Digital CBT can significantly relieve anxiety and depression, Trinity study finds

16th June 2020

Digital mental health interventions can have a significant long-term impact on anxiety and depression recovery, newly published research undertaken in collaboration with the School of Psychology at Trinity College Dublin has found.

The study, published in the Nature partner journal Digital Medicine, involved more than 360 NHS service users in the UK. It was undertaken by SilverCloud Health, the world’s leading digital mental health company, with the School of Psychology at Trinity and health economics analysis from the University of Sheffield. As part of the study a treatment group was given eight weeks of supported digital mental health intervention to treat depression and anxiety, compared with a waiting list control group that did not receive the treatment initially.

Published at a time of increased anxiety and impact on mental health from the COVID-19 pandemic, the research emphasises how digital cognitive behavioural therapy (iCBT) as part of wider psychological care can deliver strong clinical improvements and recovery. In addition to patient self-reported outcomes, the study included a formal diagnosis of depression and anxiety and results show that more than half of those with a diagnosis of anxiety and/or depression recovered after three months.

Psychiatric interviews of participants at three months after treatment found that, overall, 56.4% no longer had a diagnosis of anxiety, depression or a joint diagnosis. A further significant decrease in symptom scores was seen after 12 months.

The findings come as mental health providers anticipate a significant increase in a range of disorders linked to anxiety and depression stemming from the pandemic and emerging as the lockdown continues to ease. The potential triggers include grief, job loss, and insecurity, loneliness and isolation. 

Dr Derek Richards, Chief Science Officer at SilverCloud Health and Co-Director of the E-Mental Health Research Group, Trinity College, said:

“This is an important, large-scale research that demonstrates how digitally-provided cognitive behavioural therapy can enhance a wider mental health therapy programme calibrated to an individual’s needs.

“Due to its results on long-term improvement, recovery and cost-effectiveness, at a time of increasing demand for psychological and behavioural healthcare, digital mental health care should be viewed as a standard part of psychological support and no longer simply as an innovative approach.

“As a result of the global pandemic, many individuals within communities are facing mental health challenges and iCBT can play an important part complementing current mental healthcare services, increasing their reach and capacity, and helping support and treat more people.” 

 Notes:  

E-mental health group, School of Psychology, Trinity College Dublin is a leading research group on digital mental health interventions.  The main aim of the group is to be a world leader in the science and practice of e-mental health interventions. The areas of research interest for the group include digital mental health interventions efficacy and effectiveness, qualitative experiences of service users and supporters, cultural adaptation and personalisation of interventions, Implementation science & practice, ??natural data analytics and data mining, performance and learning, and device integration and experimentation. The group are involved in a large and broad portfolio of projects across Europe and US and collaborate with leading academic and research institutions. https://www.ementalhealthgroup.com/

SilverCloud Health is the world’s leading digital mental health company, enabling healthcare organisations to deliver clinically validated digital health/therapeutic care that improves outcomes, increases access and scale while reducing costs. The company’s multi-award-winning digital mental health platform is a result of over 16 years of clinical research with leading academic institutions. Today, SilverCloud is being used by over 250 organisations globally to meet their populations’ mental health needs.  https://www.silvercloudhealth.com

Digital Therapeutics – Blip or Lasting Trend?

Healthcare IT Today

Prior to COVID-19, mental and behavioral health was gaining momentum as a healthcare priority. Funding was starting to flow into mental health services and the technologies to support it. One of those technologies was telehealth – an effective way for patients to “visit” with their Psychiatrist. Another was digital cognitive behavior therapy solutions (digital therapeutics) which allow providers to treat more patients more effectively. Then the pandemic arrived and mental health became even more important.

Dr. Derek Richards, Chief Science Officer at SilverCloud Health, a company that creates internet-delivered cognitive behavioral therapy programs, was kind enough to answer a battery of questions in an email interview on the topic of digital mental health, cognitive therapy and digital therapeutics.

What is digital cognitive behavior therapy?

Generally speaking, digital therapy offers three benefits that are of high interest to healthcare providers who operate on the one-to-one therapy model: scalability, accessibility and affordability. Simply put, it allows them to increase the number of patients they see; the platform circumvents traditional barriers that prevent access to mental health therapy, and it dramatically decreases care delivery costs (91% reduction compared to face-to-face therapy). In the U.S., as many as 43.8 million adults will experience some form of behavioral or mental illness in a given year. In 2018, 56 percent of those wrestling with these mental difficulties did not receive care because of treatment barriers, including stigma, limited or exhausted budgets, and geographic remoteness – that’s over half the mental illness population.  Mental therapy is in need of a transformation, and digital therapeutics are a proven alternative.

Is digital therapy as effective as face-to-face?

SilverCloud’s platform is built on an extensive research base with over 30 peer reviewed clinical studies over nearly two decades. Through several randomized control trials (RCT), we have demonstrated that our programs are extremely effective and provide clinical outcomes that are equivalent to similar interventions delivered in face-to-face therapy. SilverCloud delivers structured brief interventions for the treatment of common mental health disorders including depression and anxiety.  They also have a suite of programs that address personal wellbeing and functioning such as stress management, sleep management, and resilience. These interventions are reflective of many types of interventions delivered in face-to-face services either in 1:1 formats or groups.  We have demonstrated equal effectiveness with similar evidence-based interventions delivered 1-to-1 and in group settings.

