Under lockdown, every aspect of our lives appears to be being lived out online. With everything from virtual business conferences to weddings being carried out over Zoom, the digital arena is now being used to substitute in-person interaction in a way never demanded of it before. This has had a profound impact in the field of mental health, where many people who undergo talking therapies for conditions like depression or anxiety are now turning to digital means to continue their treatment while they can’t see their therapist in person.

Mobile phone apps for mental health management have seen a global surge in popularity under lockdown. According to mobile app marketing intelligence firm Sensor Tower, the world’s top ten English-language mental wellness apps generated two million more downloads in April, as the seriousness of the situation began to dawn on people, compared to the halcyon days of January. Likewise, digital therapy workstation Kara Connect has seen a 16-fold increase in usage of its platform since the pandemic began.

This increase in public interest around mental wellbeing is to be expected during a period of significant global crisis, disruption and uncertainty. It’s fair to say that a lot of this interest is likely to stem from people with diagnosed mental health conditions that predate the pandemic.

It’s perhaps helpful to note that there are many variations of the so-called mental health applications out there, from tech driven platforms like BioBeats, which use artificial intelligence (AI) and wearables to provide mental health support to big-name wellness-based solutions like Headspace and Calm. Alongside these are online services like ICS Digital Therapies, which work as an intermediary to allow traditional talking therapies like cognitive behavioural therapy (CBT) and long-term counselling to take place virtually.

The big question for organisations in all three of these categories is whether patients will choose to continue with these digital means even when they are able to see a therapist in person again. As lockdown restrictions start to lift and the day social distancing is longer needed inches slowly closer, will the popularity of digital mental health start to taper off?

Digital therapy providers are confident in the staying power of their product

ICS operations director Sarah O’Donnell says: “It’s a societal expectation that mental health support is in a room between a therapist and an individual, one-to-one. You see it in movies, you see it on TV, it’s kind of drilled into us from a young age that that’s just what it looks like. I think the pandemic has shown that digital delivery can actually become the norm.

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“I actually think that there’ll be an improvement in the willingness of patients and therapists to work in that way. It’s really shown that mental health support can be delivered digitally, and there are many services that have been working in this way for years with really good results.”

One of the critiques of digital mental health solutions is that they inherently lack the face-to-face connection between patient and therapist. It certainly sounds strange initially to consider a person having the very personal and revealing conversations innate to mental health support with somebody they’ve technically never met.

For some patients seeing their therapist in real life rather than through a webcam will always be essential. However, for those who are open to digital therapy these pathways offer a degree of flexibility and discretion that in-person pathways cannot match.

Choosing to undergo therapy virtually means there is less disruption to the patient’s daily life, as they do not need to travel to or from their therapist’s office, something which has proven particularly useful for those living in rural areas. The ability to treat patients virtually also appeals to therapists, who may be more willing to do evening and weekend appointments if they can carry them out via their computer instead of from an office.

Plus, for people concerned about the stigma surrounding mental health treatment, undergoing CBT or counselling in the privacy of their own home can be invaluable.

Digital mental health appears to be post-pandemic friendly

It’s perhaps unsurprising that a surge in demand for mental health care services is expected post-pandemic too, with thousands of people across the world grieving lost loved ones and lost livelihoods. Resources are already stretched thin for mental health care in many regions, so the ability to access therapy digitally could shorten the path to treatment considerably as patients will no longer be limited by location-based availability. This is expected to be particularly beneficial to younger people.

“In Iceland, 30% of university students are reporting some kind of depression episode. This will be a very tough one for young people in general, because they will get hit hardest by the economic repercussions,” says Kara Connect founder Thorbjorg Helga Vigfusdóttir.

BioBeats CEO David Plans is confident that his company’s unique, workplace-centric digital mental health platform will have a role to play as society returns to something resembling normality. BioBeats combines an AI powered app, BioBase, and a wearable device that collects biometric health data, such as heart rate variability and activity, as well as psychometric data to provide employees with personalised health insights and tools.

Plans says: “Through continuous measurement, our technology is able to provide personalised coaching programmes for mental wellbeing, resilience, and recovery. Our products are purpose-built for use within companies to promote better mental health and build deeper resilience.

“As we come back to work from lockdown, the office is going to look very different. Employees will need support in coping with new ways of working and diminished socialisation as part of the work environment. These changes will undoubtedly take a toll on the mental health of workers, and workplaces have a responsibility to help guide their employees through these changes. At the end of the day, it benefits the employer as well, since improved mental wellness amongst employees translates into greater productivity and less sick days taken.”

How do patients feel about all this?

It’s perhaps unsurprising that digital metal health leaders are big believers in their own products – but how do patients feel about these solutions?

Verdict checked back in with Amanda (not her real name), who we spoke to in April toward the beginning of the pandemic. After four months of CBT to treat anxiety and low mood, Amanda and her therapist were forced to switch to communicating digitally, which she initially found she preferred.

“I still definitely prefer it,” she says. “It’s convenient and I won’t feel comfortable using public transport to get anywhere for a while so this meets my needs. I feel like now I’ve done it this way for a while it’s become ‘normal’ and I wouldn’t change it. Now that everything has become virtual, getting logged on and setting up a call for everyday things is becoming muscle memory. I can definitely see the benefits of face-to-face but right now I’m so happy with the ease and practicality of virtual.”

The digital mental health market was valued at $1.4bn (£1.1bn) in 2017 and is projected to reach $4.6bn in 2026, according to Zion Market Research. With strong industry and patient enthusiasm to back them up, if digital metal health services can adequately handle the surge in referrals predicted to swamp the sector, this could prove testament to their worth.

O’Donnell says: “Face to face appointments will not and should not go anywhere, but I do think there will be more of an expectation for flexibility. Since we’ve been in lockdown people are working from home, they’ve been home-schooling, they’ve been doing parts of their lives digitally where that was never an option before. While it’s been because we haven’t had another option, it’s proof that so much more is possible than we may have originally thought.”