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Early Warning Signs of a Mental Health Tsunami: A Coordinated Response to Gather Initial Data Insights From Multiple Digital Services Providers



Introduction: The immediate impact of COVID-19 on morbidity and mortality has raised the need for accurate and real time data monitoring and communication. The aim of this study is to document initial observations from multiple digital services providers during the COVID-19 crisis, especially those related to mental health and wellbeing. Materials and Methods: We used email and social media to announce an urgent call for support. Digital mental health services providers (N=46), financial services providers (N=4) and other relevant digital data source providers (N=3) responded with quantitative and/or qualitative data insights. People with lived experience of distress, as service users/consumers, and carers are included as co-authors. Results: This study provides proof-of-concept of the viability for researchers and private companies to work collaboratively towards a common good. Digital services providers reported a diverse range of mental health concerns. A recurring observation is that demand for digital mental health support has risen, and that the nature of this demand has also changed since COVID-19, with an apparent increased presentation of anxiety and loneliness. Conclusion: Following this study, we will continue to work with providers in more in-depth ways to capture follow-up insights at regular time points. We will also onboard new providers to address data representativeness. Looking ahead, we anticipate the need for a rigorous process to interpret insights from an even wider variety of sources in order to monitor and respond to mental health needs.
published: 10 February 2021
doi: 10.3389/fdgth.2020.578902
Frontiers in Digital Health | 1February 2021 | Volume 2 | Article 578902
Edited by:
Phuong N. Pham,
Harvard Medical School,
United States
Reviewed by:
Aikaterini Bourazeri,
University of Essex, United Kingdom
Milena B. Cukic,
Amsterdam Health and Technology
Institute (AHTI), Netherlands
Becky Inkster
Members of the Digital Mental Health
Data Insights Group are listed at the
end of the article
Specialty section:
This article was submitted to
Health Technology Innovation,
a section of the journal
Frontiers in Digital Health
Received: 01 July 2020
Accepted: 22 December 2020
Published: 10 February 2021
Inkster B and Digital Mental Health
Data Insights Group (DMHDIG) (2021)
Early Warning Signs of a Mental Health
Tsunami: A Coordinated Response to
Gather Initial Data Insights From
Multiple Digital Services Providers.
Front. Digit. Health 2:578902.
doi: 10.3389/fdgth.2020.578902
Early Warning Signs of a Mental
Health Tsunami: A Coordinated
Response to Gather Initial Data
Insights From Multiple Digital
Services Providers
Becky Inkster*and Digital Mental Health Data Insights Group (DMHDIG)
Wolfson College, University of Cambridge, Cambridge, United Kingdom
Introduction: The immediate impact of coronavirus 2019 (COVID-19) on morbidity
and mortality has raised the need for accurate and real-time data monitoring and
communication. The aim of this study is to document the initial observations from multiple
digital services providers during the COVID-19 crisis, especially those related to mental
health and well-being.
Methods: We used email and social media to announce an urgent call for support.
Digital mental health services providers (N=46), financial services providers (N=4),
and other relevant digital data source providers (N=3) responded with quantitative
and/or qualitative data insights. People with lived experience of distress, as service
users/consumers, and carers are included as co-authors.
Results: This study provides proof-of-concept of the viability for researchers and private
companies to work collaboratively toward a common good. Digital services providers
reported a diverse range of mental health concerns. A recurring observation is that
demand for digital mental health support has risen, and that the nature of this demand
has also changed since COVID-19, with an apparent increased presentation of anxiety
and loneliness.
Conclusion: Following this study, we will continue to work with providers in more
in-depth ways to capture follow-up insights at regular time points. We will also onboard
new providers to address data representativeness. Looking ahead, we anticipate the
need for a rigorous process to interpret insights from an even wider variety of sources in
order to monitor and respond to mental health needs.
Keywords: COVID-19, financial stress, isolation, anxiety, data insights, digital mental health
Inkster Digital Mental Health During COVID-19
During the coronavirus 2019 (COVID-19) pandemic, traditional
mental health services and related activities declined, in part, due
to outpatient clinics being closed to adhere to social distancing
requirements, mental health staff redeployment, and inpatient
beds being converted into COVID-19 units. As governments
attempt to contain the virus, we must mitigate the mental
health impact of the pandemic and economic crisis, especially
given that pre-COVID-19 predictions already indicated that by
2030, depression will be the leading cause of disease burden
globally (1).
During the severe acute respiratory syndrome (SARS) (2002–
2004) epidemic, social disengagement, mental stress, and anxiety
were associated with increased suicide rates in the elderly
population (2). Another study found that 30% of children
and 25% of parents who were quarantined or isolated during
pandemic diseases met the clinical criteria for post-traumatic
stress disorder (3). Data from previous economic depressions and
recessions suggest profound increases in substance use disorder,
depression, and suicide (4,5).
In the current pandemic, frontline healthcare workers face
the possibility of anxiety and burnout (6,7) and moral injury
(8), alongside fears of becoming ill. This is more pronounced
among ethnic minority frontline healthcare workers due to
the apparent increased health risks associated with COVID-
19 (9). For others living in highly conflicted households,
social distancing has meant prolonged social contact and
abuse. For example, in the UK, the number of suspected
domestic homicide victims more than doubled during the
first 3 weeks of the lockdown (10). In France, calls to
the national violence against children helpline increased by
89% (11). From an economic perspective, a survey of UK
households 3 weeks into the “lockdown” found that 49% of
households feel anxious about their finances, rising to 95%
among the households experiencing serious financial difficulties
(12). A survey conducted in March 2020, just as the lockdown
rules were coming into place in the USA, also highlighted
higher levels of psychological distress among lower income
households (13).
There is a need to obtain more granular and real-time
information to help us understand the nature and scale of the
mental health crisis. A possible source of this information is the
large number of digital mental health services providers used
by millions of people globally. These include patient to clinician
communication tools, digitally enabled treatments, self-managed
care solutions, mental health and well-being apps, online forums,
support networks, and digital communities. In addition to this,
given the established links between health, social, and economic
factors (e.g., (14)), insights should also be obtained from financial
services providers and other relevant digital data sources. The
potential value of healthcare insights in financial data is already
recognized (15,16), and financial services firms not only are a
source of uniquely constructive data on household economies
(17) but can also offer possible mechanisms of direct and indirect
mental health interventions.
To investigate the impact of COVID-19 on mental health,
we set out to collect observations from multiple digital services
providers (Supplementary Table 1). To our knowledge, this has
never been done at scale before, and we did not know how many
providers would respond or what the nature of their data insights
might be. With rapid turnaround, a diverse range of providers
came forward with collective information sourced from a user
base of at least 10 million people, but possibly reaching upwards
of 50 million globally.
We used email and social media to announce an urgent call
for support to investigate the scale and nature of the mental
health impact of COVID-19 1. Starting 6 April 2020, BI sent
emails to all speakers who had presented at previous “Digital
Innovation in Mental Health” (DIMH) conferences 2, as well
as to members of the FinHealthTech Consortium 3, and also
to a much wider digital community via LinkedIn, Twitter,
and Facebook. Additionally, we encouraged providers and co-
authors to ensure that they sought the views of people in their
own networks.
We reached out directly to 55 digital services providers. We
received confirmation of support to contribute from 53 providers
(i.e., a positive response rate of 96%), which consisted of 46
digital mental health services providers, four financial services
providers, and three other digital data source providers (N
=3). Respondents were asked to provide qualitative and/or
quantitative insights with no exchange of data or identifiable
information. A list of digital services providers can be found
in Supplementary Table 1. This study was purely exploratory.
We deliberately did not provide a framework for insights or
any analytic specifications (e.g., what specific hypotheses to test).
Therefore, all insights should be considered illustrative examples,
not primary research.