Is there any difference in the treatment received digitally? 

The treatments that are delivered online are identical to those that would be delivered in person.  Essentially as clinicians, we have a repertoire of empirically supported treatments that have been developed through research and practice over many decades.  They describe the treatment components and what works best for whom giving the presenting issues and difficulties.  It is from this repertoire that the active ingredients of treatment are composed and delivered for effective clinical outcomes. Therefore, apart from the mode of dissemination, we are delivering standard evidence-based psychological treatments.

What mental health services are most in-demand right now because of COVID-19?

At this current time, we are experiencing a pandemic like most have never witnessed before.  That alone raises the levels of distress and stress in the population. The various community initiatives to support the effective management of the COVID-19, including cocooning, social distancing, and the closure of many places of businesses and leisure pursuits will inevitably have its impact on people’s general wellbeing and their mental health.  These initiatives, while important and necessary, have a direct impact on our sense of selves, who we are, our social lives and also whether we are employed in meaningful and purposeful pursuits.

Stress management, resilience and sleep management have all been in high demand.

What is SilverCloud experiencing during this pandemic?

Due to the closure of mental health services, SilverCloud is being deployed more than ever before to maintain continuity of service provision.  This continuity helps to support those with serious and long-term mental health conditions that require ongoing management.  However, in addition and with the prospect of service doors remaining closed for the coming months, many health systems are leveraging SilverCloud to provide for the treatment of common mental health concerns such as depression and anxiety disorders. It is likely that these concerns will become more prevalent in the coming months as people face the ongoing consequences of loss and dislocation that we are experiencing.

One of the main advantages of digital is the ability to rapidly develop new content and deploy that at scale.  To that end, we have built new content specific to COVID-19.  The content is underpinned by the latest research in emergency psycho-social response that implicates the principles of mental health first aid.  The content builds on Hobfoll et al. (2007) 5 principles for intervention development during emergencies and mass violence: A sense of safety, a sense of calming, a sense of self-efficacy and collective efficacy, connectedness and hope.  We have delivered this globally, across our partnerships and networks, with particular emphasis on supporting frontline health care workers.

Is the growth that we are seeing in digital therapeutics and mental health services a blip or is it a sustained trend?

As it relates to COVID-19, we believe the heightened need for mental health therapy will sustain for quite some time for a variety of reasons. It is likely that the worsened socioeconomic conditions that will follow the crisis will have lasting effects on society, and consequently, it will be imperative that we have treatment options available to everyone who is in need. Digital therapeutics scales treatment beyond traditional one-to-one therapy models and bridges the gaps that healthcare providers and patients experience when trying to access mental health care. We believe the power and clinical outcomes of these programs will be realized even further after the COVID-19 dust settles, and we hope that those who are struggling with mental difficulties will continue to turn to digital therapeutics for treatment.  We have 20+ years of research supporting the effective and safe delivery of digital therapy for mental health, and the current circumstances only highlights how important it is that we have digital mental health solutions like SilverCloud available as part our treatment initiatives.

To learn more about SilverCloud Health, visit their website at https://www.silvercloudhealth.com/

This article is part of the #HealthIT100in100

SilverCloud Health Announces $16M Series B Funding for Digital Mental Health Platform

SilverCloud Health, the world’s leading digital mental health platform for providers, health plans and employers is to enhance its range of therapy programmes in the UK as part of expansion plans after securing $16m (~13m pounds sterling) funding from leading health investment groups. 

The new funding round will see the company further developing its innovative approaches to therapy, addressing the range of psychological conditions across all age groups. This will include the UK and Europe, and also further expand the geographical reach of its services in the US.

Founded in 2012, SilverCloud’s mental health programmes are used globally by more than 300 organisations including more than 70% of NHS mental health services. It offers more than 30 mental health programmes across the spectrum of mental health from wellness and resilience, through to severe mental health and chronic concerns.

“We are committed to providing truly impactful mental health support to all those with need,” said Ken Cahill, CEO of SilverCloud. “The need has never been greater than during this unprecedented global crisis. SilverCloud enables easier, earlier access to clinically validated mental health care that shows results equivalent to face-to-face care for the 1 in 5 people with a diagnosable mental health condition. With millions of people being asked to stay home and health systems needing to prioritise care, we recognise the heightened need for virtual support as the world copes with the COVID-19 pandemic. In response, SilverCloud is providing its clients, free of charge, expanded access to its platform to even more healthcare professionals, their families and patients to help make a difference for those in need in the current crisis.”

The new – Series B – funding round, led by MemorialCare Innovation Fund, and which included other US healthcare groups LRV Health, OSF Ventures and Unity Point Health Ventures, has helped raise the company’s total funding to more than $30 million and brings together a group of healthcare investors with extensive experience in the US healthcare market.

