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One in four say mental health worsened after receiving NHS treatment remotely

Wednesday, 28 April 2021 Mind

Our report, Trying to Connect, looks at people’s experiences of accessing mental health treatment remotely via phone or online during the pandemic.

Mind’s survey of almost 2,000 people reveals that more than one in three (35%) found support from NHS mental health services given over the phone or online difficult to use, and one in four (23%) say their mental health actually got worse as a result of using this support.

Of those who took up the offer of support by phone or online, the data also showed:

  • Almost 2 in 3 (63%) said they'd have preferred to get face-to-face support.
  • One in 10 people (10%) said they often or always had technological issues and a further quarter (24.75%) of people sometimes experience technological problems.
  • One in 3 people (34%) said they were often or always worried about confidentiality.

Respondents who took up the offer of mental health support by phone or online did however cite a number of important positives, with two in three (69%) appreciating not having to travel, almost one in two (47%) grateful for greater flexibility over appointment times and two in five (40%) saying that waiting times were shorter.

The survey data has informed Mind’s latest report, Trying to Connect, which aims to make sure that everyone can access the mental health support they need and deserve. Given respondents mentioned a range of important advantages as well as disadvantages to accessing treatment remotely, we're calling on the UK Government to make sure people who need support for their mental health are offered a choice of treatments – including face-to-face - so that they can choose the options that best suit them.

Read the Trying to Connect report

Responding to these survey findings, Geoff Heyes, Head of Health Policy & Influencing at Mind said:

"Rates of poor mental health were already high across the country even before the pandemic. In the past year, we’ve seen an increase in the number of people contacting us about their mental health and a surge in demand for our information including via our website, Infoline and our local Minds services across England and Wales. During the pandemic, services have quickly adapted to help stop the spread of coronavirus. NHS mental health services delivered over the phone or online have been a lifeline for many, with lots of people telling us having the choice helped with things like childcare responsibilities and working schedules, particularly for those struggling to get to face-to-face appointments.

"Others, however, told us about stressful experiences and concerning breaches of confidentiality. Nobody should have to worry about the wrong healthcare professional or another client attending a confidential therapy session, for example. We know our hardworking NHS staff have done an amazing job during such a difficult time, and we don’t want people to be deterred from asking for the help they need. But it is worrying that one in four of those we surveyed said their mental health had worsened because of accessing NHS treatment remotely. At the very least, people should expect their mental health to stay the same, if not improve.

"As restrictions continue to ease, and we begin to deal with the long-term impacts of the pandemic – bereavement, grief, redundancy, and insecure employment, it’s really important everyone is offered a range of options – including face-to-face treatment - so that they can pick the most convenient and appropriate option. Online therapy cannot be seen as an easy answer to fixing growing pressures on overstretched mental health services. There is no cheap fix."

40-year-old Rohan lives in Greater Manchester. Rohan has recently used online counselling through two charities for support with anxiety. At first Rohan was concerned about being overheard at home and it took some time to get used to having the sessions in his kitchen. He found it hard to switch off after sessions at times and missed having time to decompress during travel or getting a coffee as he previously did after face-to-face counselling. Rohan says:

“Nevertheless, online counselling has been very useful when my anxiety was high, and I couldn’t leave the house. I think going forward people should be offered the choice of online counselling if they want it. It helped not having to worry about factoring in time for getting ready and travelling to appointments easily. There were some problems with connectivity, and it could be quite frustrating having to repeat myself, but my relationship with my counsellor was so good it didn’t matter. I would consider using online counselling again if it meant I didn’t have to wait for 18 months.”

21-year-old Theo* lives in Devon. Theo is autistic and has been receiving mental health support since Theo was a teenager. Theo became exceedingly worried about using video calls and concerned about not feeling able to speak freely while at home. Theo says:

“After having Cognitive Behavioural Therapy (CBT) through Child and Adolescent Mental Health Services (CAMHS) as a teenager I had been doing well, but the strain of lockdowns and the pandemic started having a huge impact on my mental health. I self-referred to my local talking therapy support, where sessions were delivered through video calls. This made me quite anxious. I have autism and was concerned that I would not be able to speak freely during these sessions. Thankfully, after raising my concerns with a local youth charity, they arranged a private room I could use and checked in afterwards for a chat. Having the choice in how you receive your therapy can make a huge difference to whether therapy works or not.”

31-year-old Alissa lives in Warrington. She has been dealing with mental health problems for some time, and at her most unwell in September 2020, tried to take her own life. Alissa says:

“When I came out of hospital after trying to take my own life I was told to contact my GP for mental health services, but I had no idea. I was put in touch with a counselling service through my occupational health team at my workplace, where I was directed to self-refer to Talking Matters. The first three sessions were over the phone, although these were adapted to a zoom call, I still felt they lacked a personal touch.

“For someone who isn't competent in technology, accessing Zoom calls was quite stressful due to microphone and connection problems. This again takes the personal element away from the service. I ended up asking them to postpone my counselling session, due to the type of support being offered not working for me, but this left me without any sessions for the last three months.

“The fact that mental health services have been quick to adapt has been brilliant and allowed people to keep in contact when they can’t see each other physically, however I do feel that face to face is always going to be preferable over technology. In my lowest points, I didn't leave the bed and I hardly saw anyone. I think face-to-face therapy helps with the isolation struggling with your mental health.”

35-year-old Fiona lives in West Sussex. Fiona has experienced obsessive-compulsive disorder (OCD), anxiety, depression and body dysmorphic disorder (BDD) for a long time. Fiona resorted to private therapy after not being able to get support she needs through the NHS. Fiona says:

“I have spent time in and out of psychiatric hospitals and tried to end my life several times. The turning point for me was when I got a job as a Peer Support Worker and found my purpose. I thoroughly enjoyed supporting others and it helped to take my mind off my own problems. I felt more stable - I used to go to A&E very regularly, but managed to stay out for years, until my breakdown last year.

“I started having therapy again last year. Even though I have found face to face support the most helpful in the past, I have still benefited from having therapy sessions by phone. I personally don't like video calls as my Body Dysmorphic Disorder makes me feel very self-conscious and anxious about how I look. My therapist is very understanding about this and has agreed to carry on delivering sessions by phone even after restrictions have been lifted. I’m relieved I was given the choice.”  

*Name has been changed to protect anonymity.

We surveyed people in England and Wales, and following the Senedd election in May we’ll be updating our recommendations to include actions the NHS in Wales and the next Welsh Government should take.

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