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Mental Health in Northern Ireland: Pathways to innovation and effective collaboration

Published and last updated by Sharon Farnley

In this blog written by Andrea Cartmill from the Health Innovation Research Alliance Northern Ireland (HIRANI), she examines the robust strategies being implemented to address mental health challenges in the region, and underlines the importance of addressing socio-economic inequalities, empowering communities, and embracing innovation. 

HIRANI are one of the partners working with the Health Innovation Network South London to deliver Innovate UK's Mindset-XR Innovation Support Programme.

Mental health is an important part of overall well-being. It enables people to cope with life stresses and to contribute to their communities. Promoting good mental health for all is one of the main challenges faced by society. We know that many different factors can affect mental health. These include the continued impact of the COVID-19 pandemic, as well as the influence of health and socio-economic inequalities.

Common mental health conditions, including anxiety and depression, can be associated with significant distress and impaired function. Although many mental health conditions can be managed with relatively low costs, there are often gaps in care delivery. Economic impacts are also significant, with productivity losses far outstripping the direct costs of care.

In Northern Ireland, the impact of mental health conditions is substantial. In adults, 1 in 5 live with a probable mental condition. This number is 1 in 8 among children. Northern Ireland reports the highest prevalence of mental ill-health across the United Kingdom, underlining the urgent need for action.

Steps being taken to address these issues

In recent years, Northern Ireland has begun implementing robust strategies to address mental health challenges. In May 2020, the Department of Health launched a Mental Health Action Plan, followed by a comprehensive Mental Health Strategy in June 2021. This strategy focuses on prevention, early intervention, and care for those experiencing poor mental health. Its priorities include:

  • Promoting mental well-being and resilience.
  • Ensuring timely access to the right support.
  • Exploring innovative approaches to treatment and care.

The appointment of Professor Siobhan O’Neill as Northern Ireland’s Mental Health Champion in 2021 brought renewed focus. Serving as a prominent advocate, this role champions evidence-based services and interventions.

These initiatives signal a commitment to fostering a healthier, more resilient society, but challenges remain, particularly for marginalised communities.

 Tackling Social Exclusion and Inequalities

The Mental Health in Northern Ireland Fundamental Facts 2023 report underscores the harsh reality of socio-economic disparities. Residents in the most deprived areas are far more likely to suffer from mental illness than those in affluent communities. Child poverty is a significant factor, with 1 in 4 children living in poverty. Stable housing also plays a critical role, as evidenced by the stark statistic that nearly 70% of people experiencing homelessness have a diagnosed mental health condition.

One initiative is the (CHOICE) Project (Challenging Health Outcomes/Integrating Care Environments). This innovative network collaborates with individuals, organisations, and communities to combat social exclusion and address the physical health disparities faced by those with severe mental health conditions. By addressing social and psychological factors, the CHOICE Project places the lived experiences of individuals at the centre of the conversation. The project is focused on community-based participatory research to co-create solutions, as well as a whole-systems approach to engage public, private, and voluntary stakeholders.

The Work of Mental Health Charities

Northern Ireland’s mental health charities play a pivotal role.

  • MindWise supports individuals, families, carers, and workplaces through its services across Northern Ireland. In addition to helping those directly affected by mental health challenges, MindWise offers mental health training for employers, empowering workplaces to foster well-being and empathy.
  • Inspire operates across Northern Ireland and the Republic of Ireland, promoting "well-being for all". They aim to eliminate stigma and discrimination while celebrating the unique abilities of individuals. Campaigns like ‘Time to Talk Day’ encourage open conversations, reducing stigma and building stronger communities.
  • Action Mental Health provides a range of services, including its New Horizons program, which equips people with vocational skills, personal development opportunities, and employability training. Their ‘I AM SOMEONE’ campaign, launched in October 2024, highlights individual stories, and underscoring the importance of access to mental health services.
  • AWARE offers support groups across urban and rural areas. Their work involves support groups for those living with depression and bipolar disorder, as well as carers for people with illness, engaging with communities, schools, colleges, universities and workplaces. Programs, such as Mood Matters, Living Life to the Full, and Mental Health First Aid, educate communities and equip individuals with practical tools for resilience.

Innovations in Mental Health Treatments

Northern Ireland is also leveraging cutting-edge technologies to transform mental health care. The Health Innovation Research Alliance Northern Ireland (HIRANI) has partnered with UKRI Innovate UK and the Health Innovation Network South London to bring the £20 million Mindset programme to the region. This initiative fosters collaboration between mental health providers and the immersive technology sector. Two Northern Ireland-based companies have already received funding as part of the programme.

  • Propeer Solutions Ltd has developed a VR platform to enhance treatment of post-traumatic stress disorder (PTSD) by immersing patients in realistic, immersive environments, providing access to support which could reduce therapy times.
  • Life Process Program Ltd has developed a suite of VR experiences that augment online addiction recovery programs. These solutions could help to provide accessible care, which is engaging, and can integrate with health systems to help drive innovation in digital therapies.

Looking Forward

While there is no quick fix, a combination of sustained collaboration, strategic policy, co-design, good community engagement, and implementation of effective technological solutions offers hope. By addressing socio-economic inequalities, empowering communities, and embracing innovation, Northern Ireland can chart a path toward a place where mental health is prioritised, and every person has access to the care and support they need.