It will see the company, which has offices in Dublin, London and Boston, enhancing its current global portfolio, expanding availability of its programme offerings in the US and enabling additional research and clinical trials to be conducted. SilverCloud will also expand its presence in Europe, with new and existing partners like Thieme Telecare, part of the Thieme Group and one of the leading providers of integrated care in Germany. Existing investors ACT Venture Capital and B Capital Group, participated in the round as well.

The SilverCloud platform, used by more than 350,000 users and growing by more than 15,000 users per month, has demonstrated results on par with face-to-face therapy in multiple randomised controlled trials. Beyond its industry-leading results in clinical trials, its real-world evidence demonstrates that more than 65 percent of SilverCloud users have shown significant decreases in depression and anxiety symptoms.

SilverCloud’s programmes are evidence-based and involve clinical experts and users in the design and development of the mental and behavioural health interventions. Backed by over 17 years of research including partnerships with leading academic institutions, SilverCloud has seen exponential year-over-year growth since 2012.

Raj Ganguly, Co-founder and Partner, B Capital Group, said: “Our investment in SilverCloud Health is driven by our confidence in its team, its proven track record working with global health organisations and its esteemed partner network. This new capital will enable SilverCloud Health to continue to innovate, expand and broadly deploy its programmes to the millions of individuals who need them.”

The past year has seen some significant developments for SilverCloud. In October, it announced a research partnership with Microsoft to improve outcomes through artificial intelligence, based at Microsoft Labs in Cambridge, England. In December, it was announced that the SilverCloud platform would be included in digital health formulary of ExpressScripts, the largest independent manager of pharmacy benefits in the US.

This further shows how digital therapeutics solutions are becoming a critical component of mental health treatment and support, and how SilverCloud is determined to stay the leader in delivering outstanding outcomes. More than 94 percent of users of SilverCloud’s scalable and responsive platform said the programmes are helpful, relevant and supported them toward their goals. 

About SilverCloud Health

SilverCloud Health is the world’s leading digital mental health company, enabling providers, health plans and employers to deliver clinically validated digital health/therapeutic care that improves outcomes, increases access and scale while reducing costs. The company’s multi-award-winning digital mental health platform is a result of over 17 years of clinical research with leading academic institutions. Today, SilverCloud is being used by over 300 organizations globally to meet their populations’ mental health needs. Global experts have deeply validated the platform through full randomized control trials and real-world data from over 350,000 SilverCloud users. The platform continues to lead the industry with its effectiveness, engagement, and range of clinical programs that encompasses the spectrum of mental health needs.

About MemorialCare Innovation Fund

MemorialCare Innovation Fund (MCIF) brings strategic investment funding to accelerate the development of companies in the healthcare information technology, healthcare services, and medical device sectors that can advance high-quality, effective healthcare. MCIF is focused on companies offering innovative products, services and technologies which help healthcare systems significantly improve performance and outcomes and achieve their community missions.

About B Capital Group

B Capital Group is a global firm specializing in equity investing in venture and growth-stage companies that have achieved traction with customers. Through our extensive global network and exclusive partnership with The Boston Consulting Group, B Capital helps high growth start-ups navigate business challenges, raise capital and attract talented leadership at key points of their journeys to scale. With offices in San Francisco, New York, Los Angeles and Singapore, B Capital believes innovation can come from anywhere. Our unique multinational presence and deep industry knowledge have enabled us to build a portfolio of B2B and B2B2C start-ups that are transforming large traditional industries across borders and geographies. Portfolio companies include AImotive, Atomwise, Blackbuck, Bounce, Bright.md, CXA, Evidation Health, Icertis, INTURN, Plastiq, Ninja Van, Notable Labs and SilverCloud Health.

About LRVHealth

LRVHealth is the “Inside Healthcare” venture capital platform. LRVHealth’s investors include leading provider, payer, and vendor organizations, comprising a network that touches one in three healthcare consumers across the U.S. Together, this network collaborates to identify, invest in, and adopt innovative solutions to the industry’s most pressing needs. Founded in 2000 by an experienced team of healthcare investors, operators, and advisors, the LRVHealth team provides early stage capital, operating experience, and industry insights to build the next generation of great healthcare companies.

About OSF Ventures

OSF Ventures specializes in venture optimization, partnering financially and operationally in companies that improve patient outcomes and reduce costs to health care systems. OSF Ventures is a division of OSF HealthCare.

About Unity Point Health Ventures

Founded in 2019, UnityPoint Health Ventures makes direct investments in ideas and partners that provide an easier, more personal experience for patients and providers. As the venture capital arm of UnityPoint Health – one of the nation’s most integrated health systems – the firm invests in opportunities that improve patient outcomes and reduce the cost of health care. In addition to strategic investing, UnityPoint Health Ventures provides dedicated resources to accelerate portfolio company traction within UnityPoint Health and beyond. Through relationships with more than 315 physician clinics, 21 regional and 19 community network hospitals in metropolitan and rural communities and home care services throughout its 9 regions, UnityPoint Health provides care throughout Iowa, western Illinois and southern Wisconsin.