We asked providers to be compliant with the General Data
Protection Regulation (GDPR) and the Data Protection Act
2018 if their users were within Europe. To set a good example
of responsible innovation, this document only accepted data
insights from providers with clear and accessible privacy policies.
Other than these ethical grounds, there were no other exclusion
criteria. There were no specific inclusion criteria, but many of the
respondents had a pre-existing association with members of the
study team, for example, through the annually run conference,
DIMH, created by Dr. Becky Inkster2.
We deliberately did not select a specific methodology for this
study, and we did not test any specific hypotheses. Providers
collected very different types of data and analyzed it in their own
way using techniques that were appropriate for their data. Trying
to develop some common methodologies is a future goal, which
1Available online at: (accessed May 17,
2Available online at:
(accessed May 17, 2020).
3Available online at: (accessed May 17, 2020).
Frontiers in Digital Health | 2February 2021 | Volume 2 | Article 578902
Inkster Digital Mental Health During COVID-19
will require more time, and increased collaboration between
different providers and other stakeholders.
Data insights and draft versions of the paper were shared
among all co-authors for feedback, including from people with
a range of lived experiences of distress and service use.
Given the anecdotal nature of many of the insights and the
non-systematic way in which providers were chosen, we are
reluctant to draw conclusions from the content provided in
Supplementary Tables 2, 3. Instead, we summarize some of the
more frequent observations reported by providers.
Insights suggest changes in the type of information individuals
are seeking or presenting. From Google Trends data, searches
for “anxiety symptoms” doubled between the weeks beginning
8 March and 22 March 2020. In a similar timeframe, Mental
Health America (MHA) witnessed a 22% increase in the numbers
of Generalized Anxiety Disorder 7-item (GAD7) anxiety screens
(N=11,033) taken in March 2020 compared with February
2020. Qualitative insights suggest that individuals are seeking
practical resources and coping strategies. Participants in the It’s
Ok To Talk discussion raised questions about anxiety, strategies
to manage work, studies, sleep, dealing with domestic violence,
and difficult home relationships. Babylon reports that many
patients are seeking advice on information about local council
support services, seeking advice for activities to keep busy and
how to remain healthy, and how to get support to access food
and financial concerns. Ieso Digital Health reports up to a third
of patients mentioning COVID-19 as a reason for presenting
for mental health treatment and also reports a rise in patient
worries about viruses, with up to 15% of in-session worries
about COVID-19.
Affiliative Tendencies
Papa reported that 53% of users felt less lonely, and that
virtual companions have performed a range of tasks with elderly
users (e.g., obtaining medications, online grocery shopping).
Peer support specialists are being rapidly trained. Digital Peer
Support trained 750 peer support specialists between 10 March
and mid-April 2020. Wisdo reported a 283% increase in the
numbers of people replying to other people’s messages and an
increase of 115% in the numbers of people signing up for
roles to provide support for others. Mentally Aware Nigeria
Initiative (MANI) trained over 200 psychosocial support team
specialists/counselors on mental health.
Many providers are experiencing increased support-seeking
behaviors. For example, Ieso Digital Health reports an 84%
increase in referrals. Vala Health reports a doubled volume of
mental health-related consultations with general practitioners
(GPs) during the period 10 March to 8 April 2020. By week
4 of the UK lockdown, general health enquiries had returned
to almost pre-COVID levels, but mental health consultations
continued to rise. National Alliance on Mental Illness (NAMI)
reports a 41% increase in demand for HelpLine resources and
information. Ieso Digital Health reported an 84% increase in
referrals to their 1–1 online cognitive behavioral therapy (CBT)
service in the weeks since the lockdown was announced in
the UK, relative to the same period in 2019. Wysa witnessed
a 77% increase in new users during February to March 2020,
as compared with the same period in 2019. MANI recorded
the highest number of emergency calls in the month of April.
Qualitative insights from Orygen (Australia) revealed that young
people report privacy concerns in having telehealth consults with
family members in the background.
Many providers report observations suggesting increased
anxiety, uncertainty, loneliness, and loss. MHA reports that 45%
of people who took an anxiety screen in March (N=11,033)
scored for severe anxiety. In a self-reported questionnaire to
members of The Mighty, 89% of members reported that their
daily life has been at least somewhat impacted by increased
anxiety; 43% say that it has been extremely impacted. This is
consistent with reports from Kooth demonstrating increases in
sadness (up 161%), health anxiety (up 155%), sleep difficulties
(up 90%), concerns over body image (up 43%), eating difficulties
(up 31%), loneliness (up 23%), and bereavement (up 20%). The
Mental Health Foundation survey reported that respondents
felt increasingly lonely, and that this was most pronounced for
people aged 18–24 (44%) and 25–34 (35%). Multiple providers
report users mentioning their loss of access to care and human
support [The Mighty, MeeTwo, Wysa, consultant National
Health Service (NHS) nurse].
Qntfy’s observations suggest decreased well-being in the
general public, and that at times, this has been greater among
those who identify as healthcare providers. Unmind and Wysa
reported higher anxiety levels in health staff than in the rest
of their populations. Sangath reports that community health
workers face “fears and insecurities among their patients, as
well as added anxieties about the health and well-being of their
own children and family members.” CBTClinics report a rise of
anxiety and depressive type disorders from people emotionally
close to frontline health staff (e.g., parents, spouses, and children).
Other outcomes include increases in reporting of unsafe
domestic settings (Babylon, Wysa, Teen Line, Kooth), suicidal
risk/ideation (MeeTwo, Qntfy, Mental chat, Beyond Blue,
Mumsnet), and sleep disturbances (It’s OK to Talk, Kooth,
Mumsnet, Qare, BioBeats, Wysa). There have also been
increased prescription of anti-depressant medications (Jasvinder
Kandola), increased requests for pain killers via telehealth (Vala
Health), and increased activities on darknet markets mentioning
psychiatric medications (The TellFinder Alliance).
Financial Concerns
Financial insights show an overarching theme of the interrelation
between mental health and financial health worries. Three sub-
themes emerged from the data: (1) uncertainty and a sense of loss
of control particularly “at-risk” individuals and groups; (2) anger,
anxiety, and concerns over access to financial support especially
Frontiers in Digital Health | 3February 2021 | Volume 2 | Article 578902
Inkster Digital Mental Health During COVID-19
those who feel that they are “falling through the gaps”; and
(3) negative mental health and/or physical health with financial
health outcomes.
The Money and Mental Health Policy Institute survey (N=
568) reported a range of concerns by respondents with lived
experience of mental health problems about how changes, as a
result of COVID-19, might affect their finances: 62% worried
about having to access the benefits system, 57% worried about
losing their job, and 56% worried about creditors chasing them
for money. Tully and OpenWrks Group reported that 81% of
self-employed customers (N=650) have declared that they do
not have any work coming in due to COVID-19. Furthermore,
50% of their wider sample (N=1,822) have had income
reduced, and 19% have lost their income. The Turn2us survey
showed that 70% of respondents (N=6,198) who have had
employment affected are unable to afford rent or mortgages.
An anonymous financial services provider also shared concerns
that their on-site cashiers may be vulnerable and distressed by
customer behaviors.
Qualitative insights also make it clear both how emotive
and tangible the impacts of financial concerns and outcomes
are on mental health worries and outcomes. For example, “we
are. . . dead. . . no money no food. . . 4 weeks in isolation UC
no answers. . . I have no other way to provide for my children
and I don’t care about the bills. . . I will have to go out and
improvise something.”; “what about the thousands who started
new jobs to better ourselves after the Feb 28th cut off and
before the #coronavirus hit the UK but now sit suicidal in
the gap entitled to nothing despite being lifelong tax payers?
#newstarterjustice #newstarterprotest #newstarterfurlough”; and
“got my letter yesterday to tell me it’s being taken away. The
welfare system has kicked me when I’m down already, made me
physically ill & caused a flare up of my health just when I don’t
need to go to a hospital mid pandemic.”