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Mindset-XR Innovation Support Programme company spotlight: SyncVR Medical

Published and last updated by Sharon Farnley
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Our Mindset-XR Innovation Support Programme spotlight for November is on SyncVR Medical. 

Floris van der Breggen, SyncVR Medical’s founder and CEO, tells us a bit about the company and their Virtual Reality programme, Project Zenith. The Health Innovation Network South London is supporting SyncVR Medical as part of our delivery of the Mindset-XR Innovation Support Programme for Innovate UK.

Please give us some background on SyncVR Medical 

SyncVR Medical was founded in 2019 to reimagine healthcare with XR technology, and we’re now the largest Extended Reality (XR) healthcare platform in Europe. We’re like often described as the Netflix for XR in healthcare, selecting the best XR tech from around the world and making them available under one platform. Similar to Netflix, we develop our own content and also select/curate tech from around the world, so that a healthcare organisation has the best selection available to them. Our team is a mix of healthcare experts, engineers, and creatives, all dedicated to solving real problems with innovative, patient-focused tools. We’ve built partnerships with over 250 hospitals across Europe and the UK, implementing our applications from A to Z.

Can you tell us about Project Zenith?

Project Zenith is something we’re incredibly proud of. It’s a Virtual Reality (VR) program designed for young people with Autism Spectrum Disorder (ASD) who experience anxiety – an underserved group when it comes to accessible therapy. Zenith provides a safe, immersive space where users can build coping skills through VR-based Cognitive Behavioural Therapy (CBT) techniques. We’re developing Zenith alongside Hertfordshire Partnership NHS Foundation Trust, with the goal of not just supporting patients, but also relieving pressure on NHS services by reducing waiting times. For us, this isn’t just a project; it’s a pathway to make mental health care more proactive and approachable.

How do your innovations tackle inequalities in mental health?

Access and affordability are the biggest challenges in mental health, especially for marginalised groups. With our XR solutions, we’re bridging that gap by bringing therapy to people wherever they are, on their terms. Project Zenith is just one example: ASD patients who may not respond to traditional therapy environments can access therapeutic tools through VR, opening doors that were previously closed to them. We’re focused on making mental health care more inclusive, empowering people from all walks of life to get the support they need.

What is the biggest challenge you have faced so far in developing your innovation?

Healthcare is a highly regulated field – and that’s partly a good thing. However, it also means extra layers to navigate, from ethics approvals to clinical trial protocols. With Project Zenith, we’ve had to plan carefully around these requirements and delay formal patient inclusions. It’s challenging but eventually worth it.

Why should the NHS be excited about your innovation?

The NHS should be excited because SyncVR aligns directly with NHS priorities: faster access to care, innovative treatment options, and reduced cost pressures. Project Zenith is a perfect fit, as it offers the NHS a scalable, evidence-backed tool for ASD patients dealing with anxiety. It’s a chance to transform patient pathways with a solution that doesn’t rely on medication and offers personalisation at scale. Collaborating with us means unlocking new ways to support patients and elevate the standard of mental health care.

What three pieces of advice would you give budding innovators?

Go deep on the problem: Real impact comes from understanding the problem you’re solving from all angles – especially through the lens of those directly affected. Collaborations with clinicians is absolutely essential here.

Think beyond today: Whatever you’re building, make sure it’s designed to grow. The healthcare landscape changes fast, so adaptability is key.

Stay resilient and keep learning: Innovation is a rollercoaster. Learn from each challenge, and don’t let setbacks derail your commitment to solving the problem

What are your hopes and ambitions for the future?

Simply put, we want XR to become a trusted, mainstream part of healthcare. We’re building on Zenith’s success to create a full XR treatment that is ready for international rollout. We hope to make this happen using innovation grants to bring the tech to the next level!

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Mindset-XR Innovation Support Programme company spotlight: Play Well For Life

Published and last updated by Sharon Farnley
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Our Mindset-XR Innovation Support Programme spotlight for October is on Play Well For Life, established by Dr. Sarah Campbell in 2019.

Background

Having experienced my own mental health struggles as a young person, I saw that treatment often involved very long waits and traditional psychological therapeutic approaches that didn’t work for everyone,  and I wanted to do something to address this.

While studying for a PhD in Psychology, I worked as Head of Wellbeing at a small university and started to think about technology solutions as being the way forward rather than the traditional hard to scale models of psychological intervention. 

I co-founded an award-winning wellbeing app called 87%, and learnt a huge amount about developing digital products for psychological intervention. I also saw that apps struggled with the long-term engagement needed to bring about behavioural change. I was using game-based approaches in workshops, and that is where I started to explore digital game-based learning. I did a post-doc at University of Southampton, developing a digital game for children with chronic health conditions to learn transition skills, and started to understand these approaches.  

During my PhD I used music to study emotions, and developed a music-based listening intervention and evidenced it compared to mindfulness. As a result of this, I won funding to turn it into a digital prototype, and this was the start of Play Well For Life.

Play Well For Life was established to use game-based learning to deliver psychological intervention to young people. Our unique selling point is that all our games are social, meaning young people inherently develop communication skills, social connections and a sense of belonging, which we know is vital, particularly for teenagers, to develop a sense of wellbeing. We have developed and commercialised several games, employing game development teams from the games industry to ensure the games look and feel great, and co-producing with adolescents, clinical psychologists and educators to ensure the necessary skills are developed and have a strong evidence-base. We then work with academics to evidence that are games are doing what they were designed to do. 

