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Flo continues to grow: Mental Health

posted 21 Jun 2019, 05:42 by Hollie O'Connell



21 June 2019 


Mental health use and diversification with Flo maintains momentum into 2019 


Following on from our overview "Innovative Clinicians Drive 20x Growth in Maternity: Supporting Mums and Mums-to-be" clinicians continue to innovate with more patients being introduced to Flo for increasingly diverse applications.  In particular, the integration of Flo in mental health care has seen substantial growth in use and diversity.   Back in 2012, mental health application of Flo was divided roughly 30/70% between appointment reminders and medication reminders with positive outcomes demonstrated; take a look at the following case study and video for some of the work that has taken place within the community of practice.   However, since 2012, clinicians have built on these early foundations to apply Flo as a beneficial interactive tool to support patients receiving mental health care. 
 
Members of the Simple Telehealth Community of Practice have received recognition for their application of Flo in their delivery of mental health care.  In 2015, the Primary Care Mental Health Service in Tameside and Glossop were recognised as winners of a national Health Business Awards for Innovation in Mental Health, while in 2016 East London Foundation Trust were selected by The Health Foundation to be part of a £1.5 million innovation programme, focussing on integrating Flo to support mental health recovery and self-care for those with severe mental illness.

Newly Developing Areas

Flo’s use in mental health has continued to grow, and by 2017, the number of patients had increased by 16x those in 2012.   While such an increase is worth celebrating, the real change to note is the diversification in the innovative approaches that clinicians are developing to integrate Flo into their care delivery. While medication and appointment prompts make up around 9% of usage in 2017, a number of new applications are now in use.  These include:
  • Cancer support pathways – much of the care that patients with a cancer diagnosis receive focuses on treating the disease, however support pathways are now being used to provide care which supports the patient’s mental health in these difficult circumstances.
  • Mood monitoring – these are interactive pathways that allow clinicians to remotely monitor the mood of their patients based on the readings they send to Flo.  This means that clinicians are able to check the patient’s scores regularly and tailor care to patients, providing additional timely support if required.
  • Dementia and Mild Cognitive Impairment/Depression and Low mood – pathways have been introduced that offer support and information to patients with these conditions, which aim to support memory strategies and improve patient confidence and emotional well-being.  One example of this is North Staffordshire Combined Healthcare’s Autographer project.
  • Course/group support – pathways have been developed to support patients who are attending groups or taking courses to help them improve their mental health.  Flo supports patients throughout the length of the sessions by helping them to register and get started or attend their first session, reminding them when certain modules may be due or sessions are scheduled, as well as sending motivational messages which aim to consolidate their learning from their therapy.
  • Personalised interactive pathways - a number of pathways have been co-designed between the patient and clinician to maximise Flo’s personal nature. Clinicians have been working closely with their patients to design specific, meaningful responses, personal to each patient, that Flo will reply with dependent upon symptoms reported in real time.

Course & group support pathways

The latter group of pathways now accounts for almost 90% of the use of Flo within mental health.  They represent an increasing trend towards a holistic approach to mental health, aiming to treat the patient’s well-being as a whole.   For example, patients with depression have traditionally been medically treated via antidepressant medication, but many patients are now being referred to CBT courses or other talking therapies. These treatment pathways aim to address the root cause of any mental health issues the patient may have, and in doing so, encourage proactive steps to change the patient’s behaviour; Flo is now being used to maximise the impact of these treatments to further support and encourage positive actions by the patient.  For example, South Tyneside Foundation Trust have been seeing promising results using Flo to support patients who attend appointments with Gateshead Talking Therapies.

Health authorities are increasingly looking towards online courses to do this, as they are both time and cost efficient, as well as convenient for patients.  One such standout example being used by members of the Simple Shared community is “Beating the Blues”.
NHS Lanarkshire has had great success using Flo to further support those patients who they have been referred to “Beating the Blues”.   You can read more about their approach here. Lanarkshire’s success using Flo alongside the “Beating the Blues” programme has been noted, and community members from Powys are now looking to implement a similar approach to help patients with their mental health.  It is exciting to see community members sharing their success and best practise with members from other areas, as this continually improves services for patients.

A personalised approach to mental health with Flo:

Flo has also been used in Nottingham to support patients attending CBT sessions.  Patients joined a “Stress Spiral” pathway with Flo, where Flo would ask the patient how they were feeling, and then reply with a response dependent on this. For this pathway, the patients worked with their talking therapy clinicians to devise their own personalised stress spiral that identified certain personal behaviours as their anxiety and stress increased, and the responses Flo sent were also written by the patients.  Ensuring that Flo’s responses were personalised is an innovative approach, it made Flo’s replies even more impactful and helped patients to further reflect on their progress during therapy. 

East London Foundation Trust (ELFT) are another organisation who have incorporated Flo into their mental health pathways to great effect. Flo is used in ELFT’s REFRAME telehealth project, which aims to support patients with severe mental illness, including chronic psychosis, self-manage and maintain independence.   Flo prompts patients to take their medication as prescribed, as well as enquiring about their well-being indicators, which are personalised measures developed by the patient and clinician to recognise behaviours specific to the individual to indicate a decline in their mental health wellbeing.  Similar to the Stress Spiral protocol in use in Nottinghamshire, this personalised approach ensures that the messages have meaning and impact for each individual.  For more information about ELFT REFRAME, click here