Dr Joanna Hudson
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Dr Joanna Hudson began her career working as an Improving Access to Psychological Therapy (IAPT) practitioner. When working in IAPT, it became clear to her how much a person’s physical health condition can impact upon emotional well-being and vice versa. At that time, Dr Hudson was not aware of any evidence-based cognitive-behavioural therapy (CBT) treatments to manage the challenge of mental and physical co-morbidity. Digital health can help increase the reach of CBT for distress in the context of illness.
Read Joanna’s blog where she explains how the band Radiohead inspired her thinking about we use digital health products.
Digital Pioneer Fellowship project: Implementing COMPASS online cognitive behavioural therapy
Problem: COMPASS aims to the meet the needs of people with Long Term Conditions (LTCs) experiencing symptoms of depression and/or anxiety in response to their LTC.
An estimated 30% of people with LTCs have comorbid mental health conditions. However, people with LTCs experience barriers accessing mental health care. These include: LTC clients not identifying with the label depression/anxiety and therefore not seeking help, existing evidence-based treatments for depression/anxiety not taking account of the LTC, people with LTCs facing high treatment burden and burnout.
Solution: COMPASS online cognitive behavioural therapy (CBT) seeks to address the above barriers. COMPASS supports clients in navigating the challenges that come with having a long-term condition. It was co-developed by people with LTCs to ensure that the language used would not prevent access. The name COMPASS was chosen by LTC clients. COMPASS targets symptoms of depression/anxiety in the context of a LTC rather than seeing a person’s mental health condition as separate from their physical health. Lastly, because COMPASS is a digital health tool it can be used flexibly and does not require face-to-face appointments.
Scale: The COMPASS team is currently implementing in Southwark IAPT which receives 600 referrals per month of which a third include clients with LTCs. The project is also being implemented in Guy’s and St Thomas’ secondary care clinics, including: Xeroderma pigmentosa, Neurofibromatosis, Renal, Rheumatology, Oral Facial Pain, and Gastroenterology
Desired impact: Aim to increase access to mental health care by providing access to digital health products which meet LTC client needs. Collecting evidence to evaluate if COMPASS will improve engagement in mental health care and improve mental health outcomes.
Progress to date: The project has progressed from a stalemate position at the start of the Fellowship to now having been made live and scaled. They have been awarded £250K in investment from KCL as well as addition time from KCL to develop the business plans and license agreements. They are also now expanding the reach further afield into Buckinghamshire and Devon. Talks have commenced with these geographies with a plan to confirm roll out in sites in those two geographies in early 2020, with a target roll out in Spring 2020. Currently 45 patients are using COMPASS at SLaM, across 5 therapists in one IAPT service. Additionally it is being used by a Clinical Health Psychologist at GSTT (the team of one of the other Fellows on the programme), and 5 therapists at Guy’s & St Thomas’ NHS Foundation Trust.
“I joined the Fellowship programme to build my confidence working in digital health and to be able to network and enhance my awareness of what was going on around London. At the start of the fellowship programme my project had been in a ‘stalemate’ position for 4 months. The programme gave me a fresh perspective to unblock some of the barriers I was facing. I am part of a fantastic team and we play to our strengths.
The elements of the programme that created the most value for me were the Action Learning Set sessions. It was useful to gain a perspective from outside of my team, and to be challenged and supported.
As I continue on my digital transformation journey post Fellowship, I would like to see faster ways of translating research from academic settings into real-world practice. I have joined a working group to discuss this. I am now part of the Mental & Physical Healthcare Steering Committee as part of the Improving Access to Psychological Therapies programme. On this committee we are exploring ways of delivering training online to allow therapists to achieve the required levels of competencies to treat mental and physical health care holistically.” – Dr Joanna Hudson