A little bit of me and Buddy in The Times

I recently had the pleasure of being interviewed by Phil Robinson for a piece in The Times around mental health apps and my own experience of working for and using Buddy in my own treatment. Here is a short extract from the piece – you can find the full article linked to at the bottom of the post.

Phil Robinson,

I was staying at a five-star hotel in Greece when I broke down. I couldn’t move or speak; I wept for no reason. So I was flown home, diagnosed with depression and sent to a private psychiatric hospital, where therapists began rebuilding my mind.

For weeks, with groups of almost broken, funny, and desperate humans, I attempted to learn the tenets of cognitive behavioural therapy (CBT). I didn’t want to be stuck in a room with a bunch of people who had, like me, flunked life, but it saved me. Beyond anything that was said in that room, I was sure that I wasn’t alone.

For people suffering from depression today, access to therapy is no longer a foregone conclusion. But whatever your problem — paranoia, body dysmorphia, BPD, OCD, PTSD — there’s probably an app for it. And this month, the health and life sciences minister George Freeman launched a £650,000 innovation prize to promote the creation of a new generation of mental health software.

So far there are 26 apps (11 are free) recommended by the NHS as part of a drive to automate healthcare, relieve waiting lists for talking therapies and reduce the £100 billion that it spends on treating mental health patients every year.

One, called Buddy, has been used by 12 NHS trusts and has been used by more than 17,000 people. An SMS and browser-based diary and communication tool, it’s designed to be used in conjunction with seeing a therapist, says Kat Cormack, who is Client Director of Buddy but also uses it “in my own treatment”.

I get a daily text from Buddy,” she says. “‘Hi Kat, Buddy here, how are you doing? Rate your day from 1 to 5 and tell us how you feel!’” As well as rating her state of mind, she can add notes. “It’s connected to my clinician, so I can tell her things that I might not be able to say looking her in the eye. I can confess my darkest secrets.

IMAG1101-01

By analysing the data, a clinician can monitor a patient’s progress or use it to aid diagnosis. She cites a woman whose long-term depression was revealed to be hormonal after her Buddy data was found to correlate with information from another app tracking her menstrual cycle. “She changed her medication and is now free of depression for the first time in decades.” 

When I was being treated for depression in the Nineties, I saw my therapist once a week, my psychiatrist once a month. I can see that apps present an opportunity to collect evidence to hasten recovery, yet the ability of most apps to deliver a quality service to vulnerable people remains questionable.

Away from the NHS’s recommended apps page, there are thousands of apps dealing with every condition. In most cases their publishers are as obscure as the evidence of their clinical efficacy. At one end of the spectrum you have apps such as MoodKit, the product of the experience of two respected doctors; at the other you have apps such as Fukitol, which is named after a Robin Williams joke.

The industry is still in its infancy and evidence from clinical evaluation trials is scarce. However, in 2013, a study of Viary, a Swedish app for depression, found that 73.5 per cent of patients who used the app were no longer considered depressed after eight weeks and needed half as many therapy sessions as those who engaged in therapy without it.

The result offers a glimpse of why these apps have been seized on as the holy grail of mental healthcare: promoted as a form of triage, they enable health services to push users to take responsibility for themselves and to cut face-to-face therapy.

Cormack is aware that digital tools such as hers are used by people who are frantic for NHS counselling but have not received it.

 The waiting list for an assessment can be up to a year. That’s why people are using apps — they are either a stopgap when you are on a waiting list, or if the NHS has told you that you don’t meet their criteria. People get desperate. We are losing lots of low-cost counselling services because they can’t survive in this financial landscape

When I was at my lowest, between 1998 and 2002, it was always possible to see a counsellor at my local surgery. In 2015, a GP refers people like me to IAPT, an acronym for the suspiciously titled “Improving Access to Psychological Therapies”. It’s a stepped care program that begins with an assessment by phone from a “psychological wellbeing therapist”. Those assessed to have a condition that is interfering moderately with their lives are given a computerised CBT course to complete at home.

If this magic bullet fails, they are given self-help options, or signed up to a 100-person psychoeducation class (like speed awareness courses for people with depression). If you still stubbornly fail to regain your mojo, you can join a year-long waiting list for talking therapies, during which time you can use one of the many apps. The hope throughout this process is that patients simply disappear from the waiting lists as cured, or over the worst of it.

