 to 2.4 per cent in 2018 as the condition has become better recognised.
Similarly, autism spectrum disorder is thought to be more prevalent than previously thought, however, disruptions in services caused by Covid-19 have stalled neuro-developmental assessments.
In response to these challenges, mental health technology company, Healios is breaking down barriers to care with a digital platform that connects patients with multi-disciplinary care teams.
Health Tech World hears from the company’s CEO, Richard Andrews following the company’s HTW Award win for Team of the Year.
Andrews talks about the failings of traditional treatment models, the disastrous impact of Covid-19 on young people’s mental health and how technology can enable better quality and more efficient care.
Health Tech World: What inspired you to launch the company and dedicate your work to children’s mental health and neurodevelopmental disorders?
Richard Andrews: There was very much a personal inspiration for founding Healios that connected with my general passion around wellbeing, science and technology.
Having close family and friends who’ve suffered from mental health conditions and dementia, I experienced first-hand the challenge of accessing support for both those affected by the condition and the families involved.
I founded Healios to tackle the global inequality of healthcare provision affecting over one billion people worldwide with mental health and neurodevelopmental conditions.
After initially starting out in adult severe mental illness, we began to realise there was a massive crisis with children’s mental health services in this country.
What is your opinion on the traditional models for mental health care for children and young people and how have they failed?
The traditional model pre-pandemic – which largely means a young person and their family travels to an NHS service between nine to five, Monday to Friday – was already stretched.
There just aren’t enough qualified clinicians to cope with the demand today.
The traditional model is no longer fit for purpose for today’s society, and it’s certainly not fit for purpose for tomorrow’s society.
It fundamentally has to change how we deliver care in a more accessible and appropriate way.
It has to be more adequate and of a more consistent quality to really drive the change that we need for children and young people’s mental health.
And that includes neurodevelopmental conditions like ADHD as well.
Some waiting lists can be up to two years around the country. This is the case for autism assessments.
There is also an inadequacy aspect. Some services aren’t necessarily available in a local area or are not sufficient enough.
Then there’s the aspect of addressing the inappropriateness of some services.
You may be offered a service but that may actually not be the best service for you. The reason it’s offered is due to the local skill sets and capabilities.
We see that within mental health services, there is a postcode lottery for the quality and the range of services that you can access.
How has the pandemic impacted the demand for mental health care?
We’re certainly in a crisis when it comes to children and young people’s mental health today and that crisis was already well-established pre-pandemic.
The pandemic and emerging from it has just exacerbated the crisis even further.
It’s devastating to hear about the increased challenges that we have in our young population in regard to mental health.
Pre-pandemic, around a million children required access to mental health support in this country.
Sadly, two-thirds of them were unable to access care. The NHS has since been trying to address this challenge.
For a number of years, there has been a lot of investment coming into the NHS children’s mental health services.
They’ve trained thousands more mental health practitioners and the goal is to try to see an additional 345,000 children per year.
Some really positive progress has been made there. But still, a huge proportion of children and young people who need services today are unable to access care.
Because of such a limited capacity, the NHS services [has] responded by increasing the criteria that that you need to meet in order to enter services.
That criteria is getting higher and higher meaning, you need to be more severe to access those services.
Have you seen any specific mental health issues become more prevalent since the pandemic?
We are seeing more complex issues since the pandemic.
Prior to the pandemic, there was a lot of anxiety and depression and neurodevelopmental needs that we were working with.
Emerging from the pandemic, there is more complexity.
We have seen a rise in cases of eating disorders within our adolescent population, often co-occurring with anxiety or depression.
The complexity has increased, and there is a higher demand for neurodevelopmental services to support autism and ADHD needs.
What is the potential of tech in addressing these issues? What are the opportunities and limitations when it comes to bringing technology into mental health care?
We are a really strong believer in the power of human connection.
The reason for that is that given the complexity of a young mind and their environment, the human connection is so, so important to be able to unravel that and to piece together an appropriate care plan.
