8 new NHS online therapy courses and apps recommended to help treat depression

Eight new 'digitally enabled therapies' to treat depression and anxiety disorders have been launched, intended for use on the NHS.

The range of online mental health treatments have been recommended by the National Institute for Health and Care Excellence (NICE)

Combined, the therapies – which also address post-traumatic stress disorder (PTSD) and body dysmorphia – have the potential to help more than 40,000 people, according to NICE.

One in six people report having a common mental health problem like anxiety and depression in any given week in England, according to NHS Digital.

With high demand for NHS talking therapies and some individuals currently waiting for up to six weeks to access help, it is hoped the aid of these digital tools could both ease pressure on the health service and deliver support faster.

“Our rapid assessment of these eight technologies has shown they have promise," says Mark Chapman, Interim Director of Medical Technology and Digital Evaluation at NICE.

People will only be able to use each of the therapies (some of which are already in use) after a formal assessment with an NHS Talking Therapies therapist, as they may not be the right choice for everyone, NICE points out. If suitable, they must also then be delivered with ongoing support from a practitioner or therapist.

While the eight therapies have been conditionally recommended, further evidence still needs to be generated.

“Developed using tried and tested CBT [cognitive behavioural therapy] methods, each one has demonstrated it has the potential to provide effective treatment to the many thousands of people who live with these conditions," adds Mark Chapman.

“We want these new treatment options to be available for people to use as quickly as possible and we also want to make sure they are clinically effective and represent good value for the NHS. The additional evidence collected during this period will help us do that.

“We also want to hear what people involved in this area think – both clinicians and the people who will be using these digital technologies. We know CBT can work well for many people and we know that digitally enabled technology can help the NHS get support to people faster.”

As well as a faster service, the digital therapies are intended to offer help that is better suited to people's personal needs in terms of flexibility, time and location.

"Digital technology could transform the experience of people living with mental illnesses. It can be incredibly isolating to be on a long waiting list for in-person treatment. You might know that help is coming, you just don’t know when," says Elizabeth Mullenger, lay specialist member on the NICE committees.

“Having access to a digital therapy could help prevent this lonely feeling. Sometimes people need support most in the middle of the night, or after a busy day at work, and it’s hard to know where to turn. Having access to digital therapy, can give people the help they need, when they need it.

“These technologies will allow us to be in charge of our treatment, gaining a sense of autonomy as we navigate our own journey towards positive mental health.”

Professor Dame Til Wykes, specialist committee member and head of the School of Mental Health and Psychological Sciences at King’s College London, adds, "Digital therapies may offer welcome additional help for people with a diagnosis of anxiety or depression. They may help enough to reduce the need for face-to-face contact be that in person or virtually.

"But we don’t know enough about who will improve and who will need extra help."

While these apps show great 'promise', like with any form of mental health treatment, they may not be beneficial for everyone in-need, which NICE has acknowledged.

Dr Hana Patel and mental health coach points out, "Online and remote counselling and therapy has taken off since the COVID-19 pandemic, helping more people have access to affordable therapy. These online therapy apps may suit some people and not others.

"I think the most important thing is the reason for accessing the apps in the first place, as some mental health conditions mean that people may not be well enough to engage with online therapy as there is an element of being self-motivated and accessing the app, and they may need intensive psychiatric treatment.

"Certain mental health conditions such as anxiety disorders can be treated online, using therapies such as cognitive behavioural therapy whereas other more complex mental health and psychiatric conditions will need face to face therapy and treatment."

The likely preference of the person's demographic could also play a part in who is receptive to digital help.

"Age may also affect the satisfaction and preference of the type of therapy – face-to-face or online. Younger clients who may be more familiar with remote communication, may prefer this, and feel more able to have an open discussion, whereas others may prefer a face-to-face consultation or session, as that may be the driver for searching and needing therapy in the first place," Dr Patel points out.

"Some people may have mobility issues or find it difficult to access a face-to-face therapy session due to family, work life and this may be a convenient way of accessing help when they need it."

While the benefits of the new online therapies are clear, there are also pros and cons to consider.

"If the app is a text only app, then the therapist may not be able to see the patient's/client's body language, hear their voice or see what they look like – this is all information that is captured during a psychiatric assessment and can help to lead to a particular mental health diagnosis," explains Dr Patel.

"It may also be difficult for some people to convey through text how they are feeling, and could lead to misunderstanding in things being said between the client and therapist."

Dr Patel adds, "For clients/patients who are unwell or in a crisis, perhaps self-harming or feeling suicidal, online therapy is not the best avenue as these online apps are not set up or equipped to deal with a mental health crisis."

The technologies conditionally recommended by NICE include:

For depression: Three online CBT programmes Beating the Blues, Deprexis and Space from Depression (Silvercloud) as treatment options
For body dysmorphic disorder (BDD): Perspectives with support provided by a high intensity therapist trained in treating BDD
For generalised anxiety symptoms or unspecified anxiety disorder: Beating the Blues and Space from Anxiety (SilverCloud) with support provided by a psychological wellbeing practitioner or high intensity therapist
For post-traumatic stress disorder (PTSD): iCT-PTSD and Spring with support from a high intensity therapist trained in treating PTSD
For social anxiety disorder: iCT-SAD with support provided by a high intensity therapist who is trained in treating social anxiety disorder