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Exploring digital interventions in mental health services

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Could the use of digital technology help to reduce the increasing pressure on mental health services? Members of our Mental Health and Wellbeing team share their thoughts.

Technology has become an important part of our everyday lives. Innovative developments in technology have substantially transformed the way in which we communicate, gather information, and access goods and services, all of which can be accessed through the internet using different devices. Given the current pressures on mental health services, which are likely to increase in the following years, the use of technology could potentially reduce these pressures by delivering digital interventions, assessments, and other e-resources outside the clinic, from the comfort of people’s own homes.

At Warwick Medical School, we are conducting research on the use of technology in mental health settings. The MeMO study, for example, which is funded by the Economic and Social Research Council (ESRC) and Coventry and Warwickshire Partnership NHS Trust, specifically looks at the use of smartphone technology. Smartphone ownership has continued to increase over the years across different age groups, with the highest rates (90%) being reported for young people aged 16 to 24. Smartphones offer a variety of features, including inventive smartphone applications or “apps”, which may play a particularly important role in the delivery of mental health care. Given the flexibility in the software, this mobile technology can also be tailored to people’s individual needs, ensuring the care they receive is person-centred.

Carried out by Miss Muna Dubad, Dr Steven Marwaha, and Dr Catherine Winsper, the MeMO study aims to examine how useful mood-monitoring apps are for young people experiencing affective instability (also informally referred to as mood swings). Young people with affective instability are more likely to develop mental health issues when they are olde. Although this period in their life is when young people need the most support, it is unfortunately also when their needs are least likely to be addressed by mental health services. Mood-monitoring apps may therefore increase access to service for young people experiencing these problems in this critical stage of their life. Moreover, because the smartphone apps allow for moods or emotions to be assessed accurately in people, this could also lead to more reliable and objective assessments.

Within the last few decades, virtual reality (VR) treatment has gained momentum in its potential to provide cost-effective treatment and engagement with clinical populations whom are hard to reach. VR allows individuals to interact with three-dimensional social environments through mediums such as headsets. VR interventions have been utilised in the diagnosis and treatment of clinical populations with psychosis and have been used to treat social cognitive problems in other clinical populations. Its novelty lies in providing participants with an immersive experience, whilst allowing clinicians to control and alter such environments. Thus patients may experience responses which are similar to the real world.

Currently in WMS there are two ongoing projects, which aim to utilise VR technologies to improve social cognition deficits in those diagnosed with first episode psychosis (FEP). Dr Andrew Thompson is currently undertaking a trial called ‘Virtual Reality As A Method Of Delivering Social Cognitive Therapy in Early Psychosis’ (VEEP). Funded by MQ: Transforming Mental Health, this project aims to assess whether it is feasible and acceptable to deliver a treatment called ‘Social Cognition and Interaction Training’ in an online virtual world called Second Life®, for those diagnosed with FEP. Here, both group facilitators and patients will use avatars (a virtual representation of an individual) to attend the treatment sessions, with outcome measures (presence, feasibility, acceptability and social cognition) collected at pre and post intervention.

Under the supervision of Dr. Andrew Thompson and Professor Chris Hollis (University of Nottingham) PhD researcher Miss Farah Elahi is currently developing a novel CBT intervention, which aims to target social cognitive deficits in those with FEP. This six session treatment will be combined with 360 degree videos (a type of VR), to provide patients with a more immersive experience. Everyday social scenarios (i.e. individuals socialising in a café) will be scripted and filmed using a 360 degree video camera, which patients will be able to view using an oculus (VR headset) as part of their treatment. The aim of the 360 degree videos is to provide a stepped care approach to exposure to real life social situations. This mixed methods research project is funded by the ESRC and will collect quantitative (i.e. social cognition, quality of life, heart rate variability) and qualitative data (semi-structured interviews) pre and post intervention and at a 3 month follow up. Thus, both projects form the first step in assessing the efficacy of utilising VR in the treatment of social cognitive deficits in those with FEP, with the aim of improving their social functioning.

Muna Dubad, Postgraduate Research; Steven Marwaha, Associate Clinical Professor; Andrew Thompson, Associate Clinical Professor; Farah Elahi, Postgraduate Research, The University of Warwick