Shortening treatment and waiting times for mental health conditions from 12 months to three months by offering online cognitive behavioural therapy instead of in-person treatment could improve treatment effectiveness, a study has found.
Research by the University of York’s York Health Economic Consortium and Dorset HealthCare NHS Trust found that timely access to mental health services was key to reducing the personal and economic cost of conditions such as anxiety and depression.
The study, which involved analysis of anonymised data relating to 27,450 people and was funded by online therapy provider ieso Digital Health, compared the cost, timeliness and effectiveness of different interventions including online cognitive behavioural therapy (CBT), and those delivered through the NHS Talking Therapies programme, such as in-person CBT, counselling and group therapy.
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It found that online CBT had a ‘dominant’ incremental cost-effectiveness ratio relative to standard care, and had similar clinical effectiveness to in-person treatments but with shorter treatment times.
Online CBT was found to be the most cost-effective option for treating mild, moderate and severe depression and anxiety.
The research, published in Nature, suggested that treatment costs were minimal in comparison to the medical costs and the costs associated with the detrimental effect a mental health condition has on the patient’s quality of life. Greater use of online therapy, which can often be accessed sooner than in-person treatment, could be beneficial for both the patient and the NHS, it also argued.
“The results of this study have particularly important implications for clinical practice, given current global accessibility issues, exacerbated by the global pandemic, in which only a minority of people in need have access to psychological therapy. Internet-delivered CBT and other forms of online therapy have the potential to ameliorate this issue and substantially reduce waiting times, by offering a degree of flexibility that is not available in traditional face-to-face services,” the study says.
Sam Harper, research consultant at York Health Economics Consortium, said: “This report represents our collaborative efforts to develop a new understanding of mental health care that may assist those in charge of commissioning services in this area.
“Whilst comparing online therapy to standard care, the results of our study indicates that the right therapy delivered in a timely manner can increase quality of life and reduce costs for people by utilising real, anonymised patient data to examine how people’s treatment outcomes are related to the therapy they received.”
ieso’s executive vice president of impact Andrew Welchman said: “Modelling real-world healthcare data in this way, allowed us to show how important it is to provide rapid access to effective mental health treatment.
“Further to this, the study has provided important insights into the key factors influencing health and economic outcomes. As this data was used to track individuals through their treatment in a real-world setting, it provided information on number of sessions, waiting times, treatment requirements, and engagement with treatment, which reflected true human behaviour in a clinical practice.”
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