To our knowledge, this study is the first of its kind to bring
together a large number of private organizations, including
financial services providers, to share digital data insights about
the mental health concerns of millions of people online. Our
study is novel and radical because this is the first time that
something like this has been achieved in this field. Many people
questioned the feasibility of being able to bring together a
large group of digital services providers (some of which are in
competition with each other) to share their insights. We believe
that our study provides a proof-of-concept for the viability of
using this approach.
The information that we have quickly compiled has been
sourced from different geographies, demographics, and types
of digital interactions and provides insights into the diversity
of individual mental health needs. During our study, a paper
(18) called for mental health monitoring to move beyond NHS
linkage, in order to capture the real incidence in the community
and embrace new technologies measuring moment-to-moment
change. This initial snapshot of data that we collected could
help inform future studies, for example, it could help the
research community to understand what questions could be
asked (especially those without expertise in mental health), to
aid in the generation of specific hypotheses, or to help with the
formulation of prior probabilities. Additionally, we hope that
this study increases the research community’s awareness of the
digital mental health landscape and the services providers who
are currently collecting data, as well as the types of data insights
and metrics that they might be able to provide.
We recognize that this study is not rigorous in terms of
data collection and methodology. We did not choose these
providers in a systematic way. Using data from digital services
providers limits our population to people who have access
to these digital platforms and many “hidden” populations
are not registering in digital spaces. Furthermore, we do not
know whether our demographic is representative of any larger
population or whether whole-population impacts can be inferred
from digital service impacts. In addition, we did not verify the
insights shared by providers. This avoided privacy issues, but has
the potential to have introduced inaccuracies or biases in the
reported information. This study is also unable to characterize
mental health problems at a clinical level because most digital
providers did not report clinically-validated measurements. The
use of digital measurements to monitor mental states and distress
is still a developing space.
Prior to this study, we did not know what the response
rate would be or what types of insights we would be able to
obtain. Developing new methodologies to combine such insights
will be a substantial undertaking, which should involve many
stakeholders. Developing such methodologies is a future goal, but
it was not the purpose of this study.
It is important to note that this study was conducted in the
midst of the initial pandemic, a time of significant uncertainty.
Between the time of the data gathering for and the publication of
this study, there have been countless responses across countries
announced and enacted. The insights discussed here capture an
important moment in time during the initial pandemic phase and
also offer a useful reference for on-going data monitoring and
subsequent study follow-ups.
Following this study, we will continue to work with providers
to capture follow-up insights at later time points2and onboard
new providers to address issues of data representativeness. We
will continue to engage with and include people with a range
of experiences of distress and service use, so that we are
inclusively influenced by their insights and inputs. It will also
be important to capture insights that relate to resilience and
recovery. An important next step will be to develop rigorous
means to bring together public and private sector data to monitor
mental health needs in real-time (just as contact tracing is
used to manage the viral epidemic). This can fuel research
and understanding and help to inform high-quality responses,
which can be delivered remotely to those in need on global and
local scales.
The data analyzed in this study is subject to the following
licenses/restrictions: we only had access to the data insights
provided by digital services providers, we did not access the
Frontiers in Digital Health | 4February 2021 | Volume 2 | Article 578902
Inkster Digital Mental Health During COVID-19
data. Requests to access these datasets should be directed
Ethical review and approval was not required for the study
on human participants in accordance with the local legislation
and institutional requirements. Written informed consent from
the participants’ legal guardian/next of kin was not required
to participate in this study in accordance with the national
legislation and the institutional requirements. Digital services
providers followed their own in house ethical procedures,
terms and conditions and consent procedures for their
own data sets.
BI formulated the idea, operationalised and co-ordinated the
response, inviting co-authors to join, all having different
professional and/or lived experiences who have made important
contributions in various ways, such as performing literature
searches, writing, helping us to connect with digital providers,
idea generation, editing, interpretation, etc.
The Lifeos for additional insights and encouragement during
the study.
Becky Inkster, Wolfson College, Cambridge University,
Cambridge, UK & The Alan Turing Institute, London, UK; Ross
O’Brien, Central and North West London NHS Foundation
Trust, and Healthy London Partnership, NHS, UK; Kate
Niederhoffer, Knowable Research, Texas, USA; Niranjan
Bidargaddi, College of Medicine & Public Health, Flinders
University, Adelaide, South Australia, Australia; Anne-Claire
Camille Stona, Lee Kong Chian School of Medicine, Nanyang
Technological University, Singapore; Glen Coppersmith, Qntfy,
USA; Amanda Towler, The TellFinder Alliance; The TellFinder
Alliance, USA; Philip Resnik, Department of Linguistics
and Institute for Advanced Computer Studies, University of
Maryland, Maryland, USA; Rebecca Resnik, Rebecca Resnik and
Associates, Bethesda, Maryland, USA; Maria Liakata, Queen
Mary University of London, UK; The Alan Turing Institute,
UK; University of Warwick, UK; Helen Barker, London, UK;
Abdullahi Abubakar Kawu, Ibrahim Badamasi Babangida
University, Lapai, Nigeria, Africa; Karen Machin, School of
Health & Social Work, University of Hertfordshire, UK; Survivor
Researcher Network, UK; Pattie Pramila Gonsalves, Sangath,
India; Sweta Pal, Sangath, India; Swetha Ranganathan, Sangath,
India; John A. Naslund, Department of Global Health and
Social Medicine, Harvard Medical School, Harvard University,
Massachusetts, USA; Jo Robinson, Orygen, Parkville, Melbourne,
Victoria, Australia, Centre for Youth Mental Health & The
University of Melbourne, Parkville, Melbourne, Victoria,
Australia; Munmun De Choudhury, School of Interactive
Computing, Georgia Institute of Technology, Atlanta Georgia,
USA; Glenn Melvin, School of Psychology, Faculty of Health,
Deakin University, Melbourne, Australia; Terry Hanley,
University of Manchester, UK; Matthew Jackman, Lived
Experience Academic, Western Pacific Region, Global Mental
Health Peer Network, Melbourne, Australia; Ed Humpherson,
Director General for Regulation, United Kingdom Statistics
Authority, UK; Bo Wang, Department of Psychiatry, University
of Oxford; The Alan Turing Institute, UK; Bilal A. Mateen,
Kings College Hospital, London, UK & The Alan Turing
Institute, London, UK; Akeem Sule, Department of Psychiatry,
University of Cambridge, UK; Wolfson College, University of
Cambridge, UK; Essex Partnership University NHS Foundation
Trust, UK; Ezinne Nwankwo, Cambridge University, UK &
Harvard University, USA; Gabriela Pavarini, Department of
Psychiatry, University of Oxford; Wellcome Centre for Ethics
