Benefits of using NHS Choices amongst site users wanting to improve their mental health

Customer Insight Public information
1
May 2013
Benefits of NHS Choices for site users
wanting to improve their mental health

2
Contents
• Introduction
• Sample and methodology
• Who is using NHS Choices for mental health?
• How is NHS Choices being used for mental health?
• What is the impact of NHS Choices on mental health?
• How does NHS Choices impact on behaviour?
• What other online resources do users use?

3
Introduction.
• According to mentalhealth.org 1 in 4 people will experience some kind of
mental health problem in the course of the year. Mixed anxiety and depression
is the most common mental disorder in Britain and places a huge strain on the
NHS.
• NHS Choices contains much content that aims to offer guidance and tackle
mental health by offering information on signs and symptoms, treatment, self-
management techniques e.g. exercising regularly, eating healthily and utilising
support services.
• The overarching objective of this research is to help inform whether there has
been a decrease in the burden of treating mental health conditions by
evaluating the self-reported impact and evidence of behaviour change – in
particular – self-management techniques, which in turn will highlight the
effectiveness of the mental health content.

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Sample and Methodology
Type of survey Online pop-up survey on selected pages of the NHSC website
Methodology Online survey
Fieldwork dates February to May 2013
Sample Total sample completes N=851
Sample distribution General public – self selecting sample of site visiting for themselves
Invitation page /conditions/pages/hub.aspx
/conditions/depression/pages/symptoms.aspx
/conditions/stress-anxiety-depression/Pages/understanding-stress.aspx
/conditions/stress-anxiety-depression/Pages/reduce-stress.aspx
/conditions/stress-anxiety-depression/Pages/low-mood-stress-
anxiety.aspx
Sample & Methodology

5
5
Conclusions
1. 56% of survey participants have used NHS Choices for managing a
mental health condition and 44% have used it to manage general
mental wellbeing.
2. 67% of NHS users have utilised the depression self assessment
tool. 50% have utilised written information on mental health
conditions.
6. Data suggests NHS Choices helps facilitate and maintain
behavioural change for good mental health.
Key takeaways
5. Overall 63% of users reported to be satisfied or very satisfied with
NHS Choices for helping improve or manage their mental
health/condition.
3. NHS Choices has prompted 59% of users to seek help from a health
care professional to improve/manage their mental wellbeing/condition.
20% have reported to have used support groups/phone lines.
4. 25% of users have increased GP/Practice nurse visits and 15% of
users have decreased GP/practice nurse visits due to NHS Choices.

6
Who is using NHS Choices
for mental health?

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Profile: Predominantly females, diagnosed with a mental health
condition, aged between 25-54 and employed.
Female
80%
Male
20%
3%
14%
15%
25%
16%
17%
8%
2%
1%
Under 16
16-19
20-24
25-34
35-44
45-54
55-64
65-74
75+Base: all respondents = 851
Profile of respondents who use NHS Choices to achieve health goals
Gender
Age
35%
15%
8%8%8%
23%
4%
Employment status
Yes
70%
No
30%
Diagnosed with a
mental health
condition

8
56% of respondents use NHS Choice to manage a mental health
condition and 44% use it to improve/maintain general wellbeing.
Manage a
mental
health
condition
56%
Improve/
maintain
general
mental
wellbeing
44%
Base: all respondents = 851
Have you ever used the NHS Choices to help you achieve any of the following?

9
How is NHS Choices being
used for mental health?

10
67%
50%
39%
36%
34%
33%
30%
26%
16%
16%
11%
8%
Depression self
assessment
Written information on
mental health conditions
treatments
Mood self assessment
therapy and counselling
Written advice and tips
Finding mental health
support
Wellbeing assessment
Written real stories
Get active for mental well
being
Moodzone
Video: mental health
attitudes
10
Base: All respondents = 851
3.7
4.1
4.0
3.6
3.8
3.9
3.4
3.6
4.1
3.9
3.6
3.8
Approximately two thirds have used the depression self assessment and half
have utilised written information on mental health conditions.
What have you used on NHS Choices to help you improve/maintain your mental wellbeing or manage a health condition?
On a scale of 1 to 5, how useful have the following been in helping you achieve your mental health goals?
% of respondents who agree with the statements (Top 2 box)

11
11
Depression self assessment tool.
How useful has the depression self assessment tool been in helping you
achieve your mental wellbeing/health goal?
3.7
Qualitative responses n=119
Confirmed suspicions of being depressed 10%
Visited the GP/Sought help 9%
Helped understand feelings 5%
Useful for monitoring/tracking mood 3%
Determine extent of depression 2%
Q. How useful have the following been in helping you achieve your mental wellbeing/health goal(s)? Why
do you say that?
It made the symptoms clear,
and helped me realise that I
was suffering from
depression.
Helped me to understand myself,
felt better realising there was a
reason why I was feeling this way,
and that there was something I could
do about it.

