Digitally enabled therapies for adults with depression: early value assessment

Digitally enabled therapies are a treatment option for adults with depression. They are technologies, used online or through apps, that deliver a substantial portion of therapy through their content. They are delivered with support from a trained practitioner or therapist in NHS Talking Therapies for anxiety and depression services (formerly Improving Access to Psychological Therapies, or IAPT). The practitioner or therapist facilitates the intervention, encourages completion, recommends complementary material, and reviews progress and outcomes. The full criteria for technologies to be included in this early value assessment can be found in the scope on the NICE website. Six digitally enabled therapies that include materials based on structured cognitive behavioural therapy (CBT) were included in this evaluation:

• Beating the Blues (365 Health Solutions) is an online CBT programme comprising 8 modules. This technology is no longer available to the NHS.

• Deprexis (Ethypharm Digital Therapy) is an online CBT programme comprising 10 modules.

• Iona Mind (Iona Mind) is an app-based CBT programme that uses machine learning to anticipate and adapt the programme to a person's needs.

• Minddistrict (Minddistrict) is an online CBT programme comprising 8 modules.

• Space from Depression (SilverCloud) is an online CBT programme comprising 5 modules.

• Wysa (Wysa) is an artificial intelligence-based app with a CBT-based self-help programme.

NHS Talking Therapies for anxiety and depression services provide NICE-recommended psychological therapies for depression using a stepped care approach. For adults with depression, treatment options should be discussed and the choice of treatment matched to their clinical needs and preferences. NICE's guideline on depression in adults: treatment and management recommends several treatment options that can be used as first-line treatments for less severe and more severe depression. Guided self-help (including digitally enabled therapies) is an option for treating less severe and more severe episodes of depression. It should be considered first for most people with less severe depression because it is the least intrusive and least resource intensive treatment option. Although guided self-help is also recommended for adults with more severe depression, other treatment choices with more therapist contact should be considered first. Monitoring for treatment concordance, side effects and suicidal ideation should be done by a healthcare professional. Routine outcome monitoring and follow up should be considered.

The comparators are the treatments offered for a new episode of less severe depression or more severe depression, as described in sections 1.5 and 1.6 in NICE's guideline on depression in adults: treatment and management. These treatments are delivered by NHS Talking Therapies for anxiety and depression services.