How does your innovation tackle inequalities?

Dragons of Afterlands is an award-winning, evidence-based augmented reality board game that can be played in-person, remotely or hybrid. Free-at-the-point of access, we are targeting Dragons of Afterlands specifically at those who experience higher challenges with their mental health. Young people with chronic health conditions are 60% more likely to experience a mental health issue by the age of 15 than other teenagers. Adolescents with complex medical conditions are often uprooted from their environments and isolated in hospital when undergoing treatment. Such hospital stays reduce a young person’s autonomy, activity levels and disrupt peer relationships, leading to anxiety, depression and social withdrawal.

Our tool has been identified as an innovative way to support young people transitioning into hospital, building relationships with staff and peers during their stay and supporting continuity of care when they leave hospital. It is also being used by staff during hospital stays to help have tricky conversations and develop essential skills to support resilience, socio-emotional and advocacy skills. 

A second group we are targeting are those receiving education from hospital education services. Whilst some are young people with chronic health conditions, hospital education services increasingly support young people who experience Emotionally-Based School Avoidance (EBSA). These young people are currently offered minimal 1:1 tutoring (two hours per week in some areas). This is resource intensive and doesn’t allow for the benefits that come from learning with peers. Our tool has been identified as an innovative way to extend resources by enabling 1:3 delivery, and to build peer support opportunities, ultimately leading to faster re-integration to in-person and group learning. 

What is the biggest challenge you have faced so far in developing your innovation?

As with all projects, finding continuous funding, and enough funding is always a challenge. That’s why the Innovate UK Mindset-XR programme, and the support that comes with it from the Health Innovation Network South London, are so valuable. Aside from that, one of the big challenges we are facing at the moment is ensuring our product meets NHS infection control standards, and is inclusive and accessible to be used by young people with quite severe physical needs.

Augmented reality tracking (similar to scanning a QR code) can be affected by lighting, reflective surfaces etc. so finding a board material that works, and also can be repeatedly wiped clean with bleach has been an interesting and unexpected part of the research and development!

In terms of accessibility and inclusion, to play the game and interact with the augmented reality gameplay, players need to move their phone or tablet around to reach the different parts of the board, and some of the scenarios and content have needed to be redeveloped to be sensitive and appropriate to these audiences. We overcome challenges like these by co-producing with specific groups of young people and staff members to ensure as many barriers are removed as possible. 

What are your hopes and ambitions for the future?

Through this project, we are really coming to understand the gaps that exist for young people with chronic health conditions and for those struggling with mainstream education. Our hope is to move from piloting within the NHS to securing contracts to facilitate the adoption of Dragons of Afterlands, and then develop some of our other prototypes into fully-fledged game-based tools for healthcare staff to use with adolescents in healthcare settings.

We are also in the planning stages of developing a strong community of practice focused on adolescents, for those supporting young people in healthcare, such as Health Play Specialists, Clinical Psychologists, Occupational Therapists, and Head Teachers within alternative provisions.

What advice do you have for other innovators?

If you are planning on selling to the NHS, plan and budget for medical device registration,  co-produce your innovations with staff and users from the outset, and make the problem drive the innovation, rather than the other way round.

Finally, understand the care pathway your innovation fits into and what outcomes you need to demonstrate to convince commissioners your innovation is worth a try.  And enjoy the journey!

Want to know more about the Mindset-XR Innovator Support Programme?

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Why is Lived Experience involvement and engagement so important?

Published and last updated by Sharon Farnley

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MQ Mental Health research is an award-winning charity which funds much-needed scientific research to transform the lives of everyone affected by mental illness, working to create a world where mental illness is understood, effectively treated and ultimately prevented. MQ Mental Health Research are partnering with the Health Innovation Network South London to provide learning and advice around the role of lived experience for the Mindset-XR Innovation Support programme. Through fostering collaboration between the immersive technology sector and mental health providers, Mindset-XR aims to accelerate treatment by leveraging immersive digital therapies to offer faster and more accessible support for individuals with mental health concerns.

Championing the voices of people with lived and living experience of mental illnesses in research is at the core of MQ Mental Health’s work, and they have set up a Lived Experience Expert Network made up of over 100 people from 25 countries around the world who collaborate on our research programmes and projects. In this blog, Mariana Bolivar, Research Programme Lead at MQ Mental Health, discusses why lived experience involvement is crucial for innovators to consider. 

People with lived experience of mental illness, either because they themselves have experienced it or they are caring for someone who does, have a wealth of valuable knowledge to share. We know that lived experience involvement and engagement are crucial for successful and impactful research and product development in mental health tech research.

Within the context of healthcare, we define lived experience as personal knowledge gained directly and first-hand, rather than through representations constructed by other people.

Clinicians, researchers and innovators may not have first-hand experience of living with the mental health condition they are trying to find solutions for, which makes active participation from people who can provide personal insights on how the condition made them feel and what it’s like to live with on a daily basis all the more important.

Many research projects fall into the so-called ‘valley of death’ in research where, following what can be as long as a 17-year period of going through the process from discovery to basic research to applied research, product development and ultimately production, they fail to have real-life application.

