The pressures on public health systems is well lamented in the press. No matter where we look, especially around Europe, governments are facing difficult decisions on spending the public health budget. The fact is the population in Northern Europe is steadily growing, people are getting better at looking after themselves, and we are living longer. The long promoted formula for a healthier lifestyle has resulted in healthcare providers having to adapt to meet the demand on services that will enable this formula. The services citizens expect from their health system go beyond the acute care you would expect from a hospital - diet and weight control, smoking cessation, management of long term conditions, and so on.
But what about mental health? A report from CentreForum has found one in 10 young people in the UK has a mental health problem. That equates to 720,000 children between the ages of 5 and 16. To make matters worse, the Child and Adolescent Mental Health Service (CAMHS) seems to be severely underfunded, receiving only 0.7% of the healthcare budget. That's about £704M (€885M or $997M).CentreForum - State of the Nation - CAMHS Report - 11th April, 2016.jpg
The frightening fact that stands out is that about 23% of children are turned away that are referred for therapy.
How can we improve this situation? One way is to delivery as much of the service our children and young adults need in the way they are used to - via their own device on whatever network they have access to.
Millennials and even younger generations are very used to accessing what information they need online. It often involves a personal device and they use their own smartphones, tablets or PCs to get what they want - fast. The fact is, our society has become used to getting information quickly thanks to broadband, mobile and wifi networks. And the same goes for services. So it seems antiquated and even in some areas inequitable to restrict a crucial service such as adolescent mental health without considering a virtual approach.
A large proportion of therapy can be delivered to a young adult in a secure, high quality way. Using a virtual approach to provide therapy has a number of benefits that will greatly enhance the service too. Convenience for the client (the service user) is a huge benefit. Take this as an example; for a young person to leave school or college to travel to an appointment during the day causes great disruption. It's inconvenient and could be costly; not everyone lives in a metropolitan area. There could also be a perceived stigma attached to walking into a clinic. 'What if someone sees me?' 'What if I bump into someone I know and they talk about me?' What might seem trivial to an adult could have devastating side effects for a young person.
Then there is the matter of high non-attendance or did not show (DNS) rates. Not only does failure to show for an appointment mean wasted time for the therapist (they could have been treating someone else), it also creates an inefficiency and a cost is borne.
I acknowledge not all aspects of CAHMS or Improving Access to Psychological Therapies (IAPT) can be delivered in a virtual way. But for a majority of one to one sessions, it is far more efficient. A therapist who might normally travel to multiple locations, sometimes great distances apart, to see two or three clients in a day, can use that time to talk to double the number. I hesitate to use the phrase call-centre, but taking this approach can help tackle the 23% of children turned away, mentioned in the report.
The therapists working with our children and young adults do a fantastic job, often in difficult conditions. They are known as the Cinderella Service in the UK NHS because of the low budget they receive. Sharing the therapist expertise and giving them the tools to reach more of those in need will undoubtedly help to intervene earlier.