About Act Venture Capital

Act Venture Capital is one of the longest established VC firms based out of Ireland. We partner early with visionary founders and support them from inception to scale, and beyond. Act has raised €500m across multiple funds and this investment is made from its fifth expansion fund, Act V.

SilverCloud and Microsoft apply AI smarts to digital therapeutics

SilverCloud and Microsoft apply AI smarts to digital therapeutics

Digital mental health company SilverCloud Health has partnered with Microsoft Labs in Cambridge to explore how machine learning and artificial intelligence (AI) could be used to personalise mental healthcare.

Together, the companies are researching how digital therapeutics could be tailored to respond to each individual’s unique care needs.

This includes providing early interventions that ensure patients have access to the right support at the right time, and in the right context.

By applying machine learning and AI, Microsoft and SilverCloud hope to identify patterns of successful therapy that can be used to improve the effectiveness of digital therapeutics.

Christopher Bishop, lab director for Microsoft Research in Cambridge, said: “SilverCloud Health is one of the very few digital mental health platforms that has been deployed at scale in routine clinical care, and currently has the largest real-world patient user base of its kind.

“The aim of this project is very much aligned to our ambition to empower healthcare workers and patients through access to effective, intelligent technologies.”

SilverCloud Health offers more than 30 digital therapeutics programs.

Its digital mental health platform is used across 75% of NHS mental health services in IAPT (Improving Access to Psychological Therapies), and 250 organisations globally.

The platform is designed to remove the barriers that prevent patients from accessing mental health services.

These can include cost and clinical resources.

The company has been working with Microsoft Labs in Cambridge over the past 18 months as part of research that combines Microsoft’s machine learning and AI technologies with SilverCloud’s expertise in digital therapeutics.

The project will use data from more than one million hours of therapy delivered by SilverCloud since 2012, which it hopes will “change how online therapy is delivered for the NHS.”

Ken Cahill, CEO of SilverCloud Health, said: “Through this exciting research collaboration with Microsoft, SilverCloud Health will be able to leverage the latest in artificial intelligence and machine learning to further enhance our digital mental health platform.

“This truly is therapy for the 21st century; enabling more personalised treatment, earlier and easier access, and most importantly delivering ever increasing clinical outcomes.”

Digital therapeutics are increasingly being recognised for their effectiveness in improving access to mental health services.

In August, the University of Central Lancashire became the first UK university to offer digital therapy training as part of its curriculum.

This will be delivered in partnership with SilverCloud Health.

SilverCloud Health Collaborates with Microsoft in Pioneering Artificial Intelligence Research to Deliver More Effective Digital Mental Healthcare


BOSTON, Oct. 2, 2019 /PRNewswire/ — SilverCloud Health, the world’s leading digital mental health company, today officially announced its research collaboration with Microsoft to further enhance its online offering with artificial intelligence (AI).  SilverCloud and Microsoft have been working together over the past 18 months conducting research that combines Microsoft’s cutting-edge machine learning and AI technologies with SilverCloud’s expertise in real-world delivery of evidence-based interventions and mental health outcomes.

Mental illness is a significant disease and economic burden; one in four adults globally are affected by a diagnosable mental health condition in any given year but access to mental healthcare is often unavailable because of long wait times or under-staffed care organizations. The delivery of care online helps to overcome these barriers. 

SilverCloud’s digital mental health platform is deployed globally in routine clinical care providing coverage to 65 million people today. With over one million hours of therapy delivered since spinning out from research in 2012, the breadth of this data provides a unique opportunity for this deep research collaboration.

Together, Microsoft and SilverCloud will explore the use of machine learning and artificial intelligence to accelerate the understanding and delivery of personalized mental healthcare that responds to each patient’s unique situation, including early interventions to optimize clinical outcomes, thereby ensuring patients have access to the right support and content at the right time and in the right context. Further opportunities also exist in identifying successful patterns in therapist/coach behavior to improve therapeutic effectiveness.

“SilverCloud Health is one of the very few digital mental health platforms that has been deployed at scale in routine clinical care, and currently has the largest real-world patient user base of its kind,” said Christopher Bishop, lab director, Microsoft Research, Cambridge, UK. “The aim of this project is very much aligned to our ambition to empower healthcare workers and patients through access to effective, intelligent technologies.” 

“Through this exciting research collaboration with Microsoft, SilverCloud Health will be able to leverage the latest in artificial intelligence and machine learning to further enhance our digital mental health platform,” said Ken Cahill, CEO of SilverCloud Health. “This truly is therapy for the 21st century; enabling more personalized treatment, earlier and easier access, and most importantly delivering ever increasing clinical outcomes.”

SilverCloud is an evidence-based digital mental health platform that removes many of the barriers that prevent patients from accessing mental health services, including cost, access, clinical resources and stigma, enabling healthcare institutions to deliver clinically validated digital therapeutic care that improves outcomes and lowers costs. The company currently offers a comprehensive library of 30+ programs supported by 16 years of clinical and academic research and backed by more than 16 published papers. The company works with over 250 organizations, with over 65 percent of their service users showing a clinically significant reduction in symptom scores.

