Take Two Apps And Call Me In The Morning

By Michael Grothaus

To help tackle depression among teens, Britain’s National Health Service wants to meet them on familiar territory: by prescribing them apps.

Depression is the most common type of mental illness, affecting some 350 million people globally and contributing to other problems like obesity, cardiovascular disease, and cancer. But it often goes undiagnosed, and once you know you suffer from it, sometimes the most difficult part of treatment is just being able to regularly sit down on a therapist's couch.

That’s why Britain’s National Health Service has begun encouraging doctors to prescribe people suffering from depression—and teenagers in particular—a thoroughly modern kind of treatment: apps.

Norman Lamb, Minister of State for Care and Support in the U.K., told The Times last week that treatment-by-app was a way of meeting teens on familiar ground.

"If you’re a teenager and your world revolves around digital access, we must make sure you get access to therapy online. So these programs are being developed."

Using Apps To Treat Teenage Depression

The initiative—which involves a doctor prescribing an app alongside medication or face-to-face therapy sessions—is meant, says Lamb, to achieve "a much more seamless service that allows you access online, face to face or over the telephone, whichever is appropriate."

After a diagnosis, a patient may still be given a course of medicine and offered face-to-face cognitive behavioral therapy sessions. But under the new program, the doctor also now has the option of medically prescribing an app to help with treatment.

One in 10 British patients are waiting for over a year to be assessed for mental health treatment, according to one study. One in six said they had attempted suicide while on an NHS waitlist.

While Britain's nationalized health system hasn't endorsed a single preferred mental health app, it already recommends a handful of apps that allow patients to assess their moods and set goals and reminders—for medication or therapy sessions—that can be sent via alerts or text messages.

Such tools can be helpful in encouraging patients who may be reluctant to attend face-to-face sessions due to shame or embarrassment, or as a stopgap measure, while patients are waiting for treatment—sometimes for over a year.

A recent report by the U.K. coalition of mental health charities We Need to Talk said that one in 10 patients are waiting for more than a year to be assessed for treatment like cognitive behavioral therapy. One in six—thousands of people across the U.K.—have attempted suicide while on an NHS waitlist for psychological treatment, the report said, and two-thirds said their condition had worsened before they had a chance to see a mental health professional.

Lamb has called these long wait times "unacceptable," and said the health agency would be implementing access and waiting time standards for mental health beginning next year.

The app initiative is part of a broader NHS effort to modernize and enhance youth mental health care in Britain, says Lamb, who has also urged doctors against putting patients on anti-depressants as a "sort of default position."

Though using apps as treatment may sound bizarre to older generations of patients and medical professionals, Lamb is quick to point out that there is firm evidence that app-based therapy has been proven to work in expanding access to treatment and to reducing costs.

A Wall, a Buddy, and Games

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That proof comes from, among other places, a web-based and mobile app calledBig White Wall. The app, launched in 2007 by a British social entrepreneur named Jen Hyatt, is a hybrid of a social network and task manager for people suffering from depression and other mental health issues. The site allows users to post thoughts, drawings, and pictures in an anonymized forum that is moderated 24/7, and to advice from experts online, leave reviews of therapists, and take Internet-based cognitive behavioral therapy courses.

The site boasts impressive success rates in helping people deal with their psychological distress, noting that 75% of its members used the site to discuss a mental health issue for the first time in their lives. Eighty percent reported that Big White Wall helped them self-manage their psychological distress, and a staggering 95% of users reported one or more improvements in well-being, according to the company, which also cites peer-reviewed studies on its website. In May it launched a U.S. version.

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Cigna folds GoYou into digital health coaching program Cigna Health Matters

Cigna has developed a digital health coaching program, called Cigna Health Matters, that offers mobile tools, social media engagement, gamification, and web-based incentives. The program is available for Cigna’s 14 million US members on employer health plans.

“Cigna Health Matters integrates the latest insights and practices of the sociology of engagement, motivation and rewarding behavior change with the latest in health tools and technology,” Cigna Vice President of Product Develompent Eric Herbek said in a statement. “By combining clinical insights, health coaches, digital tools, measurement and reward engines, we have our customers’ backs to help them get on the right path, and stay on it, for better health for themselves and their families.” 

The program begins with a gamified online health assessment. After completing the assessment and answering questions about the user’s BMI, cholesterol and blood pressure, members are given a Health Matters Score. From there, as users work on improving their health, their score changes. The score also helps Cigna coaches and clinicians target the members that need the most help improving their health.

Cigna has also curated a health and wellness app store. The store has compiled the “most popular and effective health improvement apps”. Once members have downloaded health apps, they can link those apps to their Cigna Health Matters dashboard and receive various incentives or rewards, depending on their plan.

Some of the features of Cigna Health Matters are similar to those mentioned as part of an initiative that Cigna announced last year: Cigna GoYou. A Cigna spokesperson told MobiHealthNews in an email that GoYou has been folded into Health Matters and renamed.

“The GoYou Marketplace – the curated health/wellness/fitness app store — is a part of the Health Matters ecosystem. We have simply named it ‘Apps & Activities’, which in our user testing was found to be a more easily understood name,” they wrote.

Cigna began working with another company called SocialWellth, as it developed GoYou, and that partnership continues for Health Matters, a Cigna spokesperson confirmed to MobiHealthNews. As we wrote last year: Members will be able to download apps recommended to them based on their Cigna profile, some of which will be marked with an “mWellth certification.”

As part of this announcement, Cigna also released a survey of 1,847 consumers on their health and wellness habits. Cigna found that 83 percent of respondents are taking steps to improve their health and of this group just 22 percent are using some kind of an online tool to do so.

In May, Cigna partnered with Samsung to launch a feature on Samsung’s S Health app called Coach by Cigna, which will launch exclusively on the Galaxy S5. The platform is being launched in 36 countries and 26 languages. The software, which Cigna describes as a “digital health guidance system,” will incorporate health information collected either manually through the smartphone or via sensors in the Galaxy Gear or Gear Fit. It will use that information to generate a personal health coaching regimen for users.

http://mobihealthnews.com/37345/cigna-folds-goyou-into-digital-health-coaching-program-cigna-health-matters/