It’s an oft-parroted statistic that one in four people will experience a mental health problem each year, and one that has been confirmed by the British mental health charity Mind. These issues also appear to be getting more frequent among people with major symptoms – the proportion of people with severe symptoms of common mental disorders in a given week has risen from 6.9% in 1993 to 9.3% in 2014 in the UK.
However, mental health services also remain difficult to access, with the British Medical Association finding a startling rise in the number of patients sent outside their local area for treatment. The numbers increased by 40%, from 4,213 in 2014/15 to 5,876 in 2015/16. This included the case of one patient who was sent from Somerset to NHS Highland, a journey of 587 miles.
Enter Big White Wall. The first service of its kind to be registered with the Care Quality Commission (CQC), England and Wales’ health and social care regulator, Big White Wall gives patients access to a range of counselling and mental health support services via digital platforms.
Patients can speak to one of around 20 therapists of their choice through text, audio, and secure video channels, with access to cognitive behavioural therapy (CBT) programmes or longer-term counselling. These sessions can be booked quickly at a time to suit the individual, with no waiting lists – something of a blessing in an age where patients have been held on NHS waiting lists for traditional talking therapies for up to two years.
Big White Wall: easy access to mental health services
As well as live therapy, patients also have access to Big White Wall’s online peer support community which offers information, advice and guided support programmes on a range of common issues, and is monitored 24/7 by trained clinicians.
As highlighted by Big White Wall CEO Henry Jones, this format drastically increases the accessibility of mental health services to those who may be unable to attend traditional in-person talking therapies.
“Some patients will always want an in-person option,” Jones says. “However, we’re able to support those who don’t have access to it. We’ve helped people who simply cannot make their own way to hospital, working mothers who don’t have time between the office and the school run to attend a therapist’s office, and even a veteran who had been living in a caravan in Wales since he had come out of active service and didn’t have access to face-to-face treatment.
“Therapists also really like working in this way, as they can work from home at a time that suits them.”
Big White Wall is currently accessible via select NHS Care Commissioning Groups (CCGs), Trusts and Improving Access to Psychological Therapies (IAPT) services such as Chorley, South Ribble & Greater Preston CCG, South West London & St Georges Mental Health NHS Trust, and Wandsworth CCG.
It can also be accessed by students at certain higher education institutions, and select private insurers and workplace healthcare schemes, specialising in mental health care for armed forces personnel and veterans. Patients whose NHS jurisdiction, university or workplace has not signed up currently cannot access Big White Wall’s services.
Currently, these different pathways give optional access to 20 million individuals overall, with 5,000 signing up per month. The company says it has supported over 115,000 people in the time it has been operating, running around 450 therapy sessions each month.
Talking therapy: how does digital counselling compare?
One patient who has benefitted from digital counselling is psychotherapist Olivia Djouadi, who received a series of sessions online after having a transient ischaemic attack or ‘mini stroke’ in 2011. While she was still able to function day-to-day, travelling long distances was too difficult as she was experiencing fatigue and trouble walking. She says online therapy meant she was able to have continued psychological support as she recovered, which she wouldn’t have been able to access otherwise.
Already a practising psychotherapist, Djouadi was inspired to train to become an online counsellor herself. She now offers private online counselling for patients who have experienced trauma, chronic pain and dissociative disorders.
“My work means those living with chronic condition or injuries or living in remote areas can get care,” Djouadi says. “I use video sessions, and can work with both patients in the UK and Europe as well. The furthest person was from New Zealand.”
Clinical studies have also backed up the effectiveness of the digital treatment for posttraumatic stress disorder, anxiety disorders, obsessive-compulsive disorder and borderline personality disorder. Across the board, these studies have found that the efficacy of digital mental health support was comparable to in-person treatment, with high patient satisfaction and often a reduced administrative workload for therapists.
Making mental health services accessible through digital means opens them up to patients who would otherwise be physically unable to receive treatment in-person due to physical, geographical, or logistical challenges. Some patients have admitted that a lack of physical connection with their therapist can feel less intimate, but digital counselling has also been credited for improving the uptake of mental health treatment in communities with negative cultural assumptions attached to it, as they can be accessed more discreetly.
In the face of the apparent mental health crisis gripping the 21st century, online talking therapies are ultimately able to widen the accessibility of medical treatment to patients who may otherwise be unable to receive any care at all.