UCD has purchased Silver Cloud, an online mental health platform, and is planning to launch the programme during Mental Health Week. SilverCloud is a cloud-based service that provides ‘therapeutic and psycho-education programmes’. The programme was developed over ten years by the Irish company Silver Cloud Health, under founder and CEO Ken Cahill, and researchers at Trinity College, in conjunction with Parents Plus and the National Digital Research Centre. SilverCloud currently has over 80,000 users across six countries. Its customers include the National Health Service, the charity Aware and the UK Ministry of Defence.
SilverCloud does not offer one on one sessions with mental health professionals or therapy sessions through video chats, but rather is a self taught course on positive coping mechanisms. SilverCloud’s courses are based on cognitive behaviour therapy. An average course asks the user to spend 30 to 40 minutes every week on the assigned modules, over the space of at least eight weeks. User’s progress is supported and monitored by mental health professional, within universities this online monitor would be a health professional employed within the university. SilverCloud also offers a community element to the app, but users can contribute comments and advice anonymously.
The courses have between six and eight modules depending on the specific course. Courses are separated by the user’s mental health concern. For example, within the category of Anxiety there are tailored courses available on Generalised Anxiety Disorder, Health Anxiety, Obsessive Compulsive Disorder, Panic Disorder, Social Anxiety and combined Anxiety and Depression (the latter being the most common mental illness diagnosis). Though many of these anxiety specific courses were developed for the National Health service in the UK, and it has not been made clear if the entire range of courses will be available to UCD students. SilverCloud also appears to offer broader courses on dealing Depression, Stress and promoting mental wellbeing alongside Chronic Illnesses, like Coronary heart Disease, Diabete and Chronic Pain. SilverCloud is being used in Trinity, with four courses available to trinity students that focus on depression, anxiety, body image and stress respectively.
As of Thursday the 27th of September, there were 133 students on the waiting list for internal counselling services in UCD. This is a rolling list, which means that it has not started afresh this semester, but rather still includes students who choose to remain on the list since last semester and students who signed on during the summer. The number of students on this waiting list is constantly fluctuating; in March of 2018, there were reportedly 220 students on the waiting lists, while in November of 2017, that number was reported as 194. For an example of how demand on UCD’s mental health services has increased dramatically in recent years, we need only look back at Tribune reports of previous years. In October 2013, the paper reported that there were 39 students on the waiting list – a number that was considered large at the time.
Every student that comes to health services looking for counselling is offered a voucher for up to five counselling sessions with the college’s affiliated off campus counselling providers. Those students that opt not to use the voucher system are then placed on the waiting list for internal counselling. All priority cases referred to health services are offered an internal appointment immediately. There are over 70 students signing onto the waiting list every week, so the length of the list will inevitably grow over this semester.
Currently in the UCD health services, there are two senior psychologists, three student counsellors and two student counselling interns, but there is funding available for the procurement of one full time clinical lead, one full time student well being assessment professional and one part time student well being assessment professional. The role of the assessment professionals is similar to that of a triage nurse; to meet with every student who signs onto the waiting list to determine how their needs would best be met. It has not been made clear when these new staff members will be hired
The positives of the integration of SilverCloud into UCD’s student health service are clear. It is easily accessible; students can use it at any time of day, on any of their electronic devices. There is no need to schedule appointments or be placed on waiting lists. With technology an omnipresent aspect of modern life, it seems likely that this online path to mental health advice will reach more people than an face to face services do.
There are always questions raised about the effectiveness of online mental health apps and SilverCloud should be no exception to this scrutiny. Yet, it is important to recognise that SilverCloud is not exactly an app, but is more akin to a prescribed online therapy course. Secondly, SilverCloud is not an all accumulating therapy. It is a low-intensity intervention that is recommended only for stress and mild cases of anxiety and depression. Furthermore, In 2015, a study on SilverCloud’s depression course was published. It found that of the 180 users the participated, over half had experienced were in remission or has entirely recovered from their depressive symptoms.
There is also the fear that use of these online courses will see an increase in self-diagnosis, unmonitored self-treatment and use of the internet for all health advice. And beyond the health related concerns, there is the question of data. Often people feel more willing to divulge personal information online rather than face to face and this raises a relevant concerns. Users hand over a substantive amount of data on their health and wellbeing to this app, therefore privacy and data protection must be a concern.
SilverCloud was developed through a startup program and is part of a private company. In January of 2017, the Irish Examiner reported that SilverCloud had raised €7.57 million in their Series A funding round with a large amount coming from ‘B Capital’ a venture capital firm that was created by Facebook co-founder Eduardo Saverin with Raj Ganguly. This investment is a clear sign that SilverCloud hopes to expand further into North America in the near future. The private nature of the app raises a lot of questions: will the app encourage users to disengage with the programme once they have finished it? Has the app been developed with the end goal of being put out of use because it has successfully taught all it’s users CBT? If SilverCloud is operating along the same lines as an average private app this seems unlikely.
Online courses are evidently another way to treat mild mental health issues. SilverCloud has been proven to be somewhat effective, but is the programme more or less effective than counselling in person? Mental health continues to be a pressing issue for UCD students. Hopefully, the introduction of SilverCloud onto campus can be a positive move toward both alleviating the demand on student health services and best serving the growing number of UCD students struggling with mental health difficulties.
The Tribune contacted UCD Welfare Office in relation to this article, but received no reply.
By Muireann O’Shea – CoEditor