Read Microsoft’s Blog for more information. 

About SilverCloud Health

SilverCloud Health is the world’s leading digital mental health company, enabling healthcare organizations to deliver clinically validated digital health/therapeutic care that improves outcomes, increases access and scale while reducing costs. The company’s multi-award-winning digital mental health platform is a result of over 16 years of clinical research with leading academic institutions. Today, SilverCloud is being used by over 250 organizations globally to meet their populations’ mental health needs. Global experts have deeply validated the platform through full randomized control trials and real-world data from over 290,000 SilverCloud users. 

The platform continues to lead the industry with its effectiveness, engagement, and range of clinical programs that encompass the spectrum of mental health needs.

Anxiety in men: you may not know you have it

That tickly cough, excessive drinking — signs of a male mental health crisis can easily be missed

I still remember the cough. Furry, tickly and utterly unresponsive to intervention by all manner of syrups, linctuses, pastilles or lozenges. Then I saw the NHS posters. If you have a persistent cough, they warned, it may indicate something more serious. The accompanying photo was of a grey-skinned man apparently spluttering his way to the knacker’s yard. I went to the doctor fearing the worst. Within five minutes she had ruled out any physical ailment, but fortunately she was cannier than most GPs. She saw how anxious I was.

“You look worried,” she said, and after she walked me through a timeline of my ailment’s development I realised it had begun soon after I had proposed to my then-future wife. “Do you think the wedding preparations are getting on top of you?”

They were. We were blending two families and I was worried about how our respective children would get on.

I went home and, interrupting the jovial prenuptial mood, encouraged everyone to address these issues. Gradually, the cough went away.

The anxious cough illustrates a problem that mental-health practitioners are only now waking up to: anxiety can show itself very differently in men than it does in women. In the UK, statistics suggest that misreading symptoms may be leading to misdiagnosis or even no diagnosis. NHS figures show that one in five women suffers from anxiety or depression compared with one in eight men. And yet men are three times more likely to take their own lives, with suicide the biggest killer of males under the age of 49. They are also three times more likely to become alcohol-dependent or report frequent drug use.

“Male anxiety and depression present in a completely different way to women, and it’s a scandal how this means they are all but ignored,” says Martin Pollecoff, the chairman of the UK Council for Psychotherapy. “If you look at the Diagnostic and Statistical Manual of Mental Disorders, which is the bible for diagnosing mental-health conditions, there are 800 pages of symptoms women will readily recognise because they express feelings, but few for men, whose behaviours under stress can be quite displaced. It’s a terrible thing to say, but women feel and men act out. They slope off to the pub, smoke a joint, start a fight, see a prostitute. Anxious men tend to lose themselves. And then the awful thing is, their anxiety is not diagnosed and we end up in this terrible situation where the first time we know something is wrong is when they take their own lives.”

Dr Billy Boland, a consultant psychiatrist and the chairman of the faculty of general adult psychiatry at the Royal College of Psychiatrists in London, says that, despite some high-profile figures coaxing men to explore their feelings more openly, there is still a significant stigma attached to men’s anxiety.

“Men may admire celebrities like the [former] footballer Rio Ferdinand talking about his mental-health issues, but you have to remember that such figures are rarefied and more difficult to relate to than, say, male friends seen socially or at work. Men may take their cues from their immediate social circle, and broadly there remains a culture of shame around male anxiety. This can have a further effect; men go into denial and don’t even acknowledge their symptoms. It’s surprising how often men don’t even realise they are anxious and depressed, let alone that they can be helped.”

We all need a level of anxiety to function. It’s how children get delivered to school on time, jobs get done and bills get paid. One of the problems is deciding what is productive and what is destructive anxiety, Boland says.

“If I wasn’t slightly anxious about paying my mortgage then I might not bother getting out of bed and going to work. A certain level of anxiety is productive. But a man suffering headaches or muscular pain that doesn’t seem to have an obvious cause — that is possibly displaced anxiety in some way and it can be quite hard to diagnose the underlying problem. For me, the key to it all is conversation. Often it takes a friend or loved one to notice an ailment or perhaps increased risk-taking behaviour, such as drinking. It’s them who will say, ‘You know, you don’t seem quite yourself and I think we can do something to improve things.’ ”

Four years ago Henry Hobson, 44, a communications manager for a large retailer, thought he had developed a drink problem. He had almost convinced himself it was time to attend Alcoholics Anonymous. It was only after his wife suggested he see a therapist that he discovered that the truth was more nuanced.

“My dad had become very ill and died very quickly of cancer the summer before. I wouldn’t say I was particularly buttoned up. I took time off and felt I had grieved,” Hobson says. “But actually I really hadn’t got over it. Or, more to the point, my grief had evolved into a fear of me or my wife and kids dying. I was used to being in control and thinking life was something that would go on indefinitely, but the way my dad was taken away from us seemed so random. It really shook me. My world got smaller. I lost the lust for life I’d had before.

