The government must meet the increased demand for mental health services sustainably and long-term. The gap between supply and demand in mental healthcare services is not solvable through human resource capabilities. Therefore, a digital transformation included in the reformation of the Mental Health Care Act 1983 combined with the implementation of computerized Artificial Intelligence (AI) based therapy in mental health services may ensure widespread access and availability of emergency psychosocial support, with a focus on sustainability.
Opportunities and Recommendations
First, the government should include mission-led innovation policies into the potential reformation of the Mental Health Act, expressed by the commitment of the Department of Health and Social Care to prioritize the use of technologies with the mission of making mental healthcare accessible and available for the majority of citizens. The necessity of this digital transformation is emphasized exemplarily by the COVID-19 crisis its secondary consequences. Government action through legislative power can facilitate a reassessment of the standards for healthcare services. As a reformation of the Mental Health Act is already proposed, implementing innovation-oriented policies can further the government’s development to be digital by default and aim for sustainable growth. This development would be in accordance with the government’s aim to be a leader in the European AI environment, which is why we recommend actively fostering innovation in mental healthcare through high-risk investments.
Second, the NHS mental health services should efficiently adopt Artificial Intelligence to screen, diagnose, and treat patients. Particularly, a computerized cognitive behavioral therapy (CBT) software powered by AI to function as a human-like therapist may be a concrete solution. The system could be available as a mobile application to imitate the interpersonal interaction of texting. It would provide the first contact for patient assessment followed by a computerized talk-therapy. In contrary to other existing platforms such as Ieso Digital Health, the primary objective of the therapy software is not to act as a clinical decision tool by pairing patients with therapists. Moreover, the AI assists therapists by treating patients, either as the main form of therapy or temporarily until allocating a human therapist through an e-referral. This type of digital therapy might be already sufficient for patients with less severe cases. Users may register with minimal personal contact details to lower the cognitive barrier for mental health utilization unless needed for an e-referral. The development will require the formation of a policy collectivity as innovational challenges need the collaboration of public as well as private sectors. Similar to the successful NHS COVID-19 application, the development of the software can be achieved by creating public-private partnerships and following a multi-stakeholder approach. The collectivity could include private sector firms such as Zuhlke Engineering, VMware Pivotal Lab and Accenture, not-for-profit charities such as the Alan Turing Institute, Research Institutions such as Oxford University, units of the Department of Health and Social Care such as NHSx and NHS Digital, and the Health & Care Professions Council.
The state of the art of emerging technologies as well as the technologically advanced environment in the United Kingdom, promises feasibility. Comparatively, the UK is ahead of 28 European countries for the ability to capture the full potential of AI (McKinsey & Company, 2019). Further, the UK is a founding member of the Digital Nations and aims to be a leader in AI and data revolution (HM Government, 2017). With Big Tech such as IBM Research or Microsoft Research inventing new solutions, the use of AI in mental healthcare is already considered a stepping stone towards the reinvention of services through government action.
The government underlined the aim of further digitalization with an AI Sector Deal worth £950 million (McKinsey & Company, 2019; HM Government, 2017). Additionally, the NHS increased their spending on mental health services by creating a fund worth approximately £2.3 billion a year by 2023/24 (NHS, 2019). Therefore, funding for development and implementation should be realizable. Moreover, the use of AI enables the early detection of illnesses, hence preventing costs for the healthcare system caused by the late intervention.
Research has shown the effectiveness of AI in mental health services. On account of its programming, AI can identify depression-associated markers in the text language of users and changes of behavior even earlier than human therapists. AI can analyze “data of volume or complexity that is beyond the analytical capability of individual humans” (Hall & Pesenti, 2017, p.9). In contrary to humans, the computerized therapist is constantly available.
An interdisciplinary stakeholder collaboration of software developers, product managers and designers, security experts, clinical professionals, and policy-makers can produce a stable product. Further, representatives from Understanding Patient Data can provide public discourse feedback about usability and readiness, hence including patients in the process. The Ada Lovelace Institute and the Centre for Data Ethics and Innovation could be involved as ethical advisors. Equally important, the application has to comply with the General Data Protection Regulation and the Data Protection Act 2018. We recommend involving legal advisors as well as the National Cyber Security Centre. Overall, the use of emerging technologies has the promise to be an adequate solution to the increased demand for mental health services. The implementation of a “digital therapist” tackles the problem of insufficient human resource capabilities and thus eases the burden on the system. De-stressing professionals could arguably lead to an overall improvement in therapy sessions, with further benefits for patients and staff. Considering the trend towards the use of AI in healthcare and the government’s objectives, a digital transformation of the mental health care system included in the reformation of the Mental Health Act 1983 is a reasonable and necessary step to be taken.