Mental Health and Technology: what’s the best balance?

Monday, 20th January 2020

Our first sector briefing of the year proved very popular with over 80 people gathering at Mills & Reeve to understand the complex relationship between mental health and technology.

Charlotte Lewis, chair of pro-manchester’s Healthcare committee and Senior Associate at Mills & Reeve, opened the event by sharing a number of shocking statistics.

• Approximately 1 in 4 people in the UK will experience a mental health problem each year. It is estimated that 1 in 6 people in England in the past week experienced a common mental health problem.
• Mixed anxiety & depression is the most common mental disorder in Britain, with 7.8% of people meeting criteria for diagnosis. It has been estimated to cause one fifth of days lost from work in Britain and evidence suggests that 12.7% of all sickness absence days in the UK can be attributed to mental health conditions
• Women in full-time employment are nearly twice as likely to have a common mental health problem as full-time employed men (19.8% vs 10.9%). Also, the poorer and more disadvantaged are disproportionately affected by common mental health problems and their adverse consequences.
• Half of mental ill health starts by age 15 and 75% develops by age 18. The proportion of young people aged 15-16 who reported feeling depressed or anxious doubled between the mid-1980s and the mid-2000s

It’s clear from these statistics that mental health and wellbeing is an incredibly important issue. In today’s world, digital technology is everywhere and within a relatively short time it has become embedded in our social fabric. It has been reported today that on average mobile phone users spent more than 3.5 hours per day on their phones last year.

The speed of technological change means that its absorption into our day-to-day lives has occurred very rapidly; without the research into its impact that usually precedes the introduction of medical interventions. As a consequence, its wider effects are only now becoming apparent, especially with regard to how it affects us, physically, psychologically and in terms of our overall wellbeing.

Charlotte introduced the expert panellists: Nicky Lidbetter – Anxiety UK and Self Help; Dr Jenni Jardine – CAMHS.Digital; Mohammed Shabbir – SilverCloud Health; Julie McGann – Unicorn and Co; and Phil Rogerson – Calmer Sea.

We live in a digital age with an always on culture– what impact is this having on mental health and wellness?

Nicky recognises that tech can be really helpful but also harmful; it is all about moderation. Being online all the time puts pressure on people to be responsive and have no downtime. She equates it with running or going to the gym every day. You need to have rest days for your body to recover and we need to treat our minds in the same way.

Jenni adds that it’s not just about screen time but what people, particularly young people, are doing. Is it communication or cyber bullying / grooming? Tech has very positive aspects which should not be ignored but we must be mindful of the negatives. For example, we know that social comparison increases anxiety.

What steps can people take to improve their mental health and wellness given the world in which we live in?

Phil believes digital detoxes (time away from tech, keeping phones out of the bedroom etc) can be useful but we need to understand the science and root causes. He suggests three key steps.

1. Epigenetics. It is possible to turn good genes on and off by building good routines. Social isolation turns on 200 bad genes (similar to smoking) whereas positive social connection turns on 200 good genes.
2. Neuroplasticity. Neural pathways are created and strengthened by ongoing activity. In other words, we can train our brain’s responses by altering our behaviour.
3. Transient hypofrontality. This is where your brain is engaged sufficiently in one activity, e.g. running, for you to stop noticing time. The prefrontal cortex is focussed on running which leaves the rest of the brain think about everything else. Gamified apps can have the same impact.

Mohammed agrees that awareness of the issue is essential. We unlock our phones an average of 85 times a day and look at it within the first 5 seconds of waking. Apps can make our lives easier and more convenient, but it is important that we make conscious choices. Employers need to take active steps to reassure there no expectation to answer emails 24/7 and no harm in not responding immediately.

Julie adds that we now process more info in one day than in a year 25 years ago; a huge change that our brain can’t keep up with. She compares it to a caveman suddenly finding himself in Tesco: he would eat non-stop despite making himself sick. Our brains are reacting the same way to the current data overload. Many tech products came out of Silicon Valley and were planned to be addictive: notifications, likes and instant gratification. The majority of her clients (particularly Millennials) know they are addicted to tech but are not changing their behaviour. Again, it is about making conscious choices in how we use it. Look for educational, inspiring tech that makes you feel better.

Technology is being used to deliver mental health services. How is digital being used and what are the benefits / disadvantages as opposed to more ‘traditional’ services?

CAMHS.Digital has worked alongside young people ( aged 14 – 25 year olds) to develop a self harm app and is now building evidence to see if it works. They are also devising a digital platform with links to high quality online resources and signposting services. Immersive gaming has been used successfully for children with anxiety to encourage diaphragmatic breathing and manage emotional responses.

SilverCloud has an online library of programmes and works alongside Self Help. It can be accessed through referrals or self-referral, and begins with a screening or assessment with practitioner. People access the programme digitally on all formats (65% on mobiles) and feedback is that engaging with intervention much easier. CBT often includes work at home, or processes to implement in day to day life (keeping thought records etc) and it is seamless to do this digitally. Flexibility not only leads to more engagement but it has been shown that people access Silvercloud who wouldn’t seek support elsewhere.

Looking to other countries, Australia’s government has set out a national e-mental health strategy. Should there be a national vision for digital mental health?

Nicky comments that Australia is leading the way in mental health and tech, with some great platforms developed. The UK needs a more robust system. Whilst the NHS is amazing in many ways it is lagging behind in technology. Anxiety UK is currently is developing online, instant access therapy. There is a myth that face to face therapy is better than digital but actually no evidence to support that.

Jenni agrees we need a more robust plan. There are long waits to access therapy and it can be hard to access the right support or identify the issues. She stresses than back end processes can be hugely improved through digitalisation; many practitioners are still using paper notes.

Work culture was highlighted by all the panellists as essential in ensuring good mental health. Phil believes mental health first aid should be mandatory and should not just sit with HR but be embedded across the company. Mohammed agrees and notes that opt out support is more effective as it removes the stigma.

Taking questions from the floor, panellists were asked what law they would implement. Equality was key: ensuring tech is developed with a range of backgrounds, gender, race etc leads to inclusive solutions. The panellists also noted that solutions should be made with the audience in mind: is it aimed at young people? Older people? How tech savvy are they? We cannot take a “one size fits all” approach.
Mohammed expects to see more NHS data being made available (in anonymised form) to commercial companies to develop new solutions and potentially reinvest in the NHS.

There is a lot of focus on technology but Nicky reminds delegates that distress often comes from clash with internal values. Acceptance and commitment therapy helps people to reconnect with values and understand misalignment. Strategies don’t need to be tech based – just be kinder to yourself!

On that note, Charlotte brought the event to a close, thanking all speakers and attendees.