Digitizing Mental Health Support Through Internet- Delivered Cognitive Behavioral Health (icbt) Technology

Transcription

1 Digitizing Mental Health Support Through Internet- Delivered Cognitive Behavioral Health (icbt) Technology Session 207, Thursday, February 14, 2019 Joe Blomeley, Senior Vice President, Public Sector and Ontario Region Morneau Shepell l 1

2 Conflict of Interest Joe Blomeley, Morneau Shepell Has no real or apparent conflicts of interest to report. 2

3 Agenda Current mental health challenges What is icbt? Digital behavioral health What the research says Opportunities for organizations 3

4 Learning Objectives Identify how icbt technology can provide a better user experience and increase the likelihood of users successfully completing their therapy plan Define the development of effective, clinically sound, and accessible icbt programs for mental health support Recognize how behavioural health solutions that are delivered digitally have broad appeal for those eager to access nontraditional forms of treatment for mental health issues 4

5 Mental health issues continue to rise - Not sustaining the increase Public and private health care systems cannot meet the demands economically or operationally Rapid technological growth CBT Emerging as an in-demand, respected, measurable, effective, and validated behavioural health approach Thoughts Emotions Physical Symptoms Behaviors 5

6 Mental Health Challenges in Both Public and Private Psychological benefits Disability Health Care Fragmented Pockets of excellence employee selects who they want to see (lots of variation in practice) is the same issue as psychological benefits no over site or standard of practice gaps, wait lists, not enough expertise in all locations on public and private health = disorganization of health care and we are not doing as well as we could be hard to ensure a standard of practice in all location and with all diversity issues 6

7 Multiple Factors are Driving the Need for icbt Consumers Insurers What EVERYONE wants: Increasing demand from consumers for easily accessible, digitally-driven MH products Employers Dealing with spiraling MH disability, productivity and drug costs Need to better support MH related disability cases. Need to modernize paramedical benefits Public Healthcare Public systems are over-burdened, fragmented and under-equipped Clinicallyproven solution Cost effective Easy to access and use User friendly Support mildmoderate 7

8 icbt CBT skill based approach therapy focuses on changing negative thought patterns, emotional responses and behaviors. icbt provides the effectiveness of CBT with the convenience of an online program using online education, videos and assignments guided by a therapist icbt program combines a therapist with a state of the art program to create an effective platform to improve on traditional therapy 8

9 Three Pathways to Access icbt Self Directed Clients learn about icbt through their workplace promotions or self-initiated search for help. EAP Referral Clients are triaged to icbt via the EAP (if appropriate) and employers have icbt as part of service contract. The icbt journey Case Manager Referral Clients are referred to icbt by a case manager as part of a disability management case. 9

10 Emerging Health Trend Vertical Integration will transform the healthcare landscape Platform Solution move from point solutions to platform solutions for healthcare Patient & Consumer engagement AI & New Technology interactive voice, blockchain Technology 10

11 Digital behavioral health opportunity Accelerated assessment and treatment A whole-person approach to client/patient care in one setting Behavioural health is no longer one-sizefits-all Extending and changing mental health issues Compelling Clinical value of reaching people who would not use traditional supports 11

12 icbt A blended, client-centered approach Clinically validated assessment tool Personalized action plan is created for each case Digital modules for each program with educational content, clinically validated exercises The therapist uses report from the module to guide the treatment plan User receives a final report of progressthey can choose to redo modules An ecosystem that responds 24/7/365 to client needs 12

13 Multiple studies support the effectiveness of CBT Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. 3 CBT was somewhat superior to antidepressants in the treatment of adult depression 3 (In review of) 106 meta-analyses examining CBT showed strong support for effectiveness and support for greater effectiveness than other therapy methods. 2 Cognitive Behavioural Therapy (CBT), has been shown to be effective in activation of cognitive control regions in the brain was in both Major Depressive Disorder and PTSD. 1 13

14 Experts agree: icbt as effective as face-to-face CBT Across all 3 reviews, there is support for icbt as appearing to result in outcomes that may be equivalent to face-to-face care. 4 Janine V. Olthuis, PhD, Assistant Professor University of New Brunswick The answer to the question How effective is guided icbt? is: Just about as effective as face-to-face. 5 The Internet and CBT, A clinical guide. Page 60. Gerhard Andersson PhD, professor, Linköping University, Linköping, Sweden Results of icbt and face-to-face are not significantly different. Supervised icbt seems preferred to assure adherence and promote exposure. 6 Miel Vugts, University of Tilburg, The Netherlands - personal communication 14

15 The opportunities for organizations have significant value A reduction in the duration and cost of absences Cost effective method of supporting employees with proven results Offering employees alternative therapy options Helping employees return to productive health 15

16 References 1. Yang Z, Oathes DJ, Linn KA, Bruce SE, Satterthwaite TD, Cook PA5 Satchell EK, Shou H, Sheline YI. Cognitive Behavioral Therapy Is Associated With Enhanced Cognitive Control Network Activity in Major Depression and Posttraumatic Stress Disorder.Biol Psychiatry Cogn Neurosci Neuroimaging Apr;3(4): Hofmann SG1, Asnaani A, Vonk IJ, Sawyer AT, Fang A.(2012) The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses Cognit Ther Res Oct 1; 36(5): Butler AC1, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses, Clin Psychol Rev Jan;26(1): Olthuis, Janine V., PhD, Assistant Professor University of New Brunswick 5. Andersson, Gerhard, PhD, professor, Linköping University, Linköping, Sweden. The Internet and CBT, A clinical guide. Page Vugts, Miel, University of Tilburg, The Netherlands - personal communication 16

17 Questions Barb Veder Joe Blomeley Please remember to complete online session evaluation you have just participated in session

18 Multiple Choice Question #1 In high-income countries, what percentage of people with mental disorders do not receive support for mental health concerns? 18

19 Multiple Choice Question #2 The measures of icbt success should include: A. Symptom reduction B. Reduction of wait times for issue assessment and program support start C. Improvement in overall function level D. None of the above E. All of the above 19

20 True/False Question icbt can be as effective as in-person treatment modalities 20