New Savoy Conferences presents Disrupting IAPT How do we digitize the pathways to talking therapy?
Monday 10 December 2018
De Vere West One Conference, London
Follow the conference on Twitter #digitalIAPT2018
The world has changed over a generation … in our coming generation, as we live through the march of the machines, our lives will be increasingly defined by our emotional capabilities more than ever as the machines take on the cognitive tasks … as our lives have moved from the physical to the cognitive and now to the emotional, its natural and right that our healthcare must shift more to the emotional … and so our mental health services must be less about the medicinal and the pills and more about people as people
Rt Hon Matt Hancock MP, Secretary of State for Health, World mental health day 2018
The new Secretary of State for Health and Social Care is an evangelist for digitization. He made his “unsurpassable enthusiasm” clear in his speech at NHS Expo 2018. Evangelist though he is, he is far from starry eyed: “the NHS is at the same moment the world’s biggest opportunity for saving lives through modern technology, and the world’s most frustrating place to work for its IT. The power of genomics plus AI to use the NHS’s data to save lives is literally greater than anywhere else on the planet. Yet our hospitals operate dozens of systems each, that don’t talk to each other. GPs, social care, pharmacies and community care are on different systems … its clunky, clunky, clunky.” Secretary of State, 6th September, 2018
From the point of view of digital innovators and commercial providers of digital mental health products, although they won’t say this in public, of course, the NICE/IAPT axis has put the brakes on digitizing IAPT. The regime NHS England has set up in order for them to qualify for investment places serious hurdles in the way of rapid transformation. It certainly fails the first test for the Health Secretary: “the biggest risk is not driving digital transformation”. It would take a brave local commissioner to risk serious investment in something digital outside of a very small number of incumbent NICE-approved products. And this fact alone suits the pharma companies, whose marketing budgets are behind the only products big enough to get around the NICE/IAPT axis, and to secure what is effectively a blank cheque signed off by their local medical committee. It is a system designed to do the opposite of what the Health Secretary says he wants: “mental health services [that are] less about the medicinal and the pills and more about the people as people”.
Even Simon Stevens – the so-called Sun-King of Skipton House – normally the most astute of players in the game, does not know how to resolve the current impasse in mental health, where transformation has stalled, and major structural problems stand in the way of reform. [Shifting money from acute/physical to community/mental; a workforce on the frontline of IAPT that is more stressed and depressed than its patients; and stakeholders who are no longer willing to put up with meaningless spin about 1 million more patients being ‘treated’, to name just three]. His own attitude to digital is clearly skeptical to say the least. Whether his proposal to levy a tax on social media companies like Facebook, in order to pay for CYP IAPT (children and young peoples’ IAPT) is realistic, though, is probably about as doubtful as a tax levy on Big Pharma to pay for adult IAPT. Pharma is the single biggest beneficiary of our once-radical Talking Therapies revolution. And because they remain the default Step 1 in IAPT’s stepped care model, all the new investment promises to stem the tide, for example, of self-harm rates in young women, will get quickly eaten up unless Digital IAPT offers something far, far better.
So if the system leadership has little to offer where do we look to for a reason to be cheerful? New Savoy events have consistently argued we should trust the people and the practitioners on the front line, together with the best amongst our independent scientists. How can experts by experience and service users be at the forefront for driving digital transformation? How can choice and shared decision making be harnessed to drive forward reform? We start our day with two speakers who are pioneering exciting new ways of giving people a real voice in mental health services using digital technologies to create impact. Mark Brown is the founder of the former social enterprise One in Four, which was the first real service user led project to put mental health on the map. Pip Hardy is the Co-Founder of Patient Voices Programme, one of our genuinely world-leading innovations, making a difference by articulating patient experiences of mental health services.
Our afternoon sessions offer a combination of something old, something new, something borrowed, something blue. Digital psychoanalysis sounds like an oxymoron: the most traditional of talking therapies adapted to new technology. But Thomas Hesslow is one of a new breed of psychoanalytic practitioner-scientists who are breaking digital ground. Fola Omotunde, who will tell us about the new digital mental health plan for London, can now boast access to online support for Londoners 24/7, 365 days a year. And Andre Tomlin, whose National Mental Elf Service offers the most accessible up-to-date reports from cutting edge scientists and evidence based practitioners, will present findings about what the top research priorities are for digital technologies in mental health. Finally, our closing panel borrows the title of a somewhat bleak assessment not so long ago from the respected Journal of Mental Health about the minimal beneficial impact of digital solutions to problems such as depression. Is it still the case? We look forward to a lively debate. Jeremy Clarke CBE, Chair, New Savoy Conference