12
12
Written advice on mental health conditions.
How useful has the written advice on mental health conditions been in helping
you achieve your mental wellbeing/health goal?
4.1
Information
Information useful/helpful 14%
Aid understanding of symptoms/feelings 20%
Clear and trustworthy information 5%
Factual information 5%
Not enough/in depth information 2%
Action
Sought help from GP/Nurse 5%
Emotional support
Realise I am not alone 2%
do you say that?
Helped to know more about
symptoms and to realise that I
may need to seek help.
I trust the NHS as a source of
unbiased, appropriate
information.
I trust the NHS as a
source of unbiased,
appropriate
information.

13
13
Written advice on treatments.
How useful has the written advice on treatments been in helping you achieve
your mental wellbeing/health goal?
4.0
Treatment options
Good information on treatment options 12%
Factual information 5%
Concise information 3%
Not enough information 5%
Side effects
Good information on side effects 3%
Helped decide whether to take treatment 2%
do you say that?
Clear information
which is jargon-
free and to the point
.
Helpful to see
different
options available.

14
14
Mood self assessment tool.
How useful has the Mood self assessment tool been in helping you achieve
your mental wellbeing/health goal?
3.6
Information
Information useful/helpful 13%
Helped me understand/realise mood/put feelings into
perspective
3%
Ease of use
Simple tool 5%
Difficult assessment
Tool does not take into account enough symptoms 4%
do you say that?
It helped me to realise I was
low in mood.
Never really occurred to me before
that I might be suffering from anxiety.

15
What is the impact of NHS
Choices on mental health?

16
16
Action taken to improve/mental wellbeing/conditions as result of using NHS
Choices.
Sought support
Sought help from GP/doctor 23%
Taken up CBT course 3%
Sought help from support groups 1%
Self help techniques/coping strategies
More active/exercise more 10%
Changed/improved diet 2%
Practice relaxation techniques 1%
Research
Researched treatments 1%
No action taken 16%
Q. What actions, if any, have you taken to help you improve or manage your mental wellbeing/condition
because of using NHS Choices?
I make sure I take
regular exercise and
try to eat well.
I went to see my GP and
gained access to medication
and counselling support.
I make sure I take
regular exercise and
try to eat well.

17
As a result of NHS Choices three fifths of respondents have sought help
from a health care professional to improve/manage their mental
wellbeing/condition. One fifth have reported to have used support
groups/phone lines.
No
41%
Yes
59%
Base: All
respondents = 851
Have you sought help from the GP or other
healthcare professionals to help you improve or
manage your mental wellbeing condition because of
using NHS Choices?
No
81%
Yes
19%
Have you used support groups/phone lines to help
you improve or manage your mental
wellbeing/condition because of using NHS Choices?
Manage mental
condition
Improve mental
well being
Yes 65 52
No 35 48

18
14%17%15%
25%22%23%
40
20
0
20
40
60
80
100
Overall Improve/maintain general
wellbeing
Manage a mental health
condition
%ofphysicians
Increase
Decrease
25% of users have increased GP/Practice nurse visits and 15% of users have
decreased GP/practice nurse visits due to NHS Choices.
How has NHS Choices affected the number of visits that you make to the
GP/Practice nurse about your mental wellbeing/condition?
Base: All
respondents = 851

19
19
Impact of NHS Choices and decrease in GP visits.
N=125
Able to self manage symptoms/low mood 8%
Information required/needed is available on NHS
Choices
7%
Site provided reassuring information 5%
Feel reassured about symptoms/symptom checker 4%
Better understanding of condition and symptoms 3%
Patients stories are comforting and reassuring 2%
NHS Choices facilitated changes e.g. diet 2%
It (NHS Choices)
reassures me in the
same way a visit
would.
Because the advice is
available online that i
would otherwise get from a
professional.
Questions can be answered
by looking at the site so no
need to contact GP for
something simple.
Essentially I can take action
myself and employ strategies
to help lift my mood /
manage my 'low' times .
Please explain how NHS Choices has decreased the number of visits you
make to the GP/Practice nurse about your mental wellbeing/health?

20
20
31%
43%
36%
Manage a mental condition
Maintain/improve mental
wellbeing
Overall
Overall 36% of users reported NHS helped them self improve or self manage
their mental well being/condition.
Q. Overall, on scale of 1-5, to what extent has NHS Choices helped you self improve or self
manage your mental well being/condition?
Top 2 box (4 and 5 only)

21
How does NHS Choices
impact on behaviour?

22
Adaptation of DiClemente model of behaviour change.
Information/knowledge
Individual is aware of the
importance/benefits of
managing/improving
mental wellbeing/conditions
Contemplation
Individual thinks about
change
Ready to change
Individual gets into the action
stage e.g. visiting GP or
eating healthier
Make a change
Integrating healthy
behaviour in the general
lifestyle
Maintaining a change
Maintaining mental health
Relapse
Previous behaviour
Is resumed
Results support change
Direct experience
of benefits

23
61%
55%
55%
53%
I'm more conscious of the warning signs
of poor mental wellbeing/health
I'm more conscious about the importance
of managing mental wellbeing/health
I'm more conscious of self help
techniques to improve mental
wellbeing/health e.g eating healthily &
exercising
I'm more conscious of the external
factors that disturb mental
wellbeing/health
23
Data suggests NHS Choices imparts useful information/knowledge on
mental health.
Knowledge
Q. Below is a grid containing statements of possible outcomes you may have had as a result
of using the NHS Choices site. On a scale of 1 to 5 to what extent do you agree or disagree
with the following statements?