Therapy via healthcare app might seem like treatment purgatory, but anecdotal evidence from practitioners suggests that apps for depression and anxiety work particularly well with certain sectors of the population, such as the military and teenagers, who are notoriously reluctant to talk about emotions.

This is just an extract, the full piece on The Times website (subscription service).

2014: My yearly review

Well it’s been another whirlwind of a year, it seems to have flown by at breakneck speed and all of a sudden it’s the end of 2014 and I’m wondering what I’ve actually done this year.

For once it’s been no surprise that the year has flown, it’s been busy after all and I’ve done quite a lot. In fact this year I’ve not only started a new job but also moved house and been on the holiday of a lifetime. And that’s on top of my usual way more than 9-5 with some volunteering and a lot of campaigning thrown in for good measure.

So here’s a bit of an overview of my year which will be followed by a blog summing up some of my heroes of 2014.

January

2014 didn’t get off to the best start as I ran around the town I was living in and London desperately trying to get ahold of some medication. Being on long term medication feels like second nature after all the years and it does go along way to levelling me out and keeping me functioning but definitely has it’s downsides. Being on a relatively unusual medication and trying to get a GP appointment near Christmas and while working full time is not a good combination and I still manage to mess up my planning from time to time.

It did get considerably better thankfully, January was the month my Chrissy B appearance talking about growing up with mental health issues was aired.

chrissyb show

I also found time for my parent’s annual Burn’s Night party at the end of the month which was, as usual completely tartan and tasteless and a good way to celebrate the end of a very long month.

February

In February I finally got a chance to do Mental Health First Aid training with colleagues from NHS England. I think it’s great that my employer gave us all the chance to do this course and, upon competition, publicised the fact the office now had both physical and mental health first aiders. As many mental health issues surface or are even caused by work I’d love to see more workplaces taking this step. It was also an opportunity to bond with colleagues, many of whom opened up about their own experiences.

I also had the opportunity to co-facilitate a special online talk for the sadly now defunct MindFullUK during Eating Disorder Awareness Week. Having spent a few years now doing something similar for YouthNet on a regular basis it was interesting to try this method with a new group of young people.

March

As the NHS Expo was held in Manchester this year I had a great excuse to start the month of March with friends Rachael and Claire and their assortment of rats.

March was also pretty amazing in that I was given a regional award at the Vinspired Awards in the “Most Outstanding Social Entrepreneur” category for my work on the WellHappy app. I even got to attend a fancy awards ceremony at the 02 with my partner Ryan, parents and colleagues from myhealthlondon.

Boyfriend looking quite proud don't you think?

Boyfriend looking quite proud don’t you think?

April

In April I had the opportunity to speak to the Clinical Senate at the Kings Fund about young people, mental health and technology. Even though it’s a talk I’ve given so many times I could probably recite it in my sleep I received an inordinate amount of praise for this one. It got me thinking about the audiences I tend to speak to; usually a group of people who have signed up because they already have an insight and interest in what I’m speaking about, in other words, preaching to the converted. This is something that’s troubled me a lot this year; how do I reach a broader audience including some of the sceptics and naysayers?

I had the opportunity to learn a huge amount when I received Dementia Friends training from Katie Nichol and since then have, unfortunately, had the opportunity to put this learning into practice. I’d recommend the course to everyone as Dementia is something we will all be affected by at some point in our lives.

I also got a chance to attend the launch of the YoungMinds HedMeds project which had been something of a labour of love and personal interest for me. Along with a dear friend, Annabelle, we opened up the event and even preceded Jo Brand who very kindly called us a hard act to follow!

Some of us with Dr.Ranj

Some of us with Dr.Ranj

May

May was a big month that began with me presenting at the Patient Information Forum conference alongside Macmillan.

This was followed by an interview for my current role at BuddyApp..the beginning of big changes.

Then the biggest media appearance of my life, a live slot on Newsnight to talk about self harm with myself and Tanya Byron taking on the legendary Jeremy Paxman. I was approached by YoungMinds and asked if I would like to appear..only a few hours before broadcast. It was probably one of the most surreal moments of my life to be sat in the BBC green room and having a chat with Mr.Paxman.

