A national survey of the infrastructure and IT policies required to deliver computerised cognitive behavioural therapy in the English NHS

Abstract

ObjectiveThis study aimed to identify if patients have adequate access to Computerised Cognitive Behavioural Therapy (cCBT) programmes in all mental health trusts across England.DesignThe primary researcher contacted a targeted sample of information technology (IT) leads in each mental health trust in England to complete the survey.SettingTelephone, email and postal mail were used to contact an IT lead or nominated expert from each mental health trust.Participants48 of the 56 IT experts from each mental health trust in England responded. The experts who were chosen had sufficient knowledge of the infrastructure, technology, policies and regulations to answer all survey questions.Results77% of trusts provided computers for direct patient use, with computers in all except one trust meeting the specifications to access cCBT. However, 24% of trusts acknowledged that the number of computers provided was insufficient to provide a trust-wide service. 71% stated that the bandwidth available was adequate to provide access to cCBT sites, yet for many trusts, internet speed was identified as unpredictable and variable between locations. IT policies in only 56% of the trusts allowed National Health Service (NHS) staff to directly support patients as they complete cCBT courses via emails to the patients’ personal email account. Only 37% allowed support via internet video calls, and only 9% allowed support via instant messaging services.ConclusionsPatient access to cCBT in English NHS mental health trusts is limited by the inadequate number of computers provided to patients, unpredictable bandwidth speed and inconsistent IT policies, which restrict patients from receiving the support needed to maximise the success of this therapy. English NHS mental health trusts need to alter IT policy and improve resources to reduce the waiting time for psychological resources required for patients seeking this evidence-based therapy.

Collateral outcomes in e-mental health: a systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health

“…Posternak & Miller, 2001). In the stepped-care approach, it has been suggested that cCBT (or other evidence-based self-help) is offered as a first step for milder cases or to bridge the time between specialist care (Andrewes et al 2013). Thus, the question of whether cCBT can reduce waiting times may not be answered entirely through RCTs.…”

A Survey of Attitudes towards Computerized Self-Help for Eating Disorders within a Community-Based Sample

“…This is not unexpected for this sample of people recruited online. However, our recent national surveys of access to online resources via the NHS in Scotland (Kenicer, McClay and Williams, 2012) and England (Andrewes, Kenicer, McClay and Williams, 2013) has identified a lack of provision for those who do not have their own access to computers at home. In effect this means that those who are unemployed or older may have limited opportunity to access such resources.…”

Computerized Cognitive Behavioral Therapy to Treat Emotional Distress After Stroke: A Feasibility Randomized Controlled Trial

“…From a broader perspective, it is important to consider barriers that impact the use of cCBT within health services. When exploring the infrastructure and information technology (IT) policies of the NHS in the United Kingdom, it was found that service users are limited by the number of computers they have access to [ 36 ]. It has also been highlighted that IT policies restricted the ability for NHS staff to provide ongoing guidance and support to potential cCBT users through, for example, contact via service user’s personal email account.…”