Actively engaging Lived Experience Partners from the outset, seeking their feedback and using their insights to help inform the design and delivery of a research project, leads to more active co-production where responsibility and power are shared at all stages, leading ultimately to healthcare solutions that better suit their needs.

However, we know there are barriers to be aware of when engaging with Lived Experience Partners, which include digital inequalities, communication challenges and accusations of tokenism.

These can all be avoided by taking the time to understand the needs of lived experience partners, making sure there are alternatives to digital strategies where necessary, limiting the use of jargon and hard-to-understand terminology and ensuring that Lived Experience Partners are included in every stage of the decision-making process, so their contribution is valued and actual.

It is also important to make sure you involve a range of voices where possible, with a diversity of experience and backgrounds.

There are UK Standards for Public Involvement which are a useful starting point, providing guidance around inclusivity, working together in a respectful way that values all contributions and offering support and learning opportunities.

The Association of Medical Research Charities (AMRC) is another helpful resource offering information on how to fairly compensate those with lived experience who take part in your projects.

We know from our own experience that working in partnership with those with lived experience and making projects more user-led brings better results, ensuring tech products lead to tangible improvements in people’s lives.

MQ Mental Health Research are one of our partners on the Mindset-XR Innovation Support programme. 

Please visit our dedicated pages to find out more about the programme and sign up to our monthly newsletter.

The power of community for the Mindset-XR Innovation Support Programme

Published and last updated by Sharon Farnley

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The Mindset-XR Innovation Support Programme recently went out on the road, holding a series of sold out events around the country. Here, Sarah Ticho, Co-Founder of XR-Health Alliance, who chaired the event in Cardiff along with her colleague Ross O’Brien, reflects on the importance of bringing people together.

This June and July, the Mindset team travelled across the UK, connecting with innovators and creators in the XR (Extended Reality) mental health space in a series of road show events organised by the Health Innovation Network South London as part of their delivery of UKRI’s Mindset-XR Innovation Support Programme. From Belfast to Cardiff, London to Exeter, we experienced the incredible diversity of thought, passion and innovation driving our industry forward.

Ross O’Brien and I had the privilege of representing the XR Health Alliance, chairing the event in Cardiff and facilitating one of the sessions in London. Across these events, we were deeply moved by the range of voices and perspectives present. These gatherings were more than networking opportunities, they were evidence of a seismic shift in the industry. XR is no longer just a novel concept showcased at conferences; it’s gaining serious investment from a range of stakeholders committed to its development and implementation in improving mental health.

For years, XR was seen as a niche within the NHS, with projects often starting in academic labs but rarely finding a path to wider adoption, or creatives making impactful ideas but struggling to find the right partners or investors to help scale. Reservations by investors due to  the lack of adoption and pathways to distribution, combined with unclear regulation and compliance has been a significant barrier. The Mindset tour is evidence that our industry is changing. From islands and pockets of innovations left isolated, we are witnessing a new wave of XR for mental health, where lived-experience experts, commissioners, regulators, award-winning artists, theatre makers, students, and seasoned mental health professionals are coming together to create transformative products and pathways that reach people who can truly benefit from these innovations.

This superfusion of industries, skills and perspectives is unlocking a reimagining and reinventing the field, with incredible innovations being developed, researched and deployed. However, we still have a long journey ahead of us before XR and mental health reaches the mainstream. We are inching closer and closer as we are finally having meaningful conversations and taking action to tackle the challenges of regulation, distribution, financing, raising public and clinical awareness and supporting long term collaboration. These gatherings demonstrate the sheer passion and willingness to carve news pathways into spaces where people can best implement XR for mental health – from social prescribing in libraries or delivering at home to homebound patients, to bringing XR into schools for student wellbeing, collaborating with Mental Health charities or delivering within a hospital context.

The investment in the Mindset-XR programme demonstrates the willingness of UKRI and Innovate UK to create a foundation for us to build upon, enabling vital R&D and developing channels to obtain future investment by bringing on board investors. Increasingly, we are beginning to create confidence by stakeholders, as we develop more evidence and work to create a clearer path to compliance and regulation for safe deployment of XR. Working with a range of partners is essential in unlocking that next step, as well as working together to inform how policies and regulations will  evolve for XR in the future.

These events organised by the Health Innovation Network South London provided a chance to explore our future direction and identify what needs to be done, not just by individual companies or groups, but by us all as a community of experts. As the proverb goes, “If you want to go fast, go alone; if you want to go far, go together.” These gatherings are essential for gauging the industry’s progress and offer opportunities to share knowledge, insights, and to form new partnerships and communities of practice.

I am both curious and excited to see how our industry will evolve as we build momentum. It truly takes a collective effort to drive this progress. I invite you to continue joining us on this journey, bringing your spirit, enthusiasm, and commitment to true transdisciplinary collaborations where technology, healthcare, and storytelling come together to enhance lives across the country.

Many thanks to Sarah for sharing her reflections on the recent Mindset-XR Innovation Support road show events.

The Health Innovation Network South London is grateful to all our delivery partners on the Mindset-XR Innovation Support programme: XRHA, Health Innovation South West, Health Innovation North West Coast, Health Innovation North East and North Cumbria, Hardian Health, MQ Mental Health Research, The Health Innovation Research Alliance Northern Ireland and King’s College London.

Mindset-XR programme receives new funding boost

Published and last updated by Sharon Farnley

Innovate UK have today announced funding worth £3.2m for 24 projects as part of their Mindset-XR programme.