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57%
53%
42%
24%
I'm contemplating working with my
GP/healthcare professional to help me
improve and manage my mental
wellbeing
I'm contemplating taking action to
improve & manage my mental
wellbeing/health
I'm contemplating contacting support
groups/help lines to improve & manage
my mental wellbeing
I'm contemplating living a healthier
lifestyle (regular exercise & eating
healthier) to improve and manage my
mental wellbeing
24
Data suggests NHS Choices helps facilitates actions for improving
mental health.
Contemplation
for change

25
44%
40%
38%
34%
34%
34%
28%
I feel I have more coping strategies to
maintain & manage my mental
wellbeing
I feel I have more support to help me
maintain & manage my mental
wellbeing
Overall I feel better
I am enjoying life more
I am more active
I am eating better
I am sleeping better
25
Data suggests NHS Choices empowers users to maintain and manage
their mental wellbeing.
Results

26
56%
46%
20%
I will take care of my mental wellbeing
by seeking advice from the
GP/healthcare professional when
necessary
I will continue to take care of my
mental wellbeing by eating healthily
and taking regular exercise
I will take care of my mental wellbeing
by utilising support groups
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Data suggests NHS Choices helps facilitate & maintain behavioural
change for managing mental wellbeing.
Maintaining
change

27
17%
9%
9%
9%
3%
3%
4%
46%
Just started
1-2 months
3-4 months
5-6 months
7-8 months
9-10 months
11-12 months
More than one year
Overall
27
Almost half of users have used NHS Choices for more than one year to
manage/improve their mental health.
Q. How long have you been using NHS Choices to help you improve or manage your mental
health/condition?

28
45
45
22
29
17
4
2
4
4
1
4
41
Very dissatisfied Very satisfied
SatisfiedDissatisfied
Overall
Improve/maintain
general mental wellbeing
Manage a mental
condition
Overall 63% of users reported to be satisfied or very satisfied with NHS
Choices for helping improve or manage their mental health/condition.
17%
Neither satisfied
or dissatisfied
% of respondents
= 73%
Q. How would you rate your overall satisfaction with NHS Choices to help you improve or
manage your mental health/condition?
= 63%
= 62%
23%
27%

30
17%
4%3%
6%
33%
37%
Definitely
Probably
Not sure
Definitely not
Probably not
Don’t know
11%
4%3%
4%
34%
44%
Overall two thirds of users anticipate to continue using NHS Choices to help
achieve their mental health goals and are likely to recommend NHS Choices.
Manage a mental health condition
Improve/maintain general
mental well being
Overall
Q. How likely are you to recommend NHS Choices to a friend, colleague or family member to help them improve or
manage their mental health/condition?
21%
4%
4%
8%
33%
30%
Improve/maintain
general mental well
being
23%
8%
3%
38%
28%
Definitely
Probably
Not sure
Definitely not
Probably not
26%
9%
3%
38%
24%
Manage a mental
health conditionOverall
Q. Do you anticipate continuing using NHS Choices to help you improve or manage your mental health/condition?
19%
7%
3%
37%
34%

31
Other sites used

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42%
24%
19%
15%
14%
13%
10%
6%
7%
31%
MIND
BBC Health
Samaritans
Timetochange.org.uk
Rethink.org
Depression Alliance
Moodgym
Youngminds.org.uk
Living Life to the full
Used NHS Choices
only
32
MIND and BBC Health are the most common online sites used in conjunction
with NHS Choices to achieve health goals.
Q. What other websites in addition to NHS Choices have you used to
help you improve or manage your mental health/condition?

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Summary
• Those invited to take part in the survey joined because they had used the site to help
them manage their mental wellbeing or condition
• A number of findings support the site has had an impact on reducing the burden of
mental health on the NHS:
• 36% of users reported the site helped them self improve or self manage their mental
wellbeing condition
• 15% of users have decreased the number of visits to the GP/practice nurse due to a
better understanding of their condition and adoption of self help techniques/coping
strategies.
• Three fifths of the users reported having sought help from a GP or other healthcare
professionals and one quarter have increased their visits to their GP/Practice nurse as a
result of NHS Choices – suggesting earlier diagnosis/intervention
• Overall 63% of users reported to be satisfied or very satisfied with NHS Choices for
helping improve or manage their mental health/condition
• A high number of users reported they are more aware/informed of mental health and are
contemplating change to better manage their mental wellbeing/condition
• It is clear from our web analytics reports that NHS Choices gets only a relatively small
share of the internet traffic. Promotion of the mental health content of the site would
mean a greater number of the population would have access to our valuable content
• Overall the elements of content used by survey participants were given good
usefulness ratings with the written information on mental health conditions and
treatments highest rating by a big margin

34
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thechoicesteam@nhschoices.nhs.uk
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Benefits of using NHS Choices amongst site users wanting to improve their mental health

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Benefits of using NHS Choices amongst site users wanting to improve their mental health