Developing E-health Services (DES): The Feasibility and Acceptability of Group Based Video-conferencing for Adults With Depression

Around a fifth (19%) of the UK adult population has experienced depression or depressive symptoms. The overall direct and indirect costs of treating mental illness, such as depression, are estimated at £105 billion per annum. As much as 80% of mental health care takes place in G.P surgeries or hospitals, putting increased strain on existing services and increasing pressure to find suitable alternatives. One UK based RCT investigating technology as a remote intervention for physical illness reported a 15% reduction in A&E visits, a 20% reduction in emergency admissions and an 8% reduction in tariff costs. Systematic reviews of Video-Conferencing (VC) have also shown reduced costs in relation to home care and access to on-call hospital specialists.

There is growing evidence to suggest that individuals will firstly go online for health information before seeking professional advice. As much as 4.5% of all internet searches are for health information accounting for approximately 1 out of every 20 search queries on Google. Those who seek health information online may also wish to access services however, the quality of interactive support online is questionable. A recent Cochrane review of interactive telemedicine has shown evidence of the effectiveness of VC based therapy for mental health issues. The current Secretary of State for Health has also supported the use of Skype technology as part of a 'radical redevelopment' of health services. This is in tandem with the launch of Northern Ireland's eHealth strategy in March 2016, adding to a number of policy documents suggesting this technology has the potential to increase access, lower costs and promote early intervention.

In spite of this evidence base, VC services for mental health are not widely available. As such, the full risks and benefits for clinical purposes are unknown. Several studies have shown the mental health benefits of VC as comparable with face-to-face therapy. However, the acceptability of this approach may depend on factors, such as age and technical competence. After reviewing the outcomes of VC based treatment for clients with bulimia, asserted "the distance and space provided by video therapy may have helped these clients to engage in treatment to a greater extent than would have been possible face-to face". VC has shown to be effective in the treatment of mental health conditions as well as increasing engagement for groups who would otherwise struggle to do so using face-to-face services. VC has the potential to increase access to services, target hard-to-reach groups and reduce G.P and hospital waiting times by providing alternative support mechanisms. Given the ubiquitous nature of online technologies, services are easily available and accessible which may enable preventative processes to occur sooner.

This study will address the feasibility and acceptability of group based video-conferencing support groups for adults with depression. Findings will inform the design and development of a randomised controlled trial.

Aims & objectives To test the acceptability and feasibility of delivering a peer led support group intervention for depression using VC technology.