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Taking a digital approach to alleviating mental health issues

Tell us about your role at SilverCloud.

I am the CEO and cofounder of SilverCloud. My involvement with the company started when I was working for the National Digital Research Centre (NDRC). It’s an organization that is designed to help commercialize academic and clinical research across healthcare, green technology and other areas. I was an entrepreneur in residence there when I came across SilverCloud, which was the name given to the technology-enabled therapy research project. Like most of us, I have grown up with close family and 

“…we knew we had a solution that would be key to addressing the ever-increasing need in behavioral healthcare on a global level.”

friends who have struggled with mental health issues throughout their lives and I felt there was a huge unmet social and economic need for helping in the delivery of mental and behavioral health.

What did the research entail?

The genesis of the research was looking at existing online interventions that were falling short on what was needed in terms of client delivery and access, as well as extending clinical reach. Existing computized delivery methods had a number of barriers that limited their level of effectiveness, namely low levels of client engagement and a high level of client dropout rates, leading to limited clinical improvement. The SilverCloud research team took on the challenge of addressing these key issues.

In 2012, I and other members of the research team decided to spin out the innovative technologies that are at the core of SilverCloud’s success. At that point, we were five strong and now we’re over 30. Initial user trial data demonstrated SilverCloud’s viability on social, clinical, academic and commercial levels. In summary, we knew we had a solution that would be key to addressing the ever-increasing need in behavioral healthcare on a global level.

Please describe SilverCloud and the services it provides.

SilverCloud is built on a decade of academic and clinical research involving Trinity College Dublin as well as Parent plus Mater Hospital. We provide online therapeutic programs designed to enable healthcare organizations to deliver the digital equivalent of face-to-face therapy. It is based on the same interventional methods, such as cognitive behavioral therapy, mindfulness, motivation interviewing, positive psychology and more.

Clients can access SilverCloud from multiple devices to get the benefits they need, at the appropriate intensity level and, importantly, on demand for when they need them. Our programs are structured, clinically validated, evidenced-based, with integrated human support across multiple behavioral health areas—for example, depression, stress—and chronic disease management and related stressors. For instance, almost half the people who have diabetes will also have clinical levels of depression, anxiety and/or stress.

How do you address the needs of individuals?

SilverCloud is not a point solution, it fully embeds into the health system protocols and treatment pathways and we deliver across the full mental health spectrum, all the way up to severe and enduring mental illness. You can’t deliver generic services to everyone. We are mindful that we are treating a unique person, an important fact that others in the industry are still missing.

We seek to meet the unique needs of the individual by delivering programs for different segments such as age groups, militarized individuals and students. Our programs also vary by country with more than 22 evidence-based programs available.

We are ever evolving, constantly ensuring that clients using SilverCloud receive the optimum experience…monitoring how people access programs, where they abandon pages, drop off rates etc. We look at how people interact with our programs. Do they watch videos or interact with tools? Do they watch on their phone versus a computer? Do they do one module at once, or spread it out over time? Each additional shade or hue allows us to deliver the right content through the platform. And if something is not working, we iterate.

Why might people choose an online solution for help with mental illness?

There are a number of reasons, but at a high level they can be summed up in flexibility and patient choice. Some people still feel the stigma of accessing care, and online can assist with providing an anonymous, yet supported, care path. People need access to these services in an on-demand way that is tailored and fits within our modern lives. If I have an appointment on August 27 at 10 a.m. and I can’t make it, that might get pushed off. There have to be other, more flexible options available.

Another key reason is there aren’t enough therapists to deliver care. Long waiting lists and available support are ongoing challenges in service delivery. Therapists can only see a certain amount of clients a day or week, so there’s a huge backlog. It’s only getting bigger. For example, 55 percent of the therapist population in the United States alone is over 55 years old, and many are soon to retire or semi retire. SilverCloud also is a fantastic alternative for primary care physicians who often just have a script pad and pen in their arsenal. Now, they can provide a meaningful alternative to prescribing antidepressants or pharmacotherapy.

You have a background in technology. What is it about healthcare that sparks your interest, and why specifically mental health?

Like most of us, I have grown up with close family and friends who have struggled with mental health issues. I have seen what health systems can and cannot offer. They are severely resource constrained, and this has become even more pronounced as these systems are being required to do even more with less resources. Mental and behavioral healthcare is one of the biggest opportunities to affect a positive change in society. It is so related to everything we do and why we do it.

As with all entrepreneurs growing and scaling a business, I’ve had my challenges. But then, I see some of the client feedback on the platform. “SilverCloud saved my life.” Or “SilverCloud saved my marriage.” “SilverCloud pulled me back from the edge.” That feedback is what makes you passionate about what you’re doing.

What does the future look like for SilverCloud?

Our mission is to “take healthcare head on.” We’ve had proven results in major health systems globally. That’s fantastic. But we know there is more to do. Now, we’re working with global device manufacturers and some of the largest smart phone manufacturers to use their sensor technology and look at device context and activity monitoring—how we can bring in the external context. Say, within a diabetes group, we can deliver content that is highly relevant in the context of what’s going on. By taking information from a glucometer, activity sensor and SilverCloud usage, you can see indications that the client is metabolically unstable and dealing with high levels of stress.

We continue to deliver clinical results that are on par with face-to-face services. We’ve tripled our revenue each and every year since we started. We’ve had exponential growth of clients—just within the NHS, we’ve gone from supporting 1 percent of NHS mental health services two years ago to over 35 percent today. It’s effective care delivered in a far more scalable way. That’s the part that gives me butterflies in my stomach and drives me and the team on.

What is the best advice you have ever gotten?

From an entrepreneurial perspective, I’ve always, within reason, liked the Nike strapline of “Just Do It.” There are 100 reasons not to do something or naysayers in terms of building a business. However, you could drive across the entire United States at night with just your car headlights on. You may only see 100 feet in front of you, but you can keep driving. Others see the problems far too early and stop, but they don't see the vision. If you see the roadblock ahead, it is not until you approach it that you realize you can take a left or right turn; necessity is the mother of invention.

Who are your personal heroes and what influence have they had on you?

It has to be my dad. He is someone who left school when he was 14. He started and scaled a family business, was very successful and retired early. He’s still with us, thank God. It is essential if you embark on the entrepreneurial journey you have a great support network. My parents’ support, along with that of my wife, has been essential. Growing up at home my dad was always passionate about business and I think that is where I caught “the entrepreneurial bug.” That’s a fantastic advantage to have.


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