The Health Innovation Network South London will be supporting these projects as part of our delivery of the Mindset-XR Innovation Support Programme for Innovate UK.

Over the past few months we have seen increasing interest in the potential of immersive digital health therapeutics; hundreds of academics, clinicians and innovators attended our sold-out roadshows across the UK and more than 4,000 people are regularly receiving the latest XR in mental health news through our newsletter.

We have been working with projects that have already received funding as part of the Mindset-XR programme, delivering advice and expert tailored support, providing opportunities for them to meet potential collaborators and hosting subject-specific webinars and round tables.

We look forward to continuing this work and will be sharing more information over the coming months about the  innovators and how their projects aim to help millions across the UK with their mental health.

“I am so excited to learn more about the newly announced projects that we will have the privilege of working with through our Mindset-XR Innovation Support Programme. So many of us are impacted by poor mental health, either directly ourselves or through our loved ones. These novel technologies offer new hope to service users and staff within the health, care and education sectors.”Dr Amanda Begley, Director of Digital Transformation and Technology, Health Innovation Network South London

You can find out more about the Mindset-XR Innovation Support Programme on our dedicated web page, including links to a range of articles and all the previous editions of our newsletter.

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Immersive technology for mental health: understanding the evidence-generation landscape

Published and last updated by Sharon Farnley

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Building a reliable evidence base is an important consideration for any innovator in the healthcare space. In this blog, HIN Head of Insights Dr Andrew Walker provides a high-level introduction to evaluation and evidence-generation in the context of the Innovate UK Mindset-XR Innovation Support Programme.

One of the most exciting things about the Mindset-XR programme is how we are bringing together experts from so many different fields to make a difference to mental health; This includes supporting innovators with backgrounds in technology, the creative arts, education, media and gaming.

While this diversity of thought and perspective is a strength when it comes to finding creative solutions, it also poses some challenges for people less familiar with healthcare as a sector. One of the biggest challenges – and something which we’ve already heard investors flag – is around innovators understanding the importance of robust and compelling evidence for the safety and effectiveness of their XR-based intervention.

Without the right types of high-quality evidence, scale and spread of any commercial innovation is nigh-on impossible. This is especially true in the current economic environment. Commissioners, payers and patients need to be highly confident they understand how a technology will perform before they even consider paying for it.

As a result, the team that I head up at the HIN – covering evaluation, informatics and health economics – is extremely busy. We’re also involved in delivering DigitalHealth.London’s Evidence Generator Bootcamp, which has seen an explosion in interest recently.

Evaluation and evidence generation is a complex field, and the HIN south London Mindset XR Innovator Support Programme  will be providing bespoke support for innovators taking part, along with in-depth online learning resources. The purpose of this blog is to  provide a very brief overview of what the evidence generation landscape looks like in the UK, and start innovators down the right path when it comes to collecting the evidence they need for their work to succeed.

What do we mean by evidence and evaluation?

Although specialists working in the field have strict definitions for what these terms mean, you might hear them used interchangeably. Broadly speaking, it can be helpful to think of them as the below:

  • Evaluation: judging the worth or value of something, often in comparison to other available options. For example, you might seek to evaluate whether your innovation delivers better clinical outcomes than the current treatment approach.
  • Evidence: the sources of information that you might use to make a decision about something. This could include evaluations, feedback from patients or users, analytics or analyses of population health.

Within health and care innovation, it is generally considered best practice to integrate evaluation and evidence-related activities into every stage of your projects. Your stakeholders will want to see that you have used evidence to understand a particular disease area to specialise your solution for; there will be an expectation that you have methods for measuring how your innovation works with users (such as analytics within your XR software); to drive widespread adoption will eventually need to have compelling evidence that your innovation provides advantages over what is out there already.

As you start to look at what evidence and evaluation might mean for your innovation, the complexity and costs associated might begin to look quite daunting quite quickly – especially for more complex formal evaluations with patients such as clinical trials.

Luckily, in recent years, the path for developing good-quality evidence for digital health interventions has become much clearer.

The role of NICE and the MHRA

There are two key organisations who immersive technology innovators need to be aware of when it comes to defining national standards for evidence:

  • The National Institute for Health and Care Excellence (NICE)
  • The Medicines and Healthcare Regulatory Agency (MHRA)

Probably the best starting point for most digital innovators is to look at NICE’s Evidence Standards Framework (ESF). The ESF is intended to be a shared framework which allows innovators and commissioners to understand the most important types of evidence for different digital health technologies (DHTs).

Using the ESF, DHTs are grouped into three tiers based on the intended use of the innovation. While the range of applications for XR in mental health is almost limitless, we anticipate most innovations we come across during the Mindset programme will fit into Tier C (DHTs for treating or diagnosing medical conditions) or Tier B (DHTs which help people to manage their own health and wellness).

After the correct tier has been identified, the ESF lays out 21 standards for consideration, ranging from clinical effectiveness to environmental sustainability.

Because the ESF is a framework rather than a formal assessment, it does not prescribe exact evidence requirements for each of these standards. Instead, it provides a comprehensive overview of all the different evidence areas which are likely to need to be considered. Within these, companies can develop their evidence base over time as their innovation scales.

The MHRA’s role is different – they regulate (by law) all medical devices in Great Britain and Northern Ireland.

