Digital mental health therapies could free up thousands of NHS hours, NICE says

The use of digital therapies for mental health conditions could free up thousands of NHS therapists’ hours, according to the National Institute of Health and Care Excellence (NICE).

Demand for the NHS Talking Therapies service has reached an all-time high, with 1.82 million referrals in 2023/24. This is slightly higher than 2021/2022, and more than double the 884,000 received in 2012/13.

NHS Talking Therapies, a service available only in England, offers therapies such as CBT and EMDR for common mental health conditions, including depression, stress, social anxiety, phobias or post-traumatic stress disorder (PTSD). Although it is an adult service, some programmes extend their support to young people aged 16 and 17. People are able to self-refer to the service.

As more and more people are coming forward to ask for help, NICE has recommended that the NHS offer digital therapies to increase the support available. Evidence from current practice provided by NHS England and analysed by NICE shows that digital therapies recommended for PTSD could save over 5,000 hours of therapist time per 1,000 people. Almost 2,500 therapist hours per 1,000 people could be saved for social anxiety disorders, and 600 for depression, NICE has said, adding that the actual number of hours saved will depend on the proportion of patients who opt to use digital therapies. 

Digital materials are based on CBT

Mark Chapman, director of the health technologies programme at NICE, said: “Mental health services are facing record demand, and these digitally-enabled therapies can help the NHS get support to more people faster. Our rapid assessments show they have promise, and the additional evidence collected during this period will help us make sure that they are clinically effective and represent good value for money for the taxpayer.”

NICE recommends seven digitally-enabled therapies to treat depression and anxiety disorders in adults. The technologies can be used in NHS Talking Therapies while more evidence is generated on their clinical and cost-effectiveness.

The technologies can be accessed online or through apps and include materials based on cognitive behavioural therapy (CBT), NICE said, adding that they must be used with support from a trained practitioner or therapist, who monitors progress, risks, and outcomes.

Commenting on the NICE recommendations, Claire Murdoch, national director for mental health at NHS England, said: “Improving access to mental health care is a top priority for the NHS. The pandemic led to rising pressures, with more people than ever before now in contact with mental health services. NICE-recommended digital therapies can increase the support available to people where appropriate, alongside therapists, and help NHS staff to provide care in a flexible and timely manner.”

NICE also recommends four digital technologies that can help children and young people with feelings of anxiety or low mood, and another four technologies for people with psychosis: three digital therapies to help manage symptoms or prevent relapse in adults, and a virtual reality (VR) technology to treat severe agoraphobia in those over 16. These are based on Early Value Assessments and can be used while more data is being collected on their clinical effectiveness and cost-effectiveness.

Rebecca Morley, specialist committee member and team manager at NHS North Yorkshire Talking Therapies, said: “We consider digital inequalities in terms of accessibility. Clinicians can offer technological support to help patients either enter digitally enabled therapies or maintain them, depending on their needs.”

Dr Maria Loades, a specialist committee member and a clinical psychologist at the University of Bath, said: “We need to be open-minded to these innovations. We need to ensure that choice and flexibility remain in the system, and that human support is available where it is needed and in a timely manner.”