Pioneering a 21st century mental health system

By - World Healthcare Journal
Pioneering a 21st century mental health system

In the UK, 15 years ago the conversation around mental health and the approach of care systems was vastly different from today. An element of stigma and taboo surrounded mental health and those with mental health issues often suffered in silence.

This silence caused a large number of problems for the NHS. High rates of inpatient admissions and delayed discharges, under-investment of community teams and long waits for access to therapeutic services, and underskilled primary care functions all contributed to a review of mental health delivery.

Early-level intervention services were also rarely invested in, but these are now recognised as some of the most effective methods of preventing mental health conditions taking hold – 75 per cent of mental health conditions cement themselves by the age of 18. But, how did the approach and provision for mental health change in the UK? The answer, as with many things in healthcare, is digital.

XenZone’s digital solution

In 2004, we began working with the NHS to put mental health services online, offering a level of anonymity and ease that was not available before. This was a vital development for people struggling with mental health issues who either could not or would not be able to access in-person primary care, allowing them to receive the help that they needed, whenever they needed it.

Since then, XenZone has continued to improve and innovate using digital solutions within the mental health arena. As of 2019, we now provide several interventions for anybody suffering with their mental health; online content and information, forums to discuss worries and struggles in a supportive environment, or immediate access to professional and accredited counsellors.

At XenZone, we currently offer two separate services:

  • Kooth, launched in 2004, is the leading mental health platform for children and young adults in the UK Targeted at ages 11 to 25, users can discuss their mental health experiences with peers, as well as engage in text-based counselling sessions with licensed therapists and counsellors. More than 4m people have access to support and advice offered by Kooth.
  • Qwell, a service for adults in need of mental health support, provides recovery, prevention, and preassessment care resources instantly, removing the wait associated with traditional primary care for mental health.

XenZone’s impact on UK mental health service provision

The use and improvement of digital services within healthcare has had a notable effect on the UK’s mental health system, particularly for those hardest to reach, and those most in need. To ensure the development and progression of the services we offer, we continue to benchmark and monitor their impact to establish they are continuing to make a difference and change lives.

The first strand is concerned with clinical outcomes. People using the services who are undertaking treatment and therapy are provided with achievements and goals, allowing us to track their progress against these goals using standardised and proven clinical questionnaires.

The second aspect is evaluating the impact of our entire system. We maintain strong relationships with integrated care services throughout the UK which allow us to look at the impact of a whole range of services upstream, such as GP referrals and follow-on care uptake. Studies on our services for young people in England show that in many localities we reduce admissions into inpatient facilities by 8-10 per cent, this not only reduces stress on inpatient care, but also ensures that the right type of care is provided to the right people – whether that requires scaling up to referral, or personal management of mental health using tools available through digital resource.

The third part of benchmarking our services is arguably the most important: the user experience. Across our entire site with its 70,000 plus pieces of content, the way that we cooperate and collaborate with our 100,000 active users is always driven by the feedback that they generate.

In every interaction with the service, our therapists and our forums, we monitor how users feel about their experience and interactions. For example, if they believe it was beneficial or what goals that they want to achieve, which ultimately leads to a better understanding of the user, and better outcomes for all.

The three pillars of a mental health service

Globally, there is an enormous demand for mental health services. If we look at the recent World Health Organization report on mental health provision, around one in 86 people across the world are receiving mental health support. We also know that about one in five people will require mental health services at some point in their lifetime.

While this is an alarming statistic, it provides a huge opportunity for digital health providers, mental health workers, clinical services, healthcare development agencies and governments to work together to create better mental health services across the globe.

But, building a mental health service, especially from the ground up, is a monumental task and we certainly can’t do it as a sole provider. We are a building block in the range of integrated networks which, when together, provide a best-in-class mental health system. At Xenzone we deliver a clinically proven, tried and tested service that offers rapid access for millions within a population group and the baseline data that comes with that.

However, to fully develop a brilliant mental health system, we believe the foundations rest on three pillars:

  • Stigma and education
    The most important step for building a new mental health system is addressing stigma. You need to provide appropriate channels for people to raise their hand early, and make sure that they are in a position where they feel comfortable and safe doing so. The next step is to educate employers, schools and the general population on mental health issues; how to spot them, how they can be treated, what to do about them. Without this part, you can build the most fantastic clinical services and intervention programmes for mental health, but they just won’t get used.
  • Universal early intervention and prevention service
    Quashing the stigma and cultivating an environment where people and patients can feel comfortable addressing mental health, leads to a universal early intervention and prevention service, which is where we come in. This section of the system functions as the front door to the population, the first port of call for the one in five of us who may require assistance with mental health issues at some point. This is just the UK figure, globally; it may be even higher in other places.
  • First-class facilities
    The next step is to produce the follow-up facilities for the early intervention systems. No matter how effective a system you develop, there will always be a cohort that will require further assistance. Especially at the community level, a certain percentage of people will need special patient facilities, which is why it is essential to develop those systems so that when they are needed, they provide the best level of care possible.

In recognising effective mental health provision is a global need, we at XenZone are keen to work with economies and countries that are starting to tackle the mental health issue. We want to bring the best-in class clinically proven services from the UK abroad, and we want to progress down that pathway.

The beauty of the service that XenZone provides is the ease of implementation. We have a proven clinical digital model that we know works. Our clinical models and products can interact and fit in with any part of a mental health network. It doesn’t require long, arduous testing, implementation and development procedure. It’s extremely easy to transfer and translate the mental health services that we currently operate in the UK into other markets - and we would love to get started.


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