Defining what is and is not a medical device in the world of DHTs is not always straightforward; the MHRA have produced guidance on digital apps which may help to establish whether your technology falls under their remit. You can also contact them for additional guidance.

If your immersive technology is classed as a medical device, you will need to meet strict standards around safety and efficacy, including carrying out a clinical investigation. Meeting these standards is a significant undertaking and you should begin planning to meet MHRA certification criteria as early as possible in the development of your product.

Stay informed

Although evaluation can seem like a highly complex area of innovation to navigate, there is support available.

The Mindset-XR Innovator Support Programme provides specialist support – including advice on evaluation – to companies on our programmes. The team will also be producing publicly available learning materials about regulation and evidence generation for immersive technologies in the coming months; please do sign up to our newsletter if you want to be the first to get access to them.

Elsewhere, regional health innovation networks also provide support for innovators and can give you impartial advice on evaluation, as well as helping with connections to evaluation specialists.

Another useful resource for getting practical information on how to approach evaluation/evidence generation is a collection of resources on evaluating digital health products produced by the Office for Health Improvement and Disparities.

In memory: Paul Wallace

Published and last updated by Sharon Farnley

It is with great sadness that we mark the passing of Professor Paul Wallace, Health Innovation Network (HIN) South London’s Clinical Director for Digital. Paul passed away on 28 February 2024, following a long period of illness due to prostate cancer.

Paul was internationally recognised for his contributions to health and care at the intersection of clinical practice, academia and implementation science. He leaves behind a legacy of pioneering research into alcohol interventions and digital technologies in primary care, as well as driving forward the standard of evidence for digital health technologies more generally.

Paul originally began working with the HIN as Clinical Director for our alcohol programme. Much of Paul’s research portfolio was centred on the detection and management of alcohol misuse, generating more than 100 papers and book chapters on this topic. His work made particular contributions towards the development, assessment, and distribution of digital applications to reduce alcohol-related harm, being part of the vanguard for the use of digital technologies in this space.

Paul’s most recent role in the HIN began in 2017, when he was appointed Clinical Director for Digital. In the following years he brought his vast knowledge and ambition to bear primarily on DigitalHealth.London’s programmes. Initially Paul helped to assess fledgling technologies and provide advice on their evidence base; over time this focus on evidence grew into a dedicated programme which we now know as the DigitalHealth.London Evidence Generator Bootcamp. Dozens of the UK’s most promising digital health companies have directly benefitted from Paul’s support in navigating the complex yet crucial journey of evidence generation as part of the programme; countless more will indirectly benefit in years to come. Paul has left an enduring mark on Health Innovation Network and DigitalHealth.London, and his influence will live on in our work.

Paul began his professional career in primary care, practicing as a GP in north London for 20 years. He showed an early interest in clinical academia, being awarded a Medical Research Council (MRC) epidemiology training fellowship shortly after completing his specialist medical training. He went on to hold posts at the MRC, Imperial and University College London (UCL). He formerly served as National Primary Care Director for the NIHR Clinical Care Research Networks, as well as contributing to various national working groups on alcohol and acting as a senior advisor to charities Alcohol Concern and Drinkaware.

Paul’s varied and significant contributions to clinical practice and academia were recognised by a number of prestigious awards and appointments over the course of his career. He was Emeritus Professor of Primary Health Care at UCL and a Fellow of the Royal College of General Practitioners (RCGP), which awarded him its President’s Medal in 2013. Paul was also a Fellow of the Faculty of Public Health Medicine at the Royal College of Physicians.

In 2012, he co-founded the Foundation for Family Medicine in Palestine. Through the Foundation, Paul has played a major role in developing primary care infrastructure and provision in an area in desperate need.

Paul’s tireless determination to improve the world around him was exemplified by his enthusiasm for work in the final months of his life, helping to shape the latest Evidence Generator Bootcamp alongside playing an integral role in a number of academic projects.

Paul is survived by his wife Sabrina and his children.

“Paul contributed to the HIN over many years, and his passion for evidence generation in innovation was evident through his dedication until the end. He helped design and optimise programmes of support for innovators, and build relationships with partners nationally and internationally that are central to the HIN’s work.”Anna King, Commercial Director, Health Innovation Network South London

Developers of immersive technology for mental health to benefit from £20m investment and Innovator Support Programme

Published and last updated by Sharon Farnley

A new supportive ecosystem for UK innovators working on immersive digital mental health therapeutics is being launched.

The UKRI Mindset XR Innovator Support Programme is going to be led by the Health Innovation Network (HIN) South London it was announced today.

The full Mindset extended reality (XR) for digital mental health programme 2022- 2026 is a £20m investment which aims to treat more people with mental health needs by investing in Extended Reality (XR) and other immersive technologies; achieving transformation through the development and scale-up of emerging digital mental health therapies.

Through collaboration with experts across the UK, the HIN will deliver a programme of innovator support including:

  • Creating a networking and information sharing platform for potential collaborators.
  • Providing advice and expert support to existing and future competition applicants.
  • Delivering a programme of outreach and engagement activities to cover the whole of the UK, including the devolved administrations.
  • Facilitating knowledge sharing across a community of practice.
  • Providing tailored support for larger scale industrial research projects and smaller feasibility projects.
  • Delivering a learning package on a range of key topics.
  • Driving the conditions for change through industry-wide and health system-wide roundtables.