“Drinking was a way of taking the edge off my anxiety, but also driving my family away until I could come to terms with the randomness of my loss. But it was a huge relief to realise that I wasn’t an alcoholic. Anxiety is this sort of vague, gnawing monster and I don’t think men are very good at realising they are in its grip until things are bad. My wife used to say I was too proud to ask for directions when we were clearly lost driving on holiday. Well, I think that goes for getting lost in anxiety too.”

If men are prone to acting out their anxieties, which displacement activities should be seen as acceptable and which ones as diagnosable? One may argue that cashing in one’s pension to buy an Aston Martin, developing a taste for free-fall parachute jumping or wearing an ill-advised toupee are symptoms of male anxiety. Should they be challenged? While the trend is towards encouraging men to be more open and expressive about their feelings, Pollecoff thinks we should respect men’s means of self-expression. In the present cultural climate, he says, masculinity is already under siege.

“Frankly I am sick of hearing all this shit about ‘toxic masculinity’,” he says. “It’s about time we accepted that men, particularly white, working-class men, express themselves in a different way to other men and certainly to most women. Our mental-health diagnostic methods are not built to accommodate them. The fact is that men hate the idea of crying while nursey sits there with a tissue saying, ‘There there.’ If a depressed or anxious man is going to unburden himself, he is more likely to respond to humour.

“There is a great American website called mantherapy.org [the site is hosted by a blustering, fictitious therapist called Dr Rich Mahogany, although, as you click through, it does address serious issues such as addiction and suicide] and it captures exactly what men want. Yes, it’s a bit over the top, but men enjoy humour as a way into their feelings. Too often, because they do not emote in the same way as women, men are seen as the problem. I’m afraid these days we are not fashionable. In the pantheon of modern-day victimhood we don’t even make bronze.”

Improving sleep and taking exercise are standard recommendations for those suffering with anxiety and depression. And, of course psychotherapy, cognitive behavioural therapy (CBT) and mindfulness exercises have their place. One innovation that Boland believes may prove particularly attractive to men is cCBT (computerised CBT), in which patients self-refer and get treatment remotely on their computer or phone. As part of its Improving Access to Psychological Therapies programme the NHS has begun offering various therapies in this way through a service called Silvercloud.

“Men suffering with anxiety can be very private about their feelings,” Boland says. “And though that in itself can be very isolating, ironically some men find remote or computerised treatment less daunting.”

Chris, 37, a management consultant, tried a course of online CBT after a short romantic affair almost destroyed his marriage. When his wife discovered the affair she asked him to leave. Living in a friend’s spare room, he spent many hours working through his issues on a Silvercloud cCBT programme.

“My wife got pregnant. It was unplanned and not great timing for either of us. I already felt completely overwhelmed with the pressures of work and the demands of our two boys, who are 9 and 11 years old. And so what did I do? I got off with someone at a conference. It was such a stupid thing to do and I had plenty of time to think about what was going on in my head after she threw me out.

“Online CBT is fairly anonymous [a clinician checks in every week]. You self-refer, so there’s no embarrassing face-to-face interview and you can access all the tools 24 hours a day. I liked working alone and this thing called the ‘worry tree’ helped me to break down what I was really thinking. I worked out I was blowing everything up because, really, I couldn’t find a way of saying, ‘I really don’t think I can cope with another child.’ Being destructive was the only way I could get my message across. Men are not great at saying what they feel. I’m afraid we tend to lash out instead.”

Using Digital Mental Health Tools Shows Dramatic Cost Savings and Return on Investment for Mental and Behavioral Healthcare

SilverCloud Health Paper Highlights a 91% Reduction in Care Expenditures Compared to Face-to-Face Therapy

SilverCloud Health, the leading digital mental health company, today released a white paper outlining how implementing and scaling digital mental health tools reduces costs and achieves a high return on investment for mental health treatment. Key outcomes from SilverCloud’s paper include a 91% reduction in care delivery costs compared to face-to-face therapy and a ten times increase in patient throughput, while delivering equivalent clinical outcomes.  

These findings are crucial in addressing the healthcare needs of the nearly one in five US adults who live with some form of mental illness, with 56% percent not receiving treatment. Mental health disorders rank as the costliest conditions, totaling more than $201 billion in healthcare expenditure since 2016, with costs nearly 2.5 times higher than any other medical condition. 

90% of Patients Report Decrease in Medical Utilization After Digital Mental Health Treatments 

The paper’s findings, based on a review of over 90 related studies, demonstrate how 90% of patients reported a decrease of an average of 15.7%, in medical utilization following digital mental health treatment. Also, where hospital stays were measured, patients averaged a reduction of 2.52 days following treatment. 

Results clearly demonstrate how the use of Internet cognitive behavior therapy (iCBT) positively affects healthcare spending and care delivery. iCBT is the management of mental health conditions through digital platforms (supported or unsupported) that can be implemented into routine clinical practices—and scaled to increase and complement the reach of existing services. 

