Old Stoic and now practising GP, Julian Nesbitt (Chandos 07) identified the need for a quicker and more accessible service for mental health referrals, having seen first-hand the difficulties that people with mental health problems face, as well as an increasing number of people suffering with these issues.
He believes that waiting six weeks, or even longer, for a therapy session is inappropriate and made it his mission to try and provide quality therapy and mental healthcare in an accessible form. Having seen the likes of UBER® transform the taxi market by utilising technology, he wanted to bring technology to the forefront of mental healthcare and therapy by making it more widely available.
To achieve this vision, he has developed a tool that supports current systems but with an additional benefit – bringing therapy into people’s homes and giving them the convenience of having an appointment with whoever they want, when they want and where they want.
The Dr Julian app aims to increase the accessibility of mental healthcare, by connecting patients almost immediately to mental healthcare therapists using secure video/audio/text appointments.
The platform links into NHS Improving Access to Psychological Therapies (IAPT) services in England, providing an alternative to in person, face to face therapy and offering therapist appointments at a time that suits the person.
Using data across four providers currently using Dr Julian and the extensive public IAPT dataset, the health economic modelling showed an NHS return of £1.33 and a total return (including social benefits) of £2.83 for every £1 spent over five years. It also reduced the number of missed appointments by over 50%.
Mental health services face rising demand, which they are struggling to meet as a result of poor access and infrastructure and, more recently, a rapid increase in severe and more complex presentations.
With this context, NHS England (NHSE) has set a commitment to expand access to IAPT services to cover 1.9 million adults per year by 2024; referrals in 2018/19 were 1.6 million. The 1.9 million target is estimated to cover only 25% of overall demand (NHSE Mental Health Taskforce, 2016), meaning that mental health services and IAPT will almost certainly continue to grow rapidly beyond 2024. This requirement for ever-expanding services, while maintaining performance standards, demands IAPT services are as efficient as possible in order to remain sustainable in the future.
Dr Julian is an innovative mental healthcare platform that increases accessibility of mental healthcare. It is offered as a customisable ‘white label’ version of the platform to each organisation.
The tool can also be used by any mental health trust with their existing staff by utilising the benefits of the bespoke platform. It offers a CBT service with BABCP accredited therapists, as well as counselling and psychology provision for most mental health issues on a personalised platform for both mental health trusts and mental health providers, enabling waiting list times to be dramatically reduced.
The system matches a patient to the correct therapist for them using filters via language, issue and therapy type. Patients are offered a choice of who they want to see at a time convenient to them, in the medium of their choice (video/audio or instant message) and from the location of their choice, such as the comfort of their own home. This helps address the inequalities of access that can be a challenge within existing pathways. The reduction in face to face appointments also supports the NHS Net Zero agenda by reducing ‘care miles’ travelled by patients. It provids self-help resources and homework that is tailored to that individual on the app, which can augment the therapy and help the patient through their journey when not in a session. The platform also supports administrators and therapists with the technology increasing the efficiency of online therapy delivery.
All sessions are provided by fully qualified and vetted counsellors and psychologists, with at least three years clinical experience. The platform is currently in use across 20 NHS IAPT services, as well as several charities and is operating in the occupational health, corporate and private sector.
In 2020, KSS AHSN released the results of its health economic model that compares outcomes between Dr Julian and the current NHS Improving Access to Psychological Therapies (IAPT) service (see above).