The collaboration brings together UK wide reach and a set of complementary skills – service user engagement, clinical research design, regulation and digital therapeutics – critical to address the challenge of bringing immersive tech to our population and staff. As part of the Health Innovation Network, we will collaborate with networks across the country, including Health Innovation North West Coast, Health Innovation South West and Health Innovation North East and North Cumbria. As well as these we will also collaborate with:

  • Hardian Health
  • Hill Dickinson LLP
  • The Health Innovation Research Alliance Northern Ireland (HIRANI)
  • King’s College London
  • MQ Mental Health Research
  • XR Health Alliance

Dr Rishi Das-Gupta, CEO of the HIN said: “Immersive technology has the potential to dramatically improve the treatment of those with mental health conditions, which is an area we know has seen increased demand and widening health inequalities.

“Working with Innovate UK and our collaborators across the UK presents an exciting opportunity to make a wide-scale difference.”

Quotes from Partners’ Spokespeople

    Hardian Health

    “Hardian is excited to be working with innovators at the cutting edge of healthtech to ensure that their novel extended and virtual reality devices are as safe, effective and performant as can be when applied across a range of medical purposes. We look forward to stretching the boundaries of what is possible with the Mindset cohort.”

    Health Innovation North East and North Cumbria

    Dr Nicola Hutchinson, CEO of Health Innovation North East and North Cumbria, commented: “We are delighted to be a partner on this important project, which will help to mobilise groundbreaking immersive innovations to address the mental health challenges facing many people in our communities. Through the Mindset programme, we’re looking forward to working with innovators in the immersive technology space in our region to support the development of solutions that will hopefully result in people with mental health needs being treated more quickly through immersive digital mental health therapies.”

    Health Innovation North West Coast

     Dr Phil Jennings, Chief Executive of Health Innovation North West Coast, said: “We’re really excited to be involved in a project that promises to deliver tangible improvements in patient outcomes.

    “The challenges are as acute in our region as anywhere in the country but there’s also an abundance of talent and creativity we can draw on. The Mindset programme will help us bring that creativity to bear on one of our most enduring challenges.”

    Health Innovation South West

    Jon Siddall, Chief Executive Officer of Health Innovation South West, said: “This is an exciting opportunity to build upon the existing novel technologies developed in, and deployed across, the South West to support those with mental health needs. We are working with our partners in the South West to maximise the impact of research and innovation in mental health care. Mindset’s innovative therapeutics offer promising digital solutions to the mental health challenges experienced by people living within our rural and coastal communities, and will enable us to drive a digitally-enabled health and care sector across our Peninsula.”

    Hill Dickinson

    “The Mindset XR Innovator Support Programme will be a brilliant vehicle for innovators to collaborate and develop new and immersive technologies for adoption into everyday healthcare settings. Extended Reality [XR] and similar technologies have the potential to transform our current approach to treating patients accessing mental health services here in the UK. For us as specialist healthtech lawyers it’s incredibly exciting to be a part of that.”  Jamie Foster, Partner, Hill Dickinson

    Hira-ni

    “In Northern Ireland there is a distinctive mix of capabilities in digital technology and the creative industries, coupled with expertise in mental health research – so we are delighted to partner with Health Innovation Network South London to support the Innovate-UK Mindset XR programme network in this region to support innovators to unleash their potential to forge new collaborations to develop and test XR technology solutions for mental health” Joann Rhodes CEO of HIRANI.

    Innovate UK

    Dr Stella Peace, Executive Director for the Healthy Living and Agriculture Domain at Innovate UK, said: “Fostering collaboration between the immersive technology sector and mental health providers is pivotal to driving innovation to address critical challenges in mental health care. This programme, with its commitment to empowering innovators and providing robust support, will drive business growth by inspiring and unlocking innovations that make life better.”

    King’s College London

    Fiona Gaughran, Professor of Physical Health and Clinical Therapeutics in Psychiatry, King’s College London said: “We are very excited to be part of this innovative collaboration aiming to develop and scale-up new immersive digital mental health technologies. At King’s College London we have a wealth of clinical researchers who bring their patient experience right into the heart of their research to positively impact the lives of people with mental health needs and their families. We are looking forward to sharing our knowledge in this area and providing support and training across the partnership.”

    MQ Mental Health Research

    “MQ is excited to be a capacity development partner, alongside the Health Innovation Network, supporting innovators in the creation of digital therapeutic Extended Reality (XR) solutions in mental health. Specifically, and in line with what MQ stands for and strives to achieve, we look forward to helping these passionate individuals ensure people with lived experience and their needs are at the heart of their innovations and to help them along their pathway to impact.”

    XRHA

    “We desperately need to bring together science, storytelling and innovation to solve some of society’s greatest challenges. The XR Health Alliance are utterly elated be part of the Mindset program, which has the bold goals of doing exactly that. We are particularly excited to be supporting and bringing together a transdisciplinary community of patients, XR creatives, healthcare professionals and researchers to create powerful new solutions for mental health and wellbeing.”

    Notes to Editors

    Hardian health is a clinical digital consultancy helping researchers, industry and investors bring digital solutions to healthcare.

    Health Innovation North East and North Cumbria supports the health and care system to accelerate innovation which improves people’s health and the regional economy.