Up to 65%+ of SilverCloud Users Report Clinically Significant Reduction in Symptom Scores

For mild to moderate depression and anxiety, SilverCloud’s iCBT-based digital mental health platform was able to generate up to 65%+ reduction in clinically significant symptom scores. At an average cost of $65 per completed treatment, the treatment proves to be significantly lower than the cost of face-to-face therapy, which averages $475 or more per patient based on the same standards. When used as a preventive tool, the SilverCloud platform reduced mental-health related visits to the emergency department by 5%, resulting in upwards of $1,105,000 in savings through preventative care and early intervention.  

“The SilverCloud Health platform is designed to provide earlier and easier access to mental health support, care, and help, which has been proven to have a profound effect on care delivery and treatment adherence,” said Ken Cahill, CEO at SilverCloud Health. “As evidenced in this paper, with the medical cost-offset effect, iCBT in a variety of treatment scenarios has the potential to save the healthcare industry significant costs.”

Offering innovative iCBT treatments, SilverCloud has already improved patient outcomes for more than 200 organizations and over 250,000 users globally. SilverCloud currently delivers the industry’s most extensive content library of 30+ clinically validated mental and behavioral health programs. 

Learn more about how SilverCloud is providing accessible, scalable, digital behavioral healthcare that delivers measurable results and cost savings for partners and the individuals who use its programs at http://www.silvercloudhealth.com.   

Get our latest infographic highlighting the key findings of the ROI paper. Click here to read the white paper in full.

Healthy Minds Creators Unveil mHealth Resource for College Students

The developers of the Healthy Minds Network at the University of Michigan have unveiled Sage, an mHealth platform designed to give college students on on-demand link to mental health education and resources.

By Eric Wicklund

May 28, 2019 – The creators of an annual national survey assessing mental health among college students are rolling out an mHealth tool aimed at giving them on-demand resources.

The digital health platform, called Sage, is designed to provide online education and support to students identified through the Healthy Minds Network as needing those resources. It was developed by Daniel Eisenberg, PhD, a Professor of Health Management and Policy and a Faculty Associate at the Population Studies Center of the University of Michigan, and Sarah Ketchen Lipson, formerly of the U-M School of Public Health and now at the Boston University School of Public Health.

Eisenberg and Lipson created the Healthy Minds Network in 2007. Since then, the annual Healthy Minds Study has been fielded at more than 180 colleges and universities around the country, with more than 300,000 survey respondents.

“After students complete the Healthy Minds survey, they are invited to click on a link to the Sage site,” Eisenberg said in a recent press release. “There, they are shown a curated list of mental health-related resources. The resource list is tailored based on the students’ characteristics and apparent needs.”

The mobile health tool is one of several mHealth and telehealth projects aimed at giving students on-demand access to mental health resources when and where they need help.

Eisenberg is also participating in a research study launched by the Washington University School of Medicine in St. Louis to analyze the effectiveness of an mHealth platform for treating clinical depression, anxiety and eating disorders.

Funded by a five-year, $3.8 million grant from the National Institute of Mental Health of the National Institutes of Health (NIH), the study is expected to draw in some 8,000 students from 20 colleges and universities across the country and will use an mHealth platform developed by Boston-based SilverCloud Health, including a mobile health app, to deliver both self-directed and assisted care management tools.

“Not enough services are available to meet the mental health needs of students on college campuses,” lead researcher Denise E. Wilfley, PhD, the Scott Rudolph University Professor of Psychiatry and Director of the Washington University Center for Healthy Weight and Wellness, said. “We’ve been in contact with many counseling centers on a number of college campuses, and they tell us that increasing numbers of students are struggling with many more problems, including severe problems, and counselors just can’t see them all. Without timely interventions, these problems can have lasting effects on students’ health, social, educational and economic outcomes.”

That, says Eisenberg, is what Sage aims to do.

“Mental health is clearly one of the most important and challenging issues in college student populations,” he said in the press release. “It’s both a problem and an opportunity: there are lots of ways that campuses can and are addressing student mental health, and our hope is that Sage will join the growing list of effective strategies.”

Eisenberg said the resource was first rolled out on a trial basis to U-M students who completed the Healthy Minds Survey, and about half accessed the tool.

“For example, if a student indicates symptoms of severe depression, the suggested resource list would first display mental health services such as CAPS (U-M’s Counseling and Psychological Services) and a suicide prevention hotline,” he explained. “If a student does not indicate any particular mental health struggles, the list would emphasize general wellness resources such as mindfulness and meditation apps. Students can also indicate on the site which types of resources they would like to browse, such as online versus in-person.”

Eisenberg said the platform is strictly educational at present, but could be enhanced with social tools in the future, such as a feature that displays de-identified user reviews of the resources.

Mental health service uses digital platform to support NHS GP service

A mental health service is using the digital mental health platform developed by SilverCloud Health to support a confidential NHS service for GPs in England.

Efficacy is offering doctors using the GP Health Service access to the SilverCloud platform to improve mental health and related conditions.