and Humanities, University of Oxford, UK; Josip Car, Centre
for Population Health Sciences; WHO Collaborating Centre
for Digital Health and Health Education; Health Services and
Outcomes Research, LKCMedicine; Imperial College London,
UK; David Crepaz-Keay, Head of Applied Learning, Mental
Health Foundation, UK; Fellow, Royal Society for Public Health,
UK; Jasvinder Kandola, Division of Medicine, Hammersmith
Hospital Imperial College London, UK; Hannah Stewart,
The University of Texas Health Science Center at Houston
(UT Health) School of Public Health, Department of Health
Promotion & Behavioral Sciences, Texas, USA; Eiman Kanjo,
Nottingham Trent University, Smart Sensing Lab (MA220),
Clifton Lane, Nottingham, UK; Sarah Ticho, Hatsumi, London,
UK; April C. Foreman, American Association of Suicidology,
Louisiana, USA; Emma Selby, Digital Mentality, London, UK;
Stan Shepherd, Instant Access Medical, London, UK; Karen L
Fortuna, Dartmouth College, Hanover, New Hampshire, USA;
Emachi Eneje, Birmingham Mind, UK; Tamra Huesers, Harmony
Center, Minot, North Dakota, USA; Stephen Jeffreys, Survivor
Researcher Network, London, UK; Mat Rawsthorne, NIHR
Biomedical Research Centre for Mental Health & Technology,
University of Nottingham, UK; Gerry Craigen, Department
of Psychiatry, Faculty of Medicine, University of Toronto &
Associate Attending Staff Psychiatrist, Department of Psychiatry,
University Health Network, Toronto General Hospital Toronto,
Canada; Kristina Barger, Cogenta, UK; Neha Kumar, Georgia
Institute of Technology, Atlanta, USA; Sachin Pendse, Georgia
Institute of Technology, Atlanta, USA; Errin Riley, Sense About
Science, London, UK; Elvira Perez Vallejos, Nottingham NIHR
Biomedical Research Centre for Mental Health, UK & Institute
of Mental Health, Nottingham University, UK; Mark Embrett,
Dalhousie University, Canada; Ernest Okyere-Twum, Universite
Paris Descartes, France & Centre for mental health research
in Africa (CEMHRA); Kumar Jacob, MindWave Ventures,
UK; Janak Gunatilleke, MindWave Ventures, UK; Mirantha
Jayathilaka, MindWave Ventures, UK; Mariana Pinto Da Costa,
Unit for Social and Community Psychiatry, WHO Collaborating
Centre for Mental Health Services Development, Queen Mary
University of London, London, UK; Institute of Biomedical
Sciences Abel Salazar, University of Porto, Porto, Portugal;
Frontiers in Digital Health | 5February 2021 | Volume 2 | Article 578902
Inkster Digital Mental Health During COVID-19
Hospital de Magalhães Lemos, Porto, Portugal; Ana Catarino,
Ieso Digital Health; Ronan Cummins, Ieso Digital Health;
Tom Clelford, Ieso Digital Health; James de Bathe, Ieso Digital
Health; Valentin Tablan, Ieso Digital Health; Sarah Bateup,
Ieso Digital Health; Andrew D Blackwell, Ieso Digital Health;
Tejal Patel, Babylon; Keith Grimes, Babylon; Ed Sykes, Huma
Therapuetics, UK; Pete Trainor, Vala Health; Daf Rakphetmanee,
Ooca; Kanpassorn Eix Suriyasangpetch, Ooca; Annie Meharg,
Kooth; Aaron Sefi, Kooth; Derek Richards, SilverCloud Health
and Trinity College Dublin; Angel Enrique, SilverCloud Health
and Trinity College Dublin; Jorge Palacios, SilverCloud Health
and Trinity College Dublin; Antony Brown, CBTClinics; Eva
Papadopoulou, Minddistrict; Charlotte Lee, Big Health; Fanny
Jacq, Qare; Loïc Tse, Qare; David Plans, Huma Therapuetics,
UK; Senior Lecturer in Organisational Neuroscience, University
of Exeter, UK; Anika Sierk, Unmind; Heather Bolton, Unmind;
Knut Schroeder, Expert Self Care; Tarek R. Besold, Alpha
Health, Telefonica Innovation Alpha; Institute of Cognitive
Science, University of Osnabrueck, Germany; Aleksandar Matic,
Alpha Health, Telefonica Innovation Alpha; Department of
Psychological and Behavioural Science, London School of
Economics, London, UK; Iñaki Estella Aguerr, Alpha Health,
Telefonica Innovation Alpha; Department of Electrical and
Electronic Engineering, Imperial College London, London, UK;
Liz Ashall-Payne, ORCHA; Rob Daly, ORCHA; Simon Leigh,
ORCHA; Jo Aggarwal, Wysa; Ramakant Vempati, Wysa; Smriti
Joshi, Wysa; Vinod Subramanian, Wysa; Madhura Kadaba,
Wysa; Clara Falala Sechet, Owlie; Geby Chyntia Irwan, Riliv;
Audrey Maximillian Herli, Riliv; Karine Chevreul, StopBlues;
Anais Le Jeannic, StopBlues; Kathleen Turmaine, StopBlues;
Christopher Rainbow, BeyondBlue; Megan Chor Kwan Lam,
Neurum Health; Christine Hiu Man Chiu, Neurum Health;
Will Allen-Mersh, Spill; Justine Roberts, Mumsnet; Sara Ray,
The Mighty; Angelica Catalano, The Mighty; Jennifer Russell,
TalkLife; TalkCampus; Jamie Druitt, TalkLife; TalkCampus; Boaz
Gaon. Wisdo; Suzi Godson, MeeTwo; Kerstyn Comley, MeeTwo;
Satu Raappana, MIELI Mental Health Finland Mental-chat &
Mental Gaming, Finland; Michelle Carlson, Teen Line, USA;
Andrew Parker, Papa; Ken Duckworth, National Alliance on
Mental Illness, USA; Dan Gillison, National Alliance on Mental
Illness, USA; Theresa Nguyen, Mental Health America, USA;
Madeline Reinert, Mental Health America, USA; Victor Ugo,
Mentally Aware Nigeria Initiative (MANI), Nigeria; Ifedayo
Ward, Mentally Aware Nigeria Initiative (MANI), Nigeria;
Chantelle Booysen, Young Leaders for the Lancet Commission
on Global Mental Health and Sustainable Development; Ashley
Foster-Estwick, Young Leaders for the Lancet Commission on
Global Mental Health and Sustainable Development; Grace
Gatera, Young Leaders for the Lancet Commission on Global
Mental Health and Sustainable Development; David Karorero,
Young Leaders for the Lancet Commission on Global Mental
Health and Sustainable Development; Kumba Philip-Joe,
Young Leaders for the Lancet Commission on Global Mental
Health and Sustainable Development; Damian Juma, Young
Leaders for the Lancet Commission on Global Mental Health
and Sustainable Development; Claudia Sartor, Young Leaders
for the Lancet Commission on Global Mental Health and
Sustainable Development; Chinwendu Ukachukwu, Young
Leaders for the Lancet Commission on Global Mental Health
and Sustainable Development; Lian Zeitz, Young Leaders
for the Lancet Commission on Global Mental Health and
Sustainable Development; Alex Fine, Qntfy, USA; Merlyn
Holkar, Money & Mental Health Policy Institute, UK; Conor
D’Arcy, Money & Mental Health Policy Institute, UK; Katie
Alpin, Money & Mental Health Policy Institute, UK; Jo Kerr,
Turn2Us, UK; Lee Healey, IncomeMax, UK; Olly Betts, Tully
and OpenWrks Group, the team behind Tully; Andrea Severino,
Healthy Virtuoso, Italy; Will Van Der Hart, The Mind and Soul
Foundation, UK; Danielle Smalls, The TellFinder Alliance, USA;
Chris Dickson, The TellFinder Alliance, USA; Andrew Stroz,
The TellFinder Alliance, USA; Sebastian Vollmer, Warwick
University, Warwick, UK & The Alan Turing Institute, London,
UK; Hoang D. Nguyen, School of Computing Science, University
of Glasgow, Singapore; Daniel Albert Rosello, Nottingham Trent
University, Nottingham, UK; Valentino Megale, Softcare Studios,
Rome, Italy; Jan D. Smeddinck, Open Lab, Newcastle University,
Newcastle upon Tyne, UK; Rosanna Bellini, Open Lab, Newcastle
University, Newcastle upon Tyne, UK; Craig A. DeLarge, The
Digital Mental Health Project, Wise Working, California, USA;
Shivani Patel, South London and Maudsley NHS Trust, London,
UK; Jerome Uriko-kang, Global Mental Health Peer Network,
Ghana, Africa; Tunde Olatunji, Lyrical Kombat, London, UK;
Vanessa Lalo, Liberal Clinical Psychologist, Paris, France; Robert
Walker, Department of Mental Health Office of Recovery and
Empowerment, Massachusetts Department of Mental Health,
USA; Ann John, Population Data Science, National Centre
for Mental Health, Swansea University, Swansea, Wales, UK;
Diana Rayes, The Johns Hopkins Bloomberg School of Public
Health, Baltimore, USA; Marwa Elnahass, Newcastle University,
UK; Karen Elliott, Newcastle University, UK; Lil Tonmyr,
Family Violence, Mental Health & Suicide Surveillance Team,
Behaviours, Environments and Lifespan Division, Centre for
Surveillance and Applied Research, Public Health Agency
of Canada; Andrew MacKenzie, Centre for Surveillance and
Applied Research, Public Health Agency of Canada; Michael L.
