Internet-delivered mental health therapies as effective as standard care, study shows

Internet-delivered cognitive behavioral therapy (CBT) has greater cost-effectiveness and similar clinical effectiveness in comparison to standard care, a study has shown.

Researchers at the University of York, in partnership with ieso Digital Health Ltd and Dorset HealthCare University NHS Trust, also found that internet-delivered text-based therapies had a shorter waiting time and treatment time than traditional services. The research is published in the journal Nature Mental Health.

Text-based therapies are delivered online and require a patient to type their answers to a series of questions, with a professional therapist at the other end of the communication to assist. These therapies are available both privately and through the NHS.

Most studies evaluating the costs of mental health care have focused on generalized anxiety and major depression, but there is a lack of understanding around the cost-effectiveness for different treatment methods for these conditions, which includes both in-person care and digital interventions.

Cost drivers

The team analyzed data from 27,540 patients using NHS services in England, with a primary diagnosis of depression or anxiety, to evaluate the main cost drivers for different treatment options for depression and generalized anxiety disorders.

They constructed health economic models that captured a range of costs associated with different severities of the conditions. The authors found that the main cost drivers are treatment effectiveness, time from referral to end of treatment, and treatment-associated costs.

Financial burden

Sam Harper, Research Consultant at York Health Economics Consortium at the University of York said, “Shortening treatment and waiting times, and in some cases cutting it by half, could reduce the financial burden on the NHS and improve treatment outcomes and therefore quality of lives for millions of people across the UK.

“The right therapy delivered in a timely manner can increase quality of life for people and reduce costs to the NHS by utilizing real, anonymized patient data to examine how people’s treatment outcomes are related to the therapy they received.”

The researchers point out that there is no “one size fits all” approach to mental health treatment, but having the data available that shows whether internet-delivered text therapies are effective for an individual could mean an annual saving of around £600 million on average for people with all levels of anxiety and depression severities.

Policy

The research suggests that the cost savings were higher for depression than anxiety, and for more severe cases owing to the increased background costs associated with these conditions.

Researchers hope that their findings could inform policymaking for mental health services and access to care, but acknowledge that more research is needed to understand services in different parts of the UK to get a more fulsome picture of cost-effectiveness.