Kat Cormack on Newsnight

I am very used to being on the receiving end of calls for help, queries, comments and young people generally asking for help and advice but this has increased by an order of magnitude since my appearance. As I may have mentioned these messages usually start with the same phrase, “I’m really sorry but I don’t know who else to talk to”. While I’m glad that I’m seen as approachable it does sadden me that young people still struggle to find people to trust and open up to and how few positive mental health role models that they can easily access there are.

June

In June I received some good news about my health when I learnt that, by some miracle, my bone density is still at a reasonable level, certainly better than I could have hoped for. Throughout the year I’ve had countless run ins with the medical world from a personal perspective, thankfully most of them positive.

June was also the month where I prepared myself for leaving the NHS and my lovely team at myhealthlondon. This was bittersweet, I was going on to a fantastic new role but leaving so much behind. Having worked in the NHS for 18 months I learnt so much about what happens “on the inside” and it gave me a really helpful perspective for when I’ve got my service user hat on and am wondering why things aren’t happening the way I had hoped in my treatment. I also met the most amazing people during my time working for the NHS, too many to name here, and thankfully I’ve managed to stay in contact with most of them.

myhealthlondon team

I’ve argued for a long time that the people who work for the NHS are some of the best people you will ever meet, their kindness, compassion and work ethic can be incredible but they are bound by a system that can be slow, bureaucratic and seemingly impossible to navigate so it’s no wonder things don’t always work.

Something that really fascinated me during this time was the way the NHS is perceived by both the general public and the media.

I feel as though people see the NHS as one big, monolithic organisation, especially when they are commenting on their experiences, “The NHS did this/didn’t do this” etc. This is a serious misunderstanding as the reality is the NHS is a jigsaw (and the pieces don’t necessarily fit well), made up of hundreds of different providers and a huge number of staff. In fact the NHS is the biggest employer in Europe and can be almost impossible to navigate..even if you work in it.

Throughout my time in the NHS we also noticed a change in the media’s attitude towards us. It got to the point where everyday there was a new story coming out, almost all negative and this has a huge effect on staff morale as you can imagine. And yet when we reached out to the media to get good news stories they were passed up time and time again. Bad news may sell more papers but it’s disingenuous and can be downright dangerous in painting an unrealistic picture that scares people off and causes them to lose faith in what is still an incredible British institution.

Obviously I have had a huge range of experiences having used NHS mental health services in particular on and off for a decade. Some have been great, some terrible but it’s been a spectrum and I can’t just focus on one end. I also look at countries like the USA and think about how terrifying it must be to have to pay so much for what I would argue is a basic human right; the right to life. I look at my friends who have poor or no insurance and gasp in horror at their medical bills festooned with zeros and wonder what my own care has cost and wonder where I would be if I had been born on that side of the pond.

July

On the 1st of July I started my new role at BuddyApp. This has been such a huge but positive move for me. I left one of the world’s largest organisations to go work at a start up with less staff that I could count on my fingers and of which I am the only female so that was quite a shock to the system.

I can honestly say that working at Buddy for the last six months has been a pleasure and I have particularly liked working in a small, dynamic team and the chance to work on the edges of the NHS, working directly with front line staff.

There have been challenges certainly, getting the NHS to buy into and embed something innovative is a slow process, definitely more of a marathon than a sprint, but it’s worth it. Because when it does work, we help patients get better and support clinicians in doing their job, what could be better?

So July was mainly spent settling in, meeting colleagues and clincians for the first time and a few events thrown in for good measure. My favourite was probably the NHS England Youth Forum’s “Celebrating Positive Youth Mental Health” event which I attended with Miranda Bunting whose blog you can read here.

August 

In August I took part in another Cormack family tradition; Cropredy festival. Big events can be a challenge for me especially when it comes to my anxiety but last year I decided that this would be the one weekend every year when the mental health issues would just have to sit in the backseat and sulk. This year I kept this resolution going and had a great time as you can probably tell from this picture of me and my brother.

Cropredy festival

Sadly August was somewhat marred by ongoing issues in our housing situation, most notably problems with our neighbours. Having moved into our flat two years previously and built a wonderful home for ourselves, my partner and I found the last year unbearably stressful due to issues next door which culminated in a police raid-a pretty traumatic experience for anyone.