Birnbaum, The Zucker Hillside Hospital, Psychiatry Research,
Northwell Health, New York, USA; Eric D. Caine, University
of Rochester Medical Center, New York, USA; John Pestian,
Cincinnati Children’s Hospital Medical Center, University of
Cincinnati; Oak Ridge National Laboratory/VA-MPV Champion
program, Cincinnati, USA; Dan Jacobson, Oak Ridge National
Laboratory/VA-MPV Champion program, Cincinnati, USA;
Mike Sorter, Cincinnati Children’s Hospital Medical Center,
University of Cincinnati, Cincinnati, USA; Tracy Glauser,
Cincinnati Children’s Hospital Medical Center, University of
Cincinnati, Cincinnati, USA; Michael Meaney, Translational
Neuroscience programme, Singapore Institute for Clinical
Sciences, Singapore & McGill University, Quebec, Canada;
Vincent M. B. Silenzio, Rutgers School of Public Health, Rutgers
University, New Brunswick and Newark, New Jersey, USA;
Jenny Edwards, London, UK; Ricardo Araya, Centre for Global
Mental Health, King’s College London, UK; Chris Fitch, Personal
Finance Research Centre, University of Bristol, UK; Jamie
Evans, Personal Finance Research Centre, University of Bristol,
Frontiers in Digital Health | 6February 2021 | Volume 2 | Article 578902
Inkster Digital Mental Health During COVID-19
UK; Kevin Telford, University of Edinburgh, Scotland, UK;
Peggy Loo, Legal & General Group Plc, UK; Andrea Stevenson,
Independent Consultant, London, UK; Tatyana Marsh, Open
Banking Excellence, UK; Helen Child, Open Banking Excellence,
UK; Roger S. McIntyre, Mood Disorders Psychopharmacology
Unit, University Health Network, Toronto, Canada & Institute
of Medical Science, University of Toronto, Toronto, Canada &
Department of Pharmacology, University of Toronto, Toronto,
Canada & Department of Psychiatry, University of Toronto,
Toronto, Canada & Brain and Cognition Discovery Foundation,
Toronto, Canada; Henrietta Bowden-Jones, National Centre
for Behavioural Addictions, UK (National Problem Gambling
Clinic +National Centre for Gaming Disorders) & Medical
Women’s Federation & Royal Society of Medicine & Royal
College of Psychiatrists & University College London, UK; John
Torous, Digital Psychiatry Division, Department of Psychiatry,
Beth Israel Deaconess Medical Center, Harvard Medical School,
Harvard University, Massachusetts, USA; Thomas R. Insel,
Humanest Care, USA.
Becky Inkster: 0000-0003-1201-455X; Anne-Claire C. Stona:
0000-0003-0350-0345; Philip Resnik: 0000-0002-6130-8602;
Terry Hanley: 0000-0001-5861-9170; David Crepaz-Keay:
0000-0003-3845-4721; Neha Kumar: 0000-0002-7014-5585;
Ann John: 0000-0002-5657-6995; Mariana Pinto Da Costa:
0000-0002-5966-5723; Mark Embrett: 0000-0002-3969-0219;
Munmun De Choudhury: 0000-0002-8939-264X; Mat
Rawsthorne: 0000-0002-7481-693X; Vincent M. B. Silenzio:
0000-0003-1408-7955; Aleksandar Matic (Alpha Health):
0000-0002-8752-4098; Sebastian Vollmer: 0000-0002-9025-0753;
Jo Robinson: 0000-0001-5652-918X; Pete Trainor (Vala Health):
0000-0002-7778-3934; Karen L Fortuna: 0000-0003-0343-2346;
Pattie Pramila Gonsalves: 0000-0003-3780-4523; Smriti Joshi:
0000-0001-7446-2804; Hannah Stewart: 0000-0003-2536-9405;
Tarek R. Besold (Alpha Health): 0000-0002-8002-0049;
Mirantha Jayathilaka: 0000-0002-2462-4833; Gabriela Pavarini:
0000-0001-5574-4021; Sarah Bateup: 0000-0003-3926-0021;
Iñaki Estella Aguerri: 0000-0001-5110-6858; Janak
Gunatilleke: 0000-0003-1474-5735; Hoang D. Nguyen:
0000-0003-2541-3269; Ricardo Araya: 0000-0002-0420-5148;
Karen Machin: 0000-0002-0374-4238; Glenn Melvin:
0000-0002-6958-3908; John A. Naslund: 0000-0001-6777-0104;
Stephen Jeffreys: 0000-0002-5088-9309; John Torous:
0000-0002-5362-7937; Thomas R. Insel: 0000-0001-5031-0160;
Bo Wang: 0000-0002-3412-3768; Abdullahi Abubakar Kawu:
0000-0003-2531-9539; Lil Tonmyr: 0000-0002-8722-7616; Clara
Falala-Séchet (Owlie): 0000-0003-3331-5255; Maria Liakata:
0000-0001-5765-0416; Simon Leigh: 0000-0002-6843-6447;
Liz Ashall-Payne: 0000-0001-7325-195X; Karen Elliott:
0000-0002-2455-0475; Sarah Ticho: 0000-0002-5585-0497;
Bilal A. Mateen: 0000-0003-4423-6472; David Plans:
0000-0002-0476-3342; Rosanna Bellini: 0000-0002-2223-2801;
Tejal Patel: 0000-0002-7356-7054; Derek Richards:
0000-0003-0871-4078; Jorge Palacios: 0000-0002-2103-5507;
Angel Enrique: 0000-0003-0585-4008; Niranjan Bidargaddi:
0000-0003-2868-9260; Valentino Megale: 0000-0003-2150-696X;
Elvira Perez Vallejos: 0000-0002-0258-9440; Aaron
Sefi: 0000-0002-0776-3858.
The Supplementary Material for this article can be found
online at:
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covid-19 pandemic. BMJ. (2020) 368:m1211. doi: 10.1136/bmj.
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Conflict of Interest: BI is an advisor to Wysa and TalkLife and hasworked with the
majority of these providers previously via either her Digital Innovation in Mental
Health conferences and/or her FinHealthTech Consortium. KJ, JG, and MJ are
employed by MindWave Ventures. AC, RC, TC, JB, VT, SB, and AB are employed
by Ieso Digital Health. TP, KG, and ES are employed by Huma Therapuetics.
PT is employed by Vala Health. DR and KS are employed by Ooca. AM and AS
are employed by Kooth. DR, AE, and JP are employed by Silver Cloud Health
and Trinity College Dublin. AB is employed by CBTClinics. EP is employed by
Minddistrict. CL is employed by Big Health. FJ and LT are employed by Qare.
DP is employed by Huma Therapeutics. AS and HB are employed by Unmind.
KS is employed by Expert Self Care Ltd (distrACT app). TB, AM, and IA, Alpha
Health, Telefonica Innovation Alpha. LA-P, RD, and SL work with ORCHA. JA
RV, SJ, VS, and MK are employed by Wysa. CS is employed by Owlie. GI and
AH are employed by Riliv. KC, AL, and KT are employed by Stop Blues. CR is
employed by BeyondBlue. ML and CC are employed by Neurum Health. WA-M
is employed by Spill. JR is employed by Mumsnet. SR and AC are employed by
The Mighty. JR and JD are employed by TalkLife. BG is employed by Wisdo.
