Oxford Health NHS Foundation Trust.
Technology for Treatment and Prevention of Mental Illness
Dr. Karl Marlowe
Medtech has the potential to improve mental health outcomes and deliver patient value. In the UK, the National Health Service (NHS) and the population it serves benefit from more accurate and earlier diagnoses, and more effective treatments. As digital services are increasingly interwoven into our daily lives, the people we serve expect the same seamless service in their touch points in the NHS mental health services.
This article explores four ways that Medtech is currently being developed in the delivery of Mental Health services and areas of opportunity for the future.
Firstly, at Oxford Health NHS Foundation Trust, we are leading the research with Virtual Reality (VR) for the treatment of people with agoraphobia and psychosis. For example, VR treatment targets the intense anxiety that keeps many people with psychosis from participating in everyday activities. These fears can lead to functional disability, which means people avoid leaving the home, severely disrupting relationships with family and friends, their education, and their working lives. In Professor Daniel Freeman’s, ‘gameChange’ research program, a virtual therapist guides the patient through the program. So, it can be delivered in a variety of settings, including patients’ homes. The results published in the Lancet Psychiatry show significant reductions in the avoidance of everyday situations and distress. These patients experienced large and sustainable benefits – for example, being able to undertake activities they had previously found unthinkable and were maintained at the six-month follow-up.
Secondly, Oxford Health NHS Foundation Trust’s Biomedical Research Centre received an Artificial Intelligence in Health and Care Award in 2021, the first mental health project to do so. Dr. Dan Joyce, one of the CHRONOS project leads described it as a system approach to decrease the intrinsic biases from machine learning, by developing digital tools for clinicians in secondary mental health care to rapidly identify the most appropriate treatments for their patients. It is intended to support clinical decision-making. Due to the public concern about AI in medical settings, the evaluation of CHRONOS outputs include clinicians alongside patient and public
Thirdly, considering that people with dementia typically suffer from poor sleep quality, and disturbed sleep is a key predictor of cognitive decline, this is another area for Medtech innovation. The University of Surrey’s Sleep Research Centre is developing remote monitoring in the use of to support dementia-friendly ‘healthy homes’. AI sensors to track sleep and circadian rhythms. This will provide the data to develop interventions for patients and their carers to use – such as staying awake for a little longer, spending more time outside during the day, or changing the light in their living environment. The aim is to enable people to live in their own homes for as long as possible. Professor Derk-Jan Dijk has said that they are using AI sensors to track sleep and circadian rhythms. This will give us the data to develop interventions for patients and their carers to use with the aim to enable people to live in their own homes for as long as possible.
The results published in the Lancet Psychiatry show significant reductions in the avoidance of everyday situations and distress
Fourthly, we are increasingly seeing the value of point-of-care diagnostics across mental health services. An example is Early Intervention Psychosis Services, which are internationally seen as an effective public health prevention model, for early treatments to reduce morbidity. Medtech allows clinics to adopt psychical health diagnostics such as blood tests in a one-stop environment speeding up treatment and reducing harm. An example with patients who have a treatment-resistant Schizophrenic illness taking Clozapine, which as well as being the most effective medication, has life-threatening side effects. The tech ensures the treatment is safe for patients and any side effects are managed, with up to weekly blood tests, so that patients can be in a community setting.
In conclusion, this article has given examples of how Medtech is currently making an impact on 21st Century mental health care. The plan for a digital NHS has been articulated in the ‘The Topol Review (2019)- Preparing the healthcare workforce to deliver the digital future’ which gives a future direction for those readers interested.