For me a home should be somewhere that you feel safe and by the time we decided to get the hell out of dodge this was no longer the case. It has been a huge step and at times a bitter pill to swallow but, for the sake of our sanity, we left and moved in with my parents.

After 7 years away from my hometown it’s obviously taken time to adjust but I’m lucky that I still have some great friends in the area and above all a ridiculously supportive family who have taken in both myself, my partner and our ridiculous and noisy cat. It makes it easier knowing that this is a temporary solution and I’m grateful to have this time to settle, relax and rebuild.

September

September was dominated by the holiday of a lifetime as me and my family embarked on our Trans-Siberian Railway adventure. There’s definitely an entire blog post to be made out of this at some point considering we crossed China, Mongolia and Russia in 16 days and saw and experienced so much I don’t even know where to start. As someone who commutes 5 days a week as it is the idea of being on a train for the lion’s share of a fortnight initially didn’t appeal much but believe me the tube and this experience just don’t compare.

Rocking my YoungMinds Vs tshirt on the Great Wall of China

Rocking my YoungMinds Vs tshirt on the Great Wall of China

Some highlights include seeing the Terracotta Warriors, standing on the Great Wall of China in my YoungMinds Vs tshirt, drinking the water of Lake Baikal and being chased around China by people who had never seen redheads. I think my brother, all 6 foot of his bearded, tattooed and pierced self was a bit much for some of them. My brother was a bit bemused by this too, as well as many of the tshirt slogans we saw.

A confused James

Upon my return the rest of September was mostly spent given presentations at The Kings Fund, Westminster Briefing (The role of technologies: what young people want from services today) and attending the NHS AGM and NHS Citizen event where I may have caused a bit of a stir by wearing a protest t-shirt from 38degrees on stage with the NHS board of directors..oops..

October

In October I went to the launch event for the London Health Commission Better Health for London report which was held at the House of Lords and involved a lot of alcohol (how the other half live!).

The highlight of October and in fact one of the top events I took part in during 2014 was CLASP’s Walking Out of Darkness event. Over 300 of us descended on London for a 10 mile walk to raise awareness and funds for mental health and in particular, suicide. We raised a staggering £30,000 and are already planning the next event, you can join us on May 16th and raise money for whichever mental health charity you choose.

claspwalk

I also became a trustee for CLASP and have had the pleasure of working with the CEO and founder of CLASP, Kenny Johnston.

November

November truly felt like conference season was underway with me speaking at both Health 2.0 and HANDI Health Apps during EHILive about Buddy app including my experiences of using Buddy in my own treatment.

I also filmed a short piece for Techforgood.tv which you can now see here.

On top of a lot of travelling during the month I also found time to attend the Social Enterprise UK Awards around the corner from our office in Old Street. It was great to do something fun with my colleague James Ryan and I loved the atmosphere, social entrepreneurs in the UK are a fairly close knit and very supportive bunch and I’ve really enjoyed entering this world in 2014.

Social Enterprise UK Awards

December

Far from winding down towards the end of the year it feels like there was even more going on than usual during December.

I gave a presentation at UCL to Clinical Psychology students about the pros and pitfalls of peer support and social media for people experiencing mental health issues. During this I was reunited with the fabulous Tanya Byron who I shared the screen with during my Newsnight appearance. I also had the chance to have a sneaky drink with the lovely Grace who I know from VIK days, I think the students were a bit surprised to see me in their bar after the talk but it was the last day of term so I blame getting caught up in the atmosphere!

I also sat down with young people from YoungMinds Vs project (the next and very exciting generation of activists, definitely worth checking out) and Norman Lamb to discuss youth mental health, you can find more information from our afternoon with the minister here in a great blog written by two of the young activists.

On a personal note the most touching experience I had this month was helping out one of my role models Monique-Amy Newton in her annual “Help the Homeless” event. Sadly I was only able to attend one evening but we gave out clothes, food and toiletries to a large number of people both on the streets and in hostels. Their gratitude for a bowl of soup or pair of gloves was humbling and really put my own life into perspective.