SG and KC are employed by MeeTwo. SR is employed by MIELI Mental Health
Finland Mental-chat & Mental Gaming, Finland. MC is employed by Teen Line,
USA. AP is employed by Papa. KD and DG are employed by National Alliance on
Mental Illness, USA. TN and MR are employed by Mental Health America, USA.
VU and IW are employed by Mentally Aware Nigeria Initiative (MANI), Nigeria.
CB, AF-E, GG, DK, KP-J, DJ, CS, CU, and LZ are part of the Young Leaders for
the Lancet Commission on GlobalMental Health and Sustainable Development.
GC and AF are employed by Qntfy, USA. MH, CD’A, and KA are employed by
Money & Mental Health Policy Institute, UK. JK is employed by Turn2Us, UK.
LH is employed by IncomeMax, UK. OB is employed by Tully and OpenWrks
Group, the team behind Tully. AS is employed by Healthy Virtuoso, Italy. WV
is employed by The Mind and Soul Foundation, UK. AT, DS, CD, and AS work
for The TellFinder Alliance, USA. SV has received funding from iqvia for toolbox
development. TI works for Humanest Care.
Copyright © 2021 Inkster and Digital Mental Health Data Insights Group
(DMHDIG). This is an open-access article distributed under the terms of
the Creative Commons Attribution License (CC BY). The use, distribution
or reproduction in other forums is permitted, provided the original author(s)
and the copyright owner(s) are credited and that the original publication in
this journal is cited, in accordance with accepted academic practice. No use,
distribution or reproduction is permitted which does not comply with these
Frontiers in Digital Health | 8February 2021 | Volume 2 | Article 578902
... 39 Far greater emphasis and investment of resources for mental health and social services from the whole-of-society are needed to confront the "mental health tsunami". 41 With the protracted pandemic and constant threat of new variants, public health measures should shift towards supporting people holistically. Healthcare systems should seek to empower and destigmatise people who seek help. ...
Introduction: COVID-19 restrictions and lockdown measures have led to impact on the mental health and social service delivery, including the rapid adoption of digital solutions to mental healthcare delivery in Singapore. This study aims to rapidly document the quantitative and qualitative impact of the pandemic restrictions on mental health and social services. Method: This descriptive mixed-methods study consisted of a survey arm and a qualitative arm. Providers and clients from eligible mental health organisations and social service agencies were recruited. The respondents completed a survey on changes to their service delivery and the extent of impact of the pandemic on their clients. In-depth interviews were also conducted with representatives of the organisations and clients. Results: There were 31 organisation representatives to the survey, while 16 providers and 3 clients participated in the in-depth interviews. In the survey arm, all representatives reported pivoting to remote means of delivering care during the lockdown. An increase in new client referrals and more domestic violence were reported from primary and community health partners respondents who made up 55.5% of health partners respondents. Three distinct response themes were recorded in the in-depth interviews: impact on clients, impact on service provision and impact on mental health landscape. Conclusion: Two key findings are distilled: (1) mental health and social services have been challenged to meet the evolving demands brought about by the pandemic; (2) more societal attention is needed on mental health and social services. The findings indicate a necessary need for extensive studies on COVID-19 that can inform policies to build a more pandemic-resilient nation. Keywords: COVID-19, digital health, mental health, psychiatry, psychology
... is study proposes a student psychological crisis early warning method based on a cloud computing data system [7]. We identify the status of students according to different values of behavior characteristics, so as to judge whether the subject may have a psychological crisis [8]. In the process of selecting personality traits, this study consulted the opinions of student management experts and conducted a binary logistic regression analysis on some traits [9]. ...
Full-text available
At present, Chinese college students are facing a lot of psychological pressure; whether it is teaching pressure or life pressure, it will have a certain adverse impact on college students’ psychological state, and if timely guidance is not provided, it will result in some adverse consequences. Therefore, it is necessary to timely identify the psychological crisis situation of college students, but the existing form of manual identification has high limitations, which cannot obtain the psychological state of students more accurately and efficiently, so it is necessary to optimize and improve with the help of network technology. Cloud computing data system is one of the mature big data systems at present. The combination of cloud computing system and machine learning technology is effectively applied to the field of psychological crisis analysis, which can quickly screen the psychological status of college students and report abnormal data in a timely manner, so as to help college psychological teachers identify the state of college students’ psychological crisis and intervene in a timely manner to promote the physical and mental health of students. By applying machine learning technology for the establishment of a cloud computing data system and putting the system into the field of psychological crisis identification of Chinese college students, this study lays a theoretical and practical foundation for preventing students from the psychological crisis.
... A recent report showed that a new record in the deal volume of digital mental health companies was reached with 68 deals in the third quarter of 2020 alone (CB insights, State of Healthcare Q3'20 Report). This is thought to be a consequence of COVID-19 being a catalyst for DHIDs, when such remote services were suddenly required [16] and have accelerated interest and uptake of DHIDs [17]. However, it is unclear whether top-funded companies implement DHIDs that are evidence-based [18] or to what extent they leverage novel technology-driven approaches such as conversational agents (CAs), just-in-time adaptive interventions (JITAIs), or low-burden sensing technologies. ...
BACKGROUND Digital innovations in the mental health care field provide an opportunity to mitigate the global burden of mental disorders such as depression by facilitating timely, accessible, scalable, and affordable interventions. However, there is little evidence on how much these interventions rely on novel automated approaches, such as conversational agents (CAS), just-in-time adaptive interventions (JITAIs), or low-burden sensing technologies. OBJECTIVE Our objectives were: (i) to identify the top-funded companies offering digital health interventions for the prevention and treatment of depression (DHID), (ii) to review DHIDs’ scientific evidence, (iii) to identify which psychotherapy approaches are being used, and (iv) to examine the degree to which these DHIDs include novel automated approaches such as CAs, JITAIs, and low-burden sensing technologies. METHODS A systematic search was conducted using two venture capital databases (Crunchbase and Pitchbook) to identify the top 30 funded companies offering DHIDs. In addition, studies related to the DHIDs were identified via scientific databases (PubMed, Cochrane Library, and APA Psych-info) and hand-searching (companies’ websites). RESULTS The top-30 funded companies offering DHIDs received total funding of 2’592 billion USD up to February 2022. A total of 83 studies were identified by fewer than half of the companies (n=14; 46.6%), of which only 8 (n= 26.6%) employed a randomized controlled trial design. Cognitive-behavioural therapy is the most commonly used psychotherapy approach (n=25, 83.3%), whereas behavioural activation and/or interpersonal therapy (the most effective interventions for depression) were used by only 8 companies (26.6%). Regarding novel technologies, only a few companies incorporated the use of CAs (n=8, 26.6%), or low-burden sensing technologies such as biofeedback-based breathing training with heart rate measurements (n=3, 10%), and only one used a biomarker for depression based on voice features (3.33%). CONCLUSIONS Findings suggest that the amount of funding is not related to the evidence. There is a strong variation in the quantity of evidence provided and an overall need for more rigorous effectiveness trials. Few DHIDs use automated approaches such as CAs and JITAIs, limiting their scalability and delivery of actionable support at the most opportune moments. CLINICALTRIAL N/A
... Digital services providers reported a recurring observation that demand for digital mental health support has risen, and that the nature of this demand has also changed since COVID-19, with an apparent increased presentation of anxiety and loneliness. Conversely, at the same time, referral rates to NHS primary care mental health services dropped (Inkster et al. 2021). Individuals chose quick and easy access to self care wellbeing support. ...
