Western Isles leads the way for Virtual CBT

Whilst for over a decade Scotland has been trying to improve access to evidence-based psychological therapies which are free at the point of delivery and to reduce waits, NHS Western Isles has successfully developed a pilot CBT (Cognitive Behaviour Therapy) partnership in conjunction with IESO Digital Health. 

Originally supported by the Western Isles Integrated Joint Board (IJB), in 2017 the NHS Western Isles Psychology Service initiated the pilot project with iESO Digital Health to bring remote CBT delivered virtually (by live messaging writing to and fro to a qualified therapist on computer or phone) to those living across the Outer Hebrides 

Given the local small psychology service in relation to its mainland counterparts, it was hoped the pilot project would increase capacity locally for IESO Digital Health’s Cognitive Behaviour Therapy (CBT), which would result in saving patient’s the time, inconvenience and expense in travelling to appointments.   

This has proved a success, and whilst some patients may not have been clear on what was initially being offered or were unable to complete the course of between 6 and 20 required therapy sessions, which can be quite a commitment, since May 2019 almost 400 adults of all ages across the Outer Hebrides now refer themselves for virtual CBT help each year.  In addition, of those who chose the virtual route, 64% stated they preferred the option of out-of-hours appointments. 

This year’s iESO Digital Health 12-month Performance Report indicates that patient experience ratings have all been positive against various headings, and that patients who have reported an improvement in their mental health are comparable to other services for which there is regular CBT provision. 

Alison Robertson, NHS Western Isles Psychological Therapies Training Coordinator/Consultant Clinical Psychologist, said, “During 2020, 126 people successfully completed CBT treatment and over 50% saw significant improvements.   

“Very quickly and based on the success and popularity of our local pilot project, NHS Scotland showed an interest and arranged a coordinated test of change with two other areas, West Lothian and Highland.  Subsequently during summer 2020, the Scottish Government decided to fast track its rollout to all Boards across Scotland. 

Whilst some patients may not have been initially clear on what was being offered at the beginning of the pilot, with approximately 30% completing an assessment reporting they felt the virtual route was not appropriate for them, they were provided with other support.  In these cases, the patient was advised to see their GP, or the GP was asked to refer patients to the local Community Mental Health Team for face-to-face CBT, or the Clinical Psychology Service, or a multi-disciplinary approach.   

Alison continued, “Whilst we recognise that this type of virtual remote service is not the right service for everybody, we are very pleased with these initial results.  In addition, we continue to be the only Board offering a self-referral route for this service, and hope that demand does not outstrip supply when the other areas get it up and running.” 

Outcomes across the country are regularly reviewed, and heads of psychology services will continue to assess the project’s contribution.    

For further information visit: www.iesohealth.com/en-gb