Mental health discovery

By Rosalyn Hewitt.  30 April 2018.

A person holding a smartphone accessing an NHS mental health app

We recently ran a discovery on mental health, focusing on understanding the user needs of people with mild to moderate anxiety and depression, and understanding the role of NHS.UK in supporting these needs.

Approximately 1 in 4 people experience mental health problems.

1 in 6 people in England report experiencing a common mental health problem such as anxiety and depression in any given week. Stress, anxiety and depression are the key search terms driving traffic to our existing mental health content on NHS Choices. We decided to focus our discovery on exploring the user needs of people with mild to moderate anxiety and depression, and understanding any opportunities for NHS.UK to support those users.

Government’s commitment to improve mental health by 2020/21

The Five Year Forward View for Mental Health was published in 2016 and set out the Government’s commitment to improve mental health care by 2021.  Recommendations relevant to our discovery include:

  • Increasing access to talking therapies so that thousands more people receive therapy between now and 2021
  • Treating mental and physical health equally across all areas of society with schools, workplaces and community organisations needing to contribute to the promotion of good mental health and prevention of mental health problems
  • Expanding access to digital services to enable more people to receive effective care, and to provide greater accessibility and choice

Improving access to psychological therapies (IAPT) is a national programme to increase the availability of free ‘talking therapies’ on the NHS. IAPT is primarily for people who have mild to moderate mental health difficulties, such as depression, anxiety, phobias and post-traumatic stress disorder.

Exploring the landscape

As part of our research we spoke to 37 people who had experienced symptoms of anxiety and/or depression.  This included people who had visited their GP for help managing their symptoms and people who hadn’t sought any professional help.  We did a mix of face-to-face interviews both in user labs and in people’s homes, and telephone interviews.

We also spoke to stakeholders from a range of organisations including NHS England, Department of Health, Public Health England, Healthwatch England, Mind, 8 CCGs from across England, and clinicians, including GPs and therapists, who had worked directly with people who experienced mental health problems.

We also explored the existing landscape, looking at the range of services and resources available – both online and offline. We reviewed web analytics, looked at social media and reviewed policy and secondary research through academic literature reviews.

Towards the end of our discovery we pulled all our research together to help us understand the key user needs, the pain points and to create journey maps and personas.

Insights

Stigma is a barrier

Stigma is a big issue and a big barrier in preventing people from opening up or seeking support.  Some of the people we spoke to as part of our research hadn’t told anyone about their mental health problems, including their partners, spouses, friends or family members. They believed that their symptoms were something they had to deal with by themselves.   Other people were more open about their mental health problems but told us that they had experienced stigma from other people.

The trouble with men

We only managed to speak to 8 men during our research and most of the men we spoke to were in the group of people who had never spoken to anyone about their mental health problems.  Men are generally less likely to open up about their mental health; only 38% of men with anxiety and depression access IAPT services, yet 78% of deaths by suicide are male. 74% of women who have symptoms of depression have talked about it, yet only 53% of men have. (Source: Men’s Health Forum report 2017).

Recognising symptoms

Understanding mental health and recognising mental health symptoms is another key barrier for people.  Many of the people we spoke to told us that they thought they were the only person experiencing the same symptoms of them.  Some people didn’t believe that anxiety and depression symptoms was a good enough reason to go to the doctor or that there was anything anyone could do that would help.

Awareness of options

People weren’t aware of all the options available for them to help them manage their mental health and wellbeing and believed that the only options available to them would be therapy or medication.  Not everyone wants to have therapy and many people don’t want to take medication due to fear of side-effects or becoming dependent.

Most people didn’t know how to access resources or treatment, with the GP often being the first point of contact.  People told us that they visited their GP to be asked to refer to therapy or counselling when in many areas it is possible to self-refer to IAPT services.

User needs

We discovered a number of user needs during our research.  The key ones were:

As a person with symptoms of depression or anxiety, I need

  • support in recognising that I’m not the only ones with these symptoms or when to seek help
  • to know my options and be clear what services, resources, tools and techniques are available to help me manage my mental health and wellbeing
  • to know how to access treatment
  • to know what to expect when beginning treatment
  • to know what options are available when I need immediate support

Once our user needs were identified, we produced personas for each segment. These personas visually represent the needs of each segment, with a short description, followed by typical goals and pain points.  Each persona also shows a scale for awareness of mental health support, awareness of mental health treatment, attitude towards treatment and adoption of self-help techniques.

 

What’s next?

We just started our alpha phase where we will be testing prototypes with users. In discovery, we looked at the whole journey for people with anxiety and depression, from people understanding their symptoms, through to accessing help and adopting a range of techniques to manage their mental well-being. For our alpha phase, we are focussing on one part of this journey and looking at how we can make it easy for people to access IAPT services and how we can help people know what to expect from IAPT services so that we can help people make informed decisions about how to manage their mental health problems.

As we continue our work in the alpha phase, we are always looking to speak with interested stakeholders regarding anxiety and depression, so if you are interested please let us know.