Helping the homeless at Christmas

TL; DR: Overall it’s been a whirlwind of the year. I’ve had some of my greatest experiences and biggest challenges. I’m very thankful to have some time off between now and 2015 when it all starts again. Hopefully onwards and upwards to better things.

Thank you so much for everyone who has supported me this year, it has meant the world. I’ve stayed in contact with some great people and met some truly inspirational movers and shakers in the health and social care world. It’s people like these that give me the courage to keep going, keep standing up for what I believe in and keep fighting the good fight.

A particular thank you to my family, the never ending support of Ryan Jackson and a particular thanks to two ladies who have had me both in tears of laughter this year, founder of Diabetics With Eating Disorders (DWED) Jacq Allan and Kat Pugh who runs the wonderful #EndTheWait campaign for earlier intervention in Eating Disorders. I’m very lucky to be surrounded by powerful, disruptive, caring female role models.

My recent talks about digital youth mental health

Hello readers,

I must apologise for the lengthy gap between my last blog and this one. My blogging activity (or lack thereof) is directly linked to the amount of time I have spent running around working, speaking and campaigning so as you can imagine I’ve been very, very busy recently.

I will be following this post up with a blog on what young people want when it comes to mental health support, and in particular what role they want technology to play. It’s something I care about passionately and have dedicated much of the last six years of my professional life to.

There have been two events I’ve spoken at recently that have acted as the catalyst to the aforementioned blog which I thought I would summarise to give you all some context and an update on what I’ve been up to recently if you haven’t been following my Twitter account.

The Kings Fund:
The Art of The Possible: How will health and care be transformed in the age of information sharing?

This first event was a roundtable discussion, it was incredibly popular as you can imagine given the title and by the end it was standing room only. It heartens me that there is such a clear, strong appetite for discussions of this nature.

It’s also one of the first events I’ve been to in a long time where I knew next to no one- often I feel I am just preaching to the converted so this was a chance to share my experiences and ideas with a new crowd.

We adhered to Chatham House Rules during the event so I can’t divulge who said what but I will say that it was very interesting how many people started their contributions with comments along the lines of “I could never say this at work..”. This suggests to me there is still a lot of work that needs to be done to bring digital to the masses in the health sector as well as a fair amount of resistance to new ways of working which is something I certainly experienced while working for the NHS.

I gave the opening talk, sharing my personal experiences of using mental health services for the last 11 years and being a digital entrepreneur and activist. This involved a quick run through of my own health journey from the age of 6 when I became symptomatic right up to where I am now aged 25.

I spoke about how much the internet and the support I received online not only helped but probably saved me, especially during my teens when I was at my lowest point. If you’ve heard me speak before you will know I have spent a good 12 years using online support such as chat rooms, message boards and in the last few years social media to provide and receive advice, information and very importantly peer support.

If you’d like to read more I strongly recommend you read this article by Dr Roger Stedman who attended the event which has the brilliant title; Time For a Digital Citizens Revolt.

Westminster Briefing: Improving Mental Health Services for Children and Young People: Identifying Need and Targeting Support 

Yesterday I found myself on a list of speakers which pretty much sums up my dream team- three incredible women who I’ve had the distinct pleasure to work with over the last few years:

Geraldine Strathdee- When I first started working at the NHS a few years ago everyone, and I mean everyone that had anything to do with mental health said to me, “Kat you have GOT to meet Geraldine, she is your kindred spirit” – I was not disappointed.

Geraldine has some serious clout as National Clinical Director for Mental Health in England but what I find truly inspirational about her is that she’s so down to earth and when it comes to mental health she just “gets it”. She  works, often 18 hours a day, always seven days a week, to try and improve mental health services. She is a passionate advocate for service user voice and involvement and I think she, against all odds, bringing about real change in the system.

She’s on Twitter and always open to ideas, comments and suggestions- in particular if you know of good practice happening in mental health please tell her so she can share the learning. She also blogs and you can find some of them here.

Lise Hertel- Lise is one of most inspiring and driven GPs I’ve ever met. She’s based in East London and also works for Newham CCG. It has crossed my mind on more than one occasion that I should probably move to her catchment area so I would never have to worry about having a bad GP-mental health experience ever again!