We believe that cannot be replaced.
What we are believers in is that it can be optimised so that we can figure out the best way of using such a valuable and scarce resource in the most appropriate way.
That’s where technology comes in to augment our care teams.
There are so many exciting new innovations that are starting to come through which are going to advance this human connection that is so, so critical here.
Are there any particular technologies that could transform the way care is delivered?
There are areas like AI and machine learning that will play a role, both in delivering clinical services from an operational efficiency perspective, and in delivering actual therapeutic work.
Some of that can be AI-enhanced.
There are other absolutely fascinating technologies coming through. Augmented reality and virtual reality could change how we deliver new treatment approaches in a more engaging way.
Remote monitoring and wearables [could] track more data to support the ongoing interventions to understand if that young person is deteriorating.
Having that greater richness in data is certainly going to be enhanced by technological changes.
Technology can really help drive further inroads into changing the care paradigm today.
A lack of data is a critical challenge in mental health care. Can you tell us more about how technology can enable health services to gather better data and use it to better effect?
One of the areas that has long been the Achilles heel of psychiatry overall is that largely it is based on gathering subjective data.
That means that we often have to ask that child or young person how they’re feeling and using evidence-based validated questionnaires to help piece together their current needs.
That requires triangulating data points and interpreting that data to then make a diagnosis.
It can be very challenging to interpret that data and make appropriate conclusions.
I think where technology is playing a role is in creating digital biomarkers within mental or neurodevelopmental conditions.
This is the equivalent of finding cholesterol or high blood pressure, which are important biomarkers for determining cardiovascular risk.
They’re very objective and you can develop treatment algorithms to design a treatment plan and to monitor how effective that plan is based on how those biomarkers change.
AI plays a role in that and remote monitoring plays a role.
The development of these objective digital biomarkers can help us diagnose mental health or neurodevelopmental conditions more quickly or help reduce human error.
That’s an example of where AI will play a huge role in the development of digital biomarkers for mental health conditions, and also wearables as another way of capturing that data.
What is Healios doing to address the access barriers and waiting lists for mental health care?
Our goal at Healios is to remove the access barriers to care and provide appropriate, high-quality service every single time.
Our services and what we can offer change with the patient’s needs to create a seamless care experience.
It means the family does not have this fractured care experience where they are bouncing around the system.
They can continue with us to receive multiple services in a much more joined-up way that’s delivered into their home.
That takes stress away from the family.
They don’t have to travel which could bring more costs and they have to take time off work, which particularly for low-income families can be very challenging to do.
We’re really bringing a different option into the system.
What impact has this approach had on NHS services?
We have worked with the NHS for ten years now and we’ve supported over 50,000 children and teens to date so we’ve really had a huge impact on the young population.
Working with them to have this extension of a virtual service with Healios has enabled them to finally get on the front foot and improve their waiting times from many months or years down to 30 days or less.
How does Healios personalise care for each patient?
Working with a young mind is a complex task in itself.
To really bring together a service that can address the complexity of that young person, whether it’s mental health or neurodevelopmental, you need to build the capabilities within the service and that’s what we’ve really invested in.
We have built extensive capabilities within our service.
We bring in a range of clinical experts around that family and then those experts are used in different ways depending on the needs of the family.
They connect with the family through our platform, through video calls and text chat.
With that multidisciplinary care team, we’re then able to parachute in the right clinician at the right time.
What sets you apart from other platforms that address children’s and young people’s mental health?
We have the largest multidisciplinary care team providing remote-based care in this country for children and teens.
And at the heart of what we do is a family-centric approach.
We’re always engaging the family so that we drive towards a home environment that’s conducive to recovery.
Addressing an extensive range of needs also makes us very unique.
Not only do we support mental health conditions, but we also support neurodevelopmental conditions and the overlap of neurodevelopmental conditions with mental health challenges.
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