Next generation digital therapy: increasing access, driving recovery, saving costs

Investment in digital health saw unprecedented growth in 2021, with one report confirming a 79% increase between 2020 and 2021. Mental health and wellness as a category has seen particularly significant growth and several high-profile deals with impressive valuations. In part due to the injection of capital, we are now seeing increasingly sophisticated digital mental health solutions, growing scientific rigour applied to development activities, and a focus on the collection of outcomes evidence to support the effectiveness claims of these solutions.  

In this article we discuss how digital mental health has changed over the years, and how this new injection of capital has accelerated progress towards next generation digital mental health solutions.

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The age of the internet and the first telehealth providers

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The first digital mental health solutions were created by pioneers who saw the opportunity the internet provided to break down some of the barriers many face in accessing mental health care.  

Founded in 2000, we led the first wave of mental health therapy being made available online. Our text-based CBT service helped increase access across the UK, by enabling patients to get support at a time of day that suited their needs and without needing to take time off work to travel to appointments. Digitally enabled care, such as ieso’s, was revolutionary at the time and was met with some scepticism.  Peer-reviewed research, such as our randomised control trial, investigating the effectiveness of online CBT, which was published in the Lancet in 2009, demonstrated this modality is as effective as face-to-face psychotherapy and growing acceptance has helped pave the way for future progress.  

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The role of the global pandemic, capital injection and the influx of digital solutions  

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The Coronavirus pandemic was the real game-changer in many ways, forcing a rapid acceleration of digital health adoption in the absence of traditional face to face care delivery. This combined with the visible negative impact the pandemic had on the mental health of so many saw digital mental health care receive an influx of capital. This has enabled a host of digital innovators to step up to the plate and bring a huge range of solutions to the market to address this rising unmet demand.  

These new digital solutions have had to be innovative in how they approach the market and represent a huge step forward and are helping to solve the very real problem of access to mental health support. But at ieso we believe there is scope to achieve even more.

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The arrival of next generation digital therapeutics to level the playing field with physical health

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The unspoken truth is that mental health care in its current form is simply not good enough. We have limited understanding of how drugs or psychotherapy actually work and even in the countries with the most advanced mental health systems, psychotherapy recovery rates have stalled at around 50%.  Where huge strides have been made in physical health care the same cannot be said for mental health.  

The faster advancement of physical health has, in part, been a result of considerably more capital investment when compared to mental health. This massive investment into clinical ‘physical health’ research over the last 70 years has resulted in a data-enabled understanding of disease pathology which has driven radical improvements in physical healthcare and associated life expectancy rising by c. 30 years.  Care protocols are now standardised and deliver consistently reliable outcomes. Mental health has sadly not had as much attention from the investment community and as a result has not made similar advancements with respect to clinical outcomes. The scarcity of reliable data is one major hindrance to the development of meaningful insights that could dramatically improve clinical outcomes.  

At ieso we envisage a next generation of digital solutions that can drive radical improvements in outcomes through data-enabled deep understanding of what works in mental health care.  

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A new era of mental health science

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An early pioneer in digital healthcare, ieso has for many years now been delivering one to one therapy via text; tracking associated outcomes after each session and using insights drawn from this data to continually improve these outcomes.  

We now have a unique data set of over 500,000 hours of outcomes-indexed therapy transcripts that our clinicians, scientists and AI engineers can explore together to understand for the first time the active ingredients of therapy.  

For example, we have explored:  

• The way patients respond to therapists, and how that can be used to predict if they will continue to engage with and improve with therapy
• How therapists differ, and how that impacts the patients’ likelihood of responding to therapy
• How different symptoms of depression are associated with different depression subtypes and have a different likelihood of responding to therapy
• Understanding the active ingredients in therapy is enabling us to build the next generation of digital therapeutics (DTx) as clinically and scientifically led solutions that are highly personalised and that draw on what we know works best for individuals.

Our goal is to develop a new science of mental health care – a science that surpasses, rather than simply replicates, what has gone before, and that will keep on driving recovery rates up to eventually reach parity with physical health outcomes.  

For the first time, widespread recovery from mental ill health is certainly conceivable.