Mental health apps – silver bullet or nice-to-have?

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Is technology the silver bullet that can help UK Plc manage its chronic mental health challenge? Sam Barrett takes the pulse of app-based health and wellbeing

It is undoubtedly getting easier to discuss mental health problems in the workplace. However, a stigma still surrounds the topic and the search is on for more innovative ways to support employees. UK and international tech firms are on the case.

Technology is regarded as an ideal medium for supporting mental health, and not just because of its scalable, low cost, according to Jeff Archer, managing director of corporate wellness consultancy The Tonic.

He says: “The most effective interventions are those that are personal. We have our phones with us all the time so having apps on them to support our mental health can be an effective way to make it part of our day-to-day routine. Doing five minutes of mindfulness on the train into work can become a rewarding habit.”

As well as the personal element, the fact that these services are easy to access could mean more employees will use them. There is no need for a referral by a manager or HR colleague and, because the employee is usually regarded as independent of their company, there are no fears around confidentiality.

Social Spider development director Mark Brown says there can be challenges when directing staff to mental health support in the workplace.

“HR often prods employees towards counselling through the employee assistance programme but, while the service is confidential, if the employee feels insecure about their boss’s attitude to mental health, they will be unlikely to want to take this up.”

What is available?

Already there are plenty of examples of technology being used to support employees’ mental health. Many EAP providers have launched apps, enabling employees to access support, including counselling, and resources through their phone.

There are also plenty of mental health related apps, offering everything from mindfulness sessions and self-help to time management and organisational support.

Xerox HR Services senior consultant Chris Evans says these apps fall into two broad categories.

“As well as interventions that can be used when someone is suffering a mental health problem, there’s a huge range designed to maintain good mental health,” he says.  “These can make people more aware of their mental health so that they can take steps to avoid problems.”

As an example he points to an app, Little Nudge, which has been developed to improve health by gently reminding employees to take a break, stretch, drink water and so on. This is now being extended to cover mental health and wellbeing.

Apps can also provide support for problems that can lead to mental illness if left unmanaged. Dr Rajeev Dhar, consultant psychiatrist at Nightingale Hospital in London, says: “Feeling overwhelmed by emails or work can lead to stress, anxiety and depression. There are plenty of apps that can help people plan better to avoid getting to this point.”

Telephone-based services are also common, for EAP sessions and triage. These are based around standardised assessments, PHQ9 and GAD7, which can be used to enable diagnosis of mental health disorders. Evans says: “Employees don’t always know what’s the most appropriate way to get help, especially with a mental health problem. These triage services can help to direct them.”

While there are already hundreds of technology-based interventions available, Dr Dhar believes the numbers will keep growing.

“Virtual and augmented reality could be used to support mental health,” he says. “The potential is huge.”

Gift or gimmick

Although there are plenty of apps available, however, Brown says that, from a medical point of view, the evidence for this type of support remains flimsy.

“There isn’t any strong evidence to prove that these apps are therapeutically useful,” he explains. “This is partly because there’s a misalignment between technology people and health people, but it means we’re seeing lots of them being launched not on the basis of helping us but because they do no harm.”

Dr Dhar also questions the effectiveness of some apps. “They don’t always replicate the service being offered in a more traditional way,” he says. “A mindfulness app can be useful, but it won’t replace a mindfulness session run by a qualified instructor.”

Although most apps will not cause any harm, in some instances there is a potential to make someone’s condition worse. For example, Brown says that, as mindfulness focuses on the body, this could cause further distress to someone who has experienced physical trauma or abuse or where the issue is related to their body, such as an eating disorder or body dysmorphic disorder.

More work is currently under way in this area, with the NHS beginning to certify mental health apps as part of its upgrade to its Health Apps Library.

“The NHS has viewed apps as a means to provide information rather than as functional tools,” says Brown. “This review will look more closely at the efficacy of apps.”

However, in spite of his apprehensions, Brown believes apps have a role to play in helping employers to support mental health in the workplace. “These apps can help people come to terms with what they’re facing,” he says. “If I was a large employer I would definitely think about offering apps to my employees. The cost of doing this isn’t very high and it helps to create a much more positive culture around mental health.”

Making technology work

To gain the most benefit from the new wave of technology, Brown recommends offering a suite of apps. These could include therapy- and mindfulness-based apps but also ones that support mental wellbeing, such as sleep-monitoring apps, workload management tools and journals.

“If you offer this diversity, employees can pick what works for them,” he adds. “There isn’t a one-size-fits-all solution so ensure there’s a broad enough choice so that everyone can find something that helps.”

It is also essential not to regard apps and other forms of technology as the silver bullet for workplace mental health issues.

“Nothing beats talking to a person,” says Group Risk Development spokesperson Katharine Moxham. “Technology can be a great way to help people manage their mental health but, if someone has a problem, it’s fast access to talking therapies that will make the real difference.”

With fast access critical, Capita Employee Benefits head of health management Alistair Dornan says line manager training is a common recommendation. As well as enabling line managers to spot the early signs that someone is not coping, it can give them confidence to step in and help the employee.

But savvy line managers are only one part of a rounded mental health strategy. To enable them to support employees properly they need an arsenal of tools to recommend. These could include apps, flexing the employee’s working hours, and access to counselling.

“You need a joined-up approach, which includes a solid employee communication strategy,” Dornan says. “It’s about creating the right culture. Organisations that openly tackle mental health find that people do come forward when they’re having a problem. It can be very powerful. “

Mental health in the workplace – the statistics

One in four of us will experience a mental health problem each year, according to mental health charity Mind, and at least one in six workers will experience common mental health problems such as anxiety and depression.

This comes at a huge cost to the UK economy. According to the Organisation for Economic Co-operation and Development, mental health costs the UK £70bn a year in lost productivity, benefit payments and healthcare expenditure. Employers bear £26bn of these costs, equating to an average of £1,035 per employee.

But although mental illness is so common, and costly, it remains a difficult topic to raise in many workplaces. Research conducted among 50 business leaders and 500 employees by Bupa in 2014 found just how far employers still had to go.

It found that, in spite of more than three-quarters of business leaders believing they actively encouraged managers to support employees’ mental health, half of employees had never been asked about stress, depression or anxiety in a one-to-one meeting.

And these figures showed no signs of improvement when Willis PMI Group conducted research into mental health earlier this year. Its study of 1,388 UK workers found that only 35 per cent of those who had suffered mental illness had talked to their manager about it, with the figure falling to just 26 per cent among 16- to 24-year-olds.

When asked why they feared opening up to their employer, 33 per cent said it was due to concerns about how it would affect their job prospects, with 30 per cent saying they did not think they would get adequate support if they raised the issue.

Although there is clearly plenty of work to be done, both Mind and Business in the Community are launching workplace wellbeing indices this year, which will make it easier to judge if the state of play is changing and which interventions provide the support that employees want.