Lise is very forward thinking and a real believer in innovation and technology. As a service user, before I met people like Lise and other CCG mental health leads in London the idea of GPs commissioning mental health services scared the **** out of me because of my many awful experiences previously. However many of my concerns simply evaporated when I met people like Lise. I think, as much as there is a lot of risk, there is also a huge opportunity in GP led commissioning for mental health and will be watching closely to see what happens in the next few years.

Sarah Brennan– Sarah is the CEO of a charity you’ve all heard me rave about before: YoungMinds. I got involved in the organisation six years ago in January and I can honestly credit them with entirely turning my life around and giving me purpose.

Before YoungMinds I didn’t talk about my mental health offline, I didn’t wear short sleeves and I lived essentially in the mental health “closet”. YoungMinds helped me find my voice and gave me a platform to share my experiences, build my confidence and also introduced me to a group of young people who are essentially now an extension of my family.

I’d strongly recommend you:

Sign up to the YoungMinds VS campaign which has five areas in which we want to fight the pressure experienced by young people and create a mass movement for change.

Sign the YoungMinds petition to stop cuts to children and young people’s mental health services– you will be in good company as over 16,000 have already signed.

The event

I did my usual talk, very like the one I gave to the Kings Fund around what young people want from mental health services and also gave five examples of really great digital tools and services currently available including the amazing organisation I work for; BuddyApp..this will be the subject of a blog coming shortly.

We also heard from the awe inspiring work of Highfield Community Primary School in Sunderland who, through work with Place2Be have become a real beacon of hope to the children, parents and community they work with. As someone who had an awful time with mental illness at my own school growing up I really wish I had a Tardis so I could do my time again and attend this school which really prioritises the health and wellbeing of their pupils.

If you have any questions or ever want to pick my brains when it comes to technology and youth mental health please don’t hesitate to contact me, either through my twitter account or by email at kat@buddyapp.co.uk

My WellHappy app launches at Expo

Myhealthlondon attend the Healthcare Innovation Expo

On March 13th and 14th 2013 members of the myhealthlondon team attended the Healthcare Innovation Expo at the Excel Centre in London. We were there to highlight our website, our dementia community and to launch the WellHappy app for young Londoners.

It was also a great opportunity to find out what else is happening in healthcare at the moment and we met lots of interesting new people including service users, clinicians and commissioners. We also bumped into Lord Victor Abedowale, the Chief Executive of Turning Point and had a chat about WellHappy and how some of Turning Point’s services for young people are included.

 

The Appzone and Health Apps Library

One of the main attractions at the Expo was the Appzone which you can see in the pictures below. It was here that the Health Apps Library was launched by the NHS Commissioning Board.

Over the two days of the expo ten brand new, never-before-seen apps were launched including our own.

It was a great opportunity not just in terms of the amazing platform to launch our own app but also to meet other developers, designers and teams involved in app development. We shared a lot of learning on the day and have had lots of interesting conversations since, showing that what happens at Expo doesn’t have to stay there, especially not with the invention of Twitter! It’s great to see so many clinicians embracing social media and using it to help their patients and provide information and insight into the medical world.

You can find out more about the App Zone and Health Apps Library by visiting the site here or by following @healthappslib on Twitter

 

Launching the WellHappy app

 

Kat Cormack, project manager, and Bruce Kynoch, Assistant Stakeholder and Marketing Manager launch the app.

Bruce and I gave a short presentation to the audience in the Appzone to officially launch the WellHappy app. This involved talking about the app, where it came from, whose ideas went into it, who helped us develop it and what it was like working on a project of this kind.

We also gave a quick demonstration to the audience on how to use the app and encouraged people to download it from Google Play or the Apple App Store.

Joining us were colleagues from LivingWellBrightLemon and Digital White, our design and development companies who have been so integral to the making and launching of the WellHappy app. It was great to have their support on the day and to have them around to answer any technical questions people might have.

People also had a chance to try out the app on tablets at the event and give us feedback right there and then. It was great to see people trying out the app, searching for services near them and then going to download it on their own phones! All the feedback we got was incredibly positive and it was good to hear clinicians say how useful even they would find an app like ours!

It just shows that WellHappy can be used by anyone, you don’t need to be a young person to find the information in it useful and if you work with young people, whether you are a youth worker, doctor, nurse or a teacher in London it is worth a look.