The GP Health Service was established in 2013 by Lucy Warner and Dr Clare Gerada, a general practice leader who has just been appointed as co-chair of the NHS Assembly.

It aims to help doctors with mental health issues such as anxiety, stress, lack of sleep or addiction, and uses Efficacy. Efficacy, in turn, is working with SilverCloud so GPs can access their mental health and wellbeing programmes when they need them.

Lee Grant, the founder and clinical director of Efficacy, and a practicing CBT therapist, said: “A busy GP, working 8am to 8pm with a family at home, might not be able to make a face-to-face therapy session. The SilverCloud platform makes it possible for them to access the service; and the great thing is that we have found it to be as effective as one-to-one therapy.

“When we asked one of our patients why that was, they said it was because they could access their programme when they needed to. Therapy is not just what happens ‘in therapy’ but the structure around it; and that is very explicit with SilverCloud.”

Efficacy is a firm of independent CBT psychotherapists that holds contracts with insurers, companies and NHS trusts that use its BABCP-accredited consultants to provide psychological services to staff and patients. It has been shown to have an 87% recovery rate for people who complete therapy with them.

Dr Derek Richards, CSO, SilverCloud Health, said: “The SilverCloud platform was chosen because of its breadth and depth of engaging mental health content programmes and support, and also because of its extensive research and evidence-base.”

Efficacy also provides CBT services for the NHS Practitioner Health Programme, which was set up to support hospital doctors in 2008, and the GP Health Service, which was subsequently set up by the same team to work with GPs and GP trainees.

The GP Health Service refers GPs to Efficacy, which assesses the referrals to determine the most appropriate channel through which to deliver CBT: face to face, over the phone, or online using the SilverCloud platform with the support of a senior accredited therapist.

Lloyd Humphreys, head of Europe for SilverCloud Health, said: “Efficacy is a quite exceptional service that gets remarkable results. It is therefore an achievement that they have decided to use our platform to offer digital programmes to clinicians who need them.

“We all know that the NHS is doing an incredible job, often under enormous pressure in difficult circumstances as highlighted in Pulse’s GP Workload Survey which showed that GPs are working an average of 11 hours per day with them believing they are working beyond their capacity. This can have the consequence of increasing levels of stress experienced making it imperative to support and make sure clinicians are looked after properly.

“Along with a host of other initiatives being delivered by the NHS, Efficacy’s use of the SilverCloud platform will make sure that timely and effective support is provided for doctors using the GP Health Service. The impact of protecting the workforce is wide-ranging and SilverCloud is proud to support any initiative that does just that.”

In the latest NHS Staff Survey, two in five (39.8%) NHS staff in England reported that they felt unwell from the stress of their job in the previous year; the highest figure for five years.

SilverCloud Health partners with Inclusion to tackle alcohol problems through digital therapy

Digital mental health platform SilverCloud Health has formed a partnership with Inclusion, part of the Midlands Partnership NHS Foundation Trust and a national provider of mental health and substance misuses services, to develop an online treatment programme for problem drinking.

The NHS Long Term Plan highlights the importance of alcohol and problem drinking. It makes it a national priority to reduce the burden on the NHS, in the form of alcohol-related A&E visits and an increased risk of developing other conditions, such as cardiovascular disease, cancer and liver disease.

The plan aims to increase the number of alcohol care teams, to improve the continuity of care, and to create a better interface between NHS, local authority and public health initiatives.

The role of digital therapy is a common theme throughout the NHS Long-Term Plan, and it also highlights the importance of technology-enabled care for people with alcohol issues, particularly in behavioural change.

SilverCloud Health will be adding the Inclusion alcohol programme to its extensive library of more than 30 programmes and modules. Dr Lloyd Humphreys, head of Europe for SilverCloud Health, said:

“Alcohol is a pervasive issue for many with mental health problems and is now receiving attention from the secretary of state for health and social care in the NHS Long Term Plan. This latest addition to our platform will help many people actively address some of the contributing factors to their emotional wellbeing and reduce the delays in receiving evidence-based treatment.”

SilverCloud is the most comprehensive digital therapy platform. It is used by 70% of mental health services in IAPT (Improving Access to Psychological Therapies), having treated more than 250,000 people globally.

SilverCloud Health has been singled out by the National Institute for Health and Care Excellence (NICE) for its evidence-base and effectiveness. It was awarded the highest grade on its Evaluations Framework for Digital Technologies – Tier 3B – where it was also used as a case study to demonstrate the standards that others should achieve.

It is hoped that this latest programme will reduce the number of people being referred to multiple services due to existing exclusion criteria around drinking and enable them to receive continuity of care through the SilverCloud platform.

Danny Hames, head of Inclusion and sexual health, said:

“Inclusion has developed robust protocols for addressing alcohol problems with service users. Through our face-to-face services, we exceed the national average with regards to successfully treating those with problematic alcohol use.

“We are excited to take these and translate them in to the digital platform provided by SilverCloud. This latest development highlights the cutting-edge service delivery model that Inclusion provides at a national level, and our mission to meet as much need as possible. This programme will be rolled-out to all our services in a phased way.”