While the digital world is often blamed for poor mental health, some areas aim to improve it. Members of the IFoA Mental Health Working Party explain how digital mental health tools help to support insurers and their customers.
Digital health tools are varied – there are smartphone apps, wifi-enabled wearables, telehealth platforms. Mostly they are accessed by choice by the individual but in some cases they can be prescribed by medical professionals. The more clinically focused tools are often delivered in tandem with regular virtual or in-person appointments.
In Europe, there has been a growth in the adoption of such digital tools to help patients manage their health conditions. Dr Tarun Gupta, chief medical officer (UK protection) at Legal & General, believes they can add value for chronic disease monitoring and support. “I expect to see further growth in them,” he says, “especially if accessing primary and secondary care becomes more challenging and people seek evidence of engagement with therapy.”
In Japan, cognitive assessments have been integrated into insurance to help customers delay the onset of dementia. Use of digital health tools is also common there in supporting customer wellness – for instance, apps that comprehensively track someone’s physical activity and sleep.
Unsurprisingly, the adoption of these tools has increased since the Covid pandemic. Many life and health (L&H) insurers are now integrating them into their insurance propositions, to help support their customers.
Why is the Mental Health Working Party exploring them?
L&H insurers worldwide are starting to use digital tools to help customers with their mental health. There is a global mental health burden that needs addressing – the World Health Organization estimates that almost a billion people across the world are living with poor mental health.
The working party is looking at all of this, worldwide, and how an evidence base for the effectiveness of improving mental health outcomes is being established. It is also learning from the use of these tools in a clinical setting, to see if there could be further opportunities for insurers to adopt them to help customers with their mental health.
How are these tools used in medical settings?
There is an increasing focus on them within the NHS, especially for mental health and sleeping disorders. For example, last year, NICE (the National Institute for Health and Care Excellence) recommended doctors consider offering patients with insomnia the Sleepio app as an effective and cost-saving alternative to sleeping pills. The app provides a six-week self-help programme that involves a sleep test, weekly interactive CBT (cognitive behavioural therapy) sessions and a diary to record sleep patterns.
Some insurers, in countries such as Singapore, have embedded outpatient plans under group medical reimbursement insurance that includes mental health services. Users can complete a mental health self-assessment and make a same-day appointment to text-chat with psychologists and counsellors, followed by text, video or in-person consultations on a case-by-case basis.
How do authorities decide which apps to recommend?
Bodies are being set up specifically to review digital mental health apps. In the UK, the Organisation for the Review of Health and Care Apps partnered with seven integrated care systems across southwest England to improve consistency in digital health across the health system, and to empower people using digital health tools. (The cost-effectiveness of digital tools is a further consideration.)
Germany is also at the forefront in this area, with the German parliament passing rules in 2019 to support digital innovation in healthcare. The country’s Digital Healthcare Act sets up a formal process that allows companies to go through a fast-track process to get their digital healthcare apps added to a central register so doctors can prescribe them to patients. To increase accessibility, the Act requires that the cost of accessing the app should be reimbursed by statutory health insurance providers.
How do insurers use them?
In the UK, they are mostly forming part of ongoing services for life insurance and income protection policy-holders – for example, as part of wellbeing programmes and in the preventative or early-intervention space. This could help to mitigate claims, or improve claims experience longer term.
Digital mental health tools are also being used to support rehabilitation in the claims management segment of the insurance value chain. The tools commonly used are teletherapy, internet-based or computerised CBT programmes, and wellbeing apps and websites, with and without supervision.
In Asia, where the take-up of mental health services is less common, some insurers do still offer digital mental health tools. Some provide assessment and coaching tips as part of their wellness solutions and incorporate digital mental health apps into health products.
What more could insurers do?
It’s clear that there is untapped potential when it comes to using digital tools to improve mental health. Insurers could give customers access to these digital services to help prevent or manage conditions, and they could be provided under the prescription or guidance of medical professionals to improve patient outcomes at point of claim on products such as disability insurance.
Insurers could also play a valuable role in exploring which digital mental health tools are most effective, reducing the severity of people’s conditions and thus reducing or avoiding absence from work.
Integrating digital health tools can provide great client engagement and open up new sales channels by appealing to demographics that have lower penetration.
What next for the research?
In the coming months, we plan to continue to look at best practice for the use of digital mental health tools in clinical settings, and to consider how digital provision can be used to further support customers. For example, some of these tools could be used to engender new product designs that further increase access to protection insurance, provide additional ongoing support to policyholders and provide access to mental health services for customers at point of claim.
If you or your company are using, or thinking of using, digital mental health tools, and can help with this research, please get in touch with the working party.
Lisa Balboa is head of life and health digital business accelerator at Hannover Re
Mark Jones is product and propositions director, retail annuities at Legal & General
Serena Soong is head of risk and solvency planning at Legal & General
Bernice Yu is senior product and solutions manager – Greater China and SEA at Partner Re
Benjy Gordon is in actuarial assurance at Rothesay
All are members of the IFoA Mental Health Working Party
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