Technical Report
Full-text available
Executive Summary The time has come for a change of pace. The global face of XR in healthcare is evolving. The COVID-19 pandemic has ushered in the use of XR in healthcare as providers are forced to accelerate their digital transformation journeys and adopt novel and innovative solutions to navigate the impact of the pandemic. A unique opportunity presents itself for the UK to lead this expanding market. AR and VR have been revolutionising the global healthcare market and demonstrating impact, value and efficiencies for some time before the pandemic struck. The predicted growth of the AR healthcare market is expected to generate US$10 billion in revenues, with the VR Healthcare market reaching US$1.2 billion in 2024 (ABI Research Oct 7th, 2020). In the UK use-at-home market, The Times reported in January 2021 that the sales of VR headsets had risen by 350% as those trapped at home seek a safe way to escape the lockdown. At the start of last year, one in 17 UK households had a VR headset at home, according to Ofcom, up from one in 20 in 2018. There is a nascent but world-class XR innovation emerging in the UK’s healthcare market, as cutting-edge research is undertaken in UK universities and ground-breaking innovation is happening in start-ups and SMEs. In addition, novel collaborations and trials are demonstrating the potential value and cost savings to be gained from the application of XR in healthcare and the impact on and improvement to people’s lives. Despite the market potential for the UK, the evidence generated is not being measured efficiently and the benefits, although becoming clearer, are not being valued to the extent needed to trigger the funding, investment and strategic interventions needed to grow a sustainable and thriving UK XR healthcare sector. One of the biggest drivers within the NHS is to provide value for money. The health economics in this report emphasises the potential that XR offers in supporting healthcare services to deliver highly effective outcomes in a more cost-effective way. XR can be used to help patients face operations and treatments that they would otherwise avoid, this could lead to £2 million of possible savings per year. Delivering therapies remotely via VR can be 2-3 times cheaper than traditional rehabilitation, cut wait times, improve engagement and reduce the likelihood of symptoms exacerbating. Finally, XR can reduce costs to training, and improve overall surgical performance by as much as 230% versus traditional training methods. This evidence is a fundamental requirement for the health system and it is unlikely any XR solution can be adopted into clinical practice or attract the investment needed to scale without the data to support its effectiveness. Research and development of XR is hampered by a fragmented ecosystem and the lack of opportunities for cross-sector collaboration. Pockets of innovation sit in industry, isolated from the clinicians or researchers needed to turn ideas into reality. There is, as yet, no marketplace for efficiently distributing XR in healthcare solutions. It is extremely difficult for products or experiences to convert into clinical trials to substantiate the value and impact. It is even harder to get in front of commissioners, procurers or purchasers. Funded and market-ready solutions struggle to find a route to market, as, in order to get onto a procurement platform, XR solutions have to meet standards and assurances which currently are not fit for purpose for the unique applications of XR. The aim of this report is to outline what we mean by XR in healthcare and how it is being implemented in the UK. It identifies the potential value of XR, explores the evidence that demonstrates its impact on human health and estimates the potential cost savings to the UK healthcare system. The report delves into use cases of XR in healthcare across a number of key application areas, including mental health and wellbeing, physiotherapy and rehabilitation, pain management, healthcare professional clinical skills training and patient education. Our goal is to showcase the people and projects innovating in this space and to demonstrate the potential value XR could bring to clinical and non-clinical settings. The report also highlights the unique collaborations emerging on the clinical front line, bringing clinicians, academics, gaming and XR companies and others together to address real needs within the health system. More importantly, this report brings together for the first time a snapshot of XR in healthcare in the UK today, outlines the barriers to its growth and makes recommendations that will help government and public health services make informed decisions on future strategies. This will ensure the UK is in the best position to unlock the potential of XR in healthcare and ultimately improve patient outcomes and quality of life. The report proposes three key recommendations to move XR healthcare in the UK into a world leading position: 1. Undertake a comprehensive mapping and analysis of the businesses, healthcare organisations and universities working with XR in healthcare to better understand the UK’s capacity and capabilities, the size and scale of the market, its potential value and future growth. 2. Develop collaborative ‘Centres of Excellence’ (CoEs) in healthcare XR to create a development pipeline which enables a clear pathway from concept to investment and scaling to market.Working in partnership, CoEs would facilitate the production of clinically robust, engaging, marketable products to be made available on national platforms for secure purchase to healthcare providers, improving patient experience, quality and value in health intervention. Vitally, CoEs will also act to further develop a body of evidence. 3. Establish a representative and impartial alliance network that facilitates the connection of academic institutions, researchers, healthcare providers, clinicians, XR, digital and creative industries in order to support new collaborations, inform, signpost and share insights and expertise.
... The coronavirus pandemic re-ignited global discourses on mental health as a vital component of attaining the MDGs, considering that Covid-19 has lasting adverse implications on mental health (Inkster, 2021). The onset of large-scale triggers of mental health challenges witnessed during the pandemic has revolutionised the outlook on mental health issues (Moreno et al., 2020). ...
Full-text available
BAME people faced personal and environmental challenges that disproportionately predispose them to different mental health outcomes pre-pandemic. Notably, there is a mental health disparity among BAME. Although the disparity is recognised at the policy and practitioner levels, the causes of the gap in mental health outcomes are primarily speculated to be the BAME population's inequality challenges. The current research analyses the mental health outcomes among the BAME population. The study adopted a systematic literature review design. Nineteen sources were selected and scrutinized for appropriate data. The results showed that the BAME population had a high prevalence of developing negative mental health outcomes. The primary adverse mental effects identified included depression, anxiety disorders, suicide ideation, psychotic disorders such as schizophrenia, PTSD unhappiness, and low life fulfilment. The Covid-19 pandemic worsened the mental health outcomes of BAME increase with an increase in depression and anxiety disorders. The researcher concluded that BAME people faced specific inequality challenges that predisposed them to adverse mental health outcomes. The investigator recommends creating mental health support groups and policies to deal with inequality challenges noted, negative attitudes, and misconceptions on mental health services to increase awareness and uptake of mental healthcare services.
... Like any type of healthcare tool, digital mental health presents both opportunities as well as challenges. 1 The need for some regulation is evidenced by the risk benefit ratio of digital mental health apps. There are tremendous potential benefits of digital mental health, including real-time symptom reporting, increasing portability and accessibility, cost savings, 1,2,4 and allowing for clinicianpatient engagement outside of the therapy milieu are well known. But these apps are not without tangible risks including ongoing concerns about safety, privacy, and efficacy. ...
Background: Mental health (MH) apps are growing in popularity. While MH apps may be helpful, less is known about how crises such as suicidal ideation are addressed in apps. Aims: We examined the proportion of MH apps that contained language mentioning suicide or suicidal ideation and how apps communicated these policies and directed users to MH resources through app content, terms of services, and privacy policies. Method: We chose apps using an Internet search of “top mental health apps,” similar to how a user might find an app, and extracted information about how crisis language was presented in these apps. Results: We found that crisis language was inconsistent among apps. Overall, 35% of apps provided crisis-specific resources in their app interface and 10.5% contained crisis language in terms of service or privacy policies. Limitations: This study employed a nonsystematic approach to sampling apps, and therefore the findings may not broadly represent apps for MH. Conclusion: To address the inconsistency of crisis resources, crisis language should be included as part of app evaluation frameworks, and internationally accessible, vetted resources should be provided to app users.
Full-text available
This article has been arrived at from a nation level webinar presented recently to help prepare Indian counselling and clinical psychologists to move their practice onto an online service delivery format. This article offers details around competencies needed to offer psychotherapy via online modalities and also guidelines for offering these services in a legally and an ethically safe manner. These have been collated from best practices and guidelines being followed by countries where online delivery of psychotherapy started much earlier and also have evidence around what works and what does not work.
