The landscape of digital mental health services has changed considerably since the outbreak of Covid-19. Lockdown has created new challenges for charities, whilst changes that were already starting to affect the digital mental health sector before the pandemic have been magnified.
Charities providing digital mental health services will almost certainly have to make further changes going forward, as they consider the sustainability of their funding and how to protect against staff burnout. Charities will need to co-ordinate their efforts to ensure a good variety of services is offered to those who need it, and that interaction is not solely online or solely over the phone. Charities who shifted to digital delivery will need to decide whether to carry on with this march to digital or resume face-to-face services.
Now more than ever, funders need to educate themselves on what good digital behaviour is. Digital services can be useful in many ways, but they will not suit everyone, so funders should make sure they are protecting offline, in-person options for those who need it.
About this research
In April 2019, NPC published a discovery paper, commissioned by Nominet, which looked at the landscape of the charity sector and others working on digital services to support children and young people with mental health issues. Nominet used this research to launch the #RESET Mental Health Programme, a large-scale grant funding programme.
Recognising the impact Covid-19 has had on the social sector, in the autumn of 2020 Nominet asked NPC to update our original research. This report reveals how the landscape has changed amidst the pandemic, and what challenges and opportunities there are for charities and funders to support young people with mental health issues. We share insights from experts in the field about what to expect in 2021 and beyond.
We are grateful for the time that many people have given to this research, and for the insights they generously shared with us. We hope this work helps charities and their funders to alleviate some of the pain young people have suffered in this unprecedented time.
- The biggest increases in need from young people were related to anxiety and depression. Young people are fearful of the future, financial pressures, and prevailing uncertainty. One charity we spoke to said that the young people they supported were experiencing ‘skin hunger’, yearning for the physical contact (e.g. hugs) they used to have with others.
- School leavers and new graduates are pessimistic about getting a job in a Covid world or post-Covid world. They fear missing out on educational and professional opportunities.
- With schools shut, children have lost the coping mechanisms—private conversations with friends, sports and other hobbies, access to mental health support at school, etc.—that might have helped them maintain their emotional wellbeing and reduce anxiety. They might not even have realised that their peers were their support network until they were gone.
- Charities are seeing more calls relating to familial conflict; tensions rise when everyone is confined together. Children are more exposed to family challenges, such as money troubles, and are increasingly expressing concern for their parents and other family members.
- The promise of making unique and lifelong friendships has been taken from those who were excited about university. Students feel dejected by missing out on the promised university experience that they have worked hard for.
- As the vaccine is rolled out, new anxieties are likely to emerge around the safety of re-entering spaces that have been ‘off limits’. Having spent months being told not to go out, training oneself to feel safe may be a challenge.
- The lockdown meant many charities moved their services online for the first time or deepened their digital offer.
- Charities are taking their existing face-to-face services and transferring them to a digital format, rather than starting from scratch and creating new ‘digital-first’ services. This is understandable but raises questions about how effective these transplanted activities will be.
- We are seeing less service user testing, adjustments, and feasibility checks before an app is launched to check its effectiveness. This has arguably been necessary because of the pace at which charities needed to respond, but it remains important that service users and mental health practitioners continue to be involved to ensure that digital approaches are accessible, clinically suitable, safe and effective.
- Digital offers vital opportunities to support people through a variety of mediums at any time anywhere. Digital services are replicable and scalable, so can therefore bring great efficiencies. But there is a risk that, as charities and funders come around to the need to engage with and invest in digital services, opinion swings too far and other services start to be seen as too expensive, low in reach or unnecessarily intensive. The sector needs to continue advocating for approaches such as blended care and some of the more expensive kinds of support (such as one-to-one counselling), to ensure that quality and depth is not lost in a quest for reach.
- Long term, charities should consult with their existing and new service users as they decide if a heavy digital presence will be a temporary stopgap or a permanent pivot.
- We are seeing more funders recognise the value and importance of funding digital work, although funder engagement with digital continues to lag behind need. Charities continue to struggle to secure funding for digital services, particularly in the long-term.
To tackle emerging issues in digital mental health, funders should ask themselves:
- How much unrestricted funding can you give?
- Do you have to fund a service, or could you provide more backend support?
- What are the opportunities to support blended care services?
- How could you encourage user-led design?
- Could you be doing more to facilitate collaboration and information-sharing between charities?
- Where could there be better signposting between charities?