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Importance Health care workers exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed. Objective To assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China. Design, Settings, and Participants This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from 1257 health care workers in 34 hospitals from January 29, 2020, to February 3, 2020, in China. Health care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 were eligible. Main Outcomes and Measures The degree of symptoms of depression, anxiety, insomnia, and distress was assessed by the Chinese versions of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, and the 22-item Impact of Event Scale–Revised, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes. Results A total of 1257 of 1830 contacted individuals completed the survey, with a participation rate of 68.7%. A total of 813 (64.7%) were aged 26 to 40 years, and 964 (76.7%) were women. Of all participants, 764 (60.8%) were nurses, and 493 (39.2%) were physicians; 760 (60.5%) worked in hospitals in Wuhan, and 522 (41.5%) were frontline health care workers. A considerable proportion of participants reported symptoms of depression (634 [50.4%]), anxiety (560 [44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers (eg, median [IQR] Patient Health Questionnaire scores among physicians vs nurses: 4.0 [1.0-7.0] vs 5.0 [2.0-8.0]; P = .007; median [interquartile range {IQR}] Generalized Anxiety Disorder scale scores among men vs women: 2.0 [0-6.0] vs 4.0 [1.0-7.0]; P < .001; median [IQR] Insomnia Severity Index scores among frontline vs second-line workers: 6.0 [2.0-11.0] vs 4.0 [1.0-8.0]; P < .001; median [IQR] Impact of Event Scale–Revised scores among those in Wuhan vs those in Hubei outside Wuhan and those outside Hubei: 21.0 [8.5-34.5] vs 18.0 [6.0-28.0] in Hubei outside Wuhan and 15.0 [4.0-26.0] outside Hubei; P < .001). Multivariable logistic regression analysis showed participants from outside Hubei province were associated with lower risk of experiencing symptoms of distress compared with those in Wuhan (odds ratio [OR], 0.62; 95% CI, 0.43-0.88; P = .008). Frontline health care workers engaged in direct diagnosis, treatment, and care of patients with COVID-19 were associated with a higher risk of symptoms of depression (OR, 1.52; 95% CI, 1.11-2.09; P = .01), anxiety (OR, 1.57; 95% CI, 1.22-2.02; P < .001), insomnia (OR, 2.97; 95% CI, 1.92-4.60; P < .001), and distress (OR, 1.60; 95% CI, 1.25-2.04; P < .001). Conclusions and Relevance In this survey of heath care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 in Wuhan and other regions in China, participants reported experiencing psychological burden, especially nurses, women, those in Wuhan, and frontline health care workers directly engaged in the diagnosis, treatment, and care for patients with COVID-19.
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Background: Commercial transaction records, such as data collected through banking and retail loyalty cards, present a novel opportunity for longitudinal population studies to capture data on participants’ real-world behaviours and interactions. However, little is known about participant attitudes towards donating transactional records for this purpose. This study aimed to: (i) explore the attitudes of longitudinal population study participants towards sharing their transactional records for health research and data linkage; and (ii) explore the safeguards that researchers should consider implementing when looking to request transactional data from participants for data linkage studies. Methods: Participants in the Avon Longitudinal Study of Parents and Children were invited to a series of three focus groups with semi-structured discussions designed to elicit opinions. Through asking participants to attend three focus groups we aimed to facilitate more in-depth discussions around the potentially complex topic of data donation and linkage. Thematic analysis was used to sort data into overarching themes addressing the research questions. Results: Participants (n= 20) expressed a variety of attitudes towards data linkage, which were associated with safeguards to address concerns. This data was sorted into three themes: information, trust, and control. We discuss the importance of explaining the purpose of data linkage, consent options, who the data is linked with and sensitivities associated with different parts of transactional data. We describe options for providing further information and controls that participants consider should be available when studies request access to transactional records. Conclusions: This study provides initial evidence on the attitudes and concerns of participants of a longitudinal cohort study towards transactional record linkage. The findings suggest a number of safeguards which researchers should consider when looking to recruit participants for similar studies, such as the importance of ensuring participants have access to appropriate information, control over their data, and trust in the organisation.
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Objectives: This study investigated the psychosocial responses of children and their parents to pandemic disasters, specifically measuring traumatic stress responses in children and parents with varying disease-containment experiences. Methods: A mixed-method approach using survey, focus groups, and interviews produced data from 398 parents. Adult respondents completed the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (PTSD-RI) Parent Version and the PTSD Check List Civilian Version (PCL-C). Results: Disease-containment measures such as quarantine and isolation can be traumatizing to a significant portion of children and parents. Criteria for PTSD was met in 30% of isolated or quarantined children based on parental reports, and 25% of quarantined or isolated parents (based on self-reports). Conclusions: These findings indicate that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic. Because pandemic disasters are unique and do not include congregate sites for prolonged support and recovery, they require specific response strategies to ensure the behavioral health needs of children and families. Pandemic planning must address these needs and disease-containment measures.
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This paper systematically reviews the relationship between personal unsecured debt and health. Psychinfo, Embase and Medline were searched and 52 papers were accepted. A hand and cited-by search produced an additional 13 references leading to 65 papers in total. Panel surveys, nationally representative epidemiological surveys and psychological autopsy studies have examined the relationship, as have studies on specific populations such as university students, debt management clients and older adults. Most studies examined relationships with mental health and depression in particular. Studies of physical health have also shown a relationship with self-rated health and outcomes such as obesity. There is also a strong relationship with suicide completion, and relationships with drug and alcohol abuse. The majority of studies found that more severe debt is related to worse health; however causality is hard to establish. A meta-analysis of pooled odds ratios showed a significant relationship between debt and mental disorder (OR=3.24), depression (OR=2.77), suicide completion (OR=7.9), suicide completion or attempt (OR=5.76), problem drinking (OR=2.68), drug dependence (OR=8.57), neurotic disorder (OR=3.21) and psychotic disorders (OR=4.03). There was no significant relationship with smoking (OR=1.35, p>.05). Future longitudinal research is needed to determine causality and establish potential mechanisms and mediators of the relationship.
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Previous studies revealed that there was a significant increase in suicide deaths among those aged 65 and over in 2003. The peak coincided with the majority of SARS cases being reported in April 2003. In this paper we examine the mechanism of how the SARS outbreak resulted in a higher completed suicide rate especially among older adults in Hong Kong. We used Qualitative data analysis to uncover the association between the occurrence of SARS and older adult suicide. Furthermore, we used a qualitative study based on the Coroner Court reports to provide empirical evidence about the relationship between SARS and the excessive number of suicide deaths among the elderly. SARS-related older adult suicide victims were more likely to be afraid of contracting the disease and had fears of disconnection. The suicide motives among SARS-related suicide deaths were more closely associated with stress over fears of being a burden to their families during the negative impact of the epidemic. Social disengagement, mental stress, and anxiety at the time of the SARS epidemic among a certain group of older adults resulted in an exceptionally high rate of suicide deaths. We recommend that the mental and psychological well-being of the community, in particular older adults, be taken into careful account when developing epidemic control measures to combat the future outbreak of diseases in the community. In addition, it is important to alert family members to vulnerable individuals who are at potential risk because of their illnesses or anxieties.
The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
A review of the literature investigating the role of psychological factors in the relationship between financial hardship and mental health was completed. The review sought to identify which factors have been most consistently and reliably indicated, and the mechanisms by which these factors are proposed to contribute to the association between hardship and mental health. Although the review identified that a broad variety of factors have been investigated, skills related to personal agency, self-esteem and coping were most frequently and reliably associated with the relationship between financial hardship and mental health outcomes. Just over half of the studies reviewed concluded that the psychological factor investigated was either eroded by financial hardship, increasing vulnerability to mental health difficulties, or protected mental health by remaining intact despite the effects of financial hardship. The remaining studies found no such effect or did not analyse their data in a manner in which a mechanism of action could be identified. The methodological quality of the research included in the review was variable. The valid and reliable measurement of financial hardship, and conclusions regarding causation due to the use of predominantly cross-sectional design were areas of particular weakness.