    It works closely with the NENC ICS and its member organisations, including the NHS Trusts and universities, across the NENC to help them identify, evaluate, adopt and disseminate transformative innovation. It works a lot with industry too, as a source of innovation and also to help industry access the expertise within the NHS that is so crucial to the development, testing and deployment of products and services that are the basis of the UK’s Life Sciences sector.

    Health Innovation North West Coast supports the discovery, development and deployment of innovations and improvements in health and care across Cheshire, Merseyside, Lancashire and South Cumbria.

    The innovations it supports are ideas, services, products and processes which improve health and the quality of care and drive costs down.

    Health Innovation South West is one of 15 Health Innovation Networks set up by NHS England in 2013.

    It exists to help transform the way health and care systems in the South West identify, adopt and spread innovation to transform lives, improve population health, and drive economic growth. Together with its local and national partners it is increasing the impact of research and innovation across the peninsula.

    An international commercial law firm that provides wise counsel and market insight, to not only help deal with the issue at hand, but to help seize opportunities and plan ahead.

    The Health Innovation Research Alliance Northern Ireland (HIRANI) was established to strengthen the Life & Health Sciences ecosystem by maintaining a clear vision and strategic direction, and to act as a single voice for the sector with a focus on promoting Life and Health sciences capabilities in Northern Ireland.

    Innovate UK is creating a better future by inspiring, involving and investing in businesses developing life-changing innovations.

    We provide targeted sectors with expertise, facilities and funding to test, demonstrate and evolve their ideas, driving UK productivity and economic growth. Join our network and communities of innovators to realise the potential of your ideas and accelerate business growth.

    King’s College London is an internationally renowned university delivering exceptional education and world-leading research. It is dedicated to driving positive and sustainable change in society and realising its vision of making the world a better place.

    Its vision is to create a world where mental illness is understood, effectively treated and ultimately prevented. With the help of its supporters and a global network of leading scientists, it is championing and funding research into mental health that will change millions of lives.

    The XR Health Alliance is dedicated to the responsible development, investment and adoption of immersive technologies in healthcare. Bridging the gap between industry, research and healthcare to unlock new cross-sector innovation and collaboration.  XRHA aims to share best practice, support and connect inclusive and diverse communities of patients, creators, researchers and healthcare professionals.

    Mental Health

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    Reducing restrictive practice: it’s always the right time to make a difference

    Published and last updated by Sharon Farnley

    Post Title

    Forensic mental health units (sometimes referred to as secure units) provide a vital service in caring for people with severe mental health conditions who may be a risk to the safety of themselves or others.

    Reducing the use of restrictive practices (such as inappropriate physical restraint or rapid tranquilisation) in these units poses a unique set of challenges. In this blog, we hear from HIN Project Manager Ayobola Chike-Michael, Expert by Experience, Igoche Ikwue and Ward Manager Toheeb Bawala about how a recent visit to a forensic ward provided proof that impactful interventions can still be implemented successfully in the face of significant operational pressures.

    This is the latest in a series of reflective blogs about the Health Innovation Network’s involvement in local efforts to reduce restrictive practice based on the findings of a successful pilot led by the National Collaborating Centre for Mental Health. Find links to all our blogs here.

    Ayo

    An integral part of our reducing restrictive practice programme is to visit participating mental health wards to build relationships and support systematic quality improvement.  We have worked with ten wards across our region to enable shared learning, suggesting and supporting change ideas through codesign and coproduction with experts by experience and insights related to health inequalities.

    One of the wards we have visited is Ruby Ward – a 10 bedded, female forensic ward. Although Ruby Ward was not the first mental health ward we have visited, visiting a forensic ward was a unique experience which offered valuable insights into the world of forensic mental health and challenges faced by both staff and service users.

    As expected, there was a high level of security at the ward. This meant we passed through several checkpoints and adhered to strict rules before being allowed access to the unit. The ward itself was clean, well-maintained and staffed by a team of dedicated healthcare professionals led by Toheeb Bawala, the ward manager.

    Delivering high-quality person-centred care on forensic wards is inherently more complex and potentially more challenging than other inpatient settings, and the Ruby Ward team also have to contend with limited physical space (although we were pleased to hear that the ward is moving to a more spacious location) and the current workforce pressures affecting mental health staffing levels. Although many mental health services are experiencing problems with recruitment and retention of staff, forensic units face particular challenges due to the high staff-to-service user ratio required to safely deliver this type of specialist care.

    Despite these difficulties, we immediately noticed that the staff demonstrated a deep understanding of the unique needs and challenges faced by service users and they were committed to providing the best possible care and support.

    We also discussed positive interventions that had worked to reduce restrictive practice in their environment. The ward manager Toheeb talked us through their collaborative daily planning exercises with service users; a simple but highly effective technique which they had found reduced conflict and created a calmer environment for everyone on the ward. Daily, staff engaged with all patients after their breakfast to co-plan their day. This helped staff with planning and gave service users a voice to express their own preferences.

    Although the intervention itself was straightforward, coming to these arrangements needed flexibility on the part of staff to move away from previous protocols (such as more rigid weekly activity planning), working with service users to listen and adapt the approach taken to their care.

    I was grateful to the staff for allowing us to visit at a time when pressures were so high, for showing us that a quality improvement philosophy can still make a difference to outcomes even when teams are exceptionally busy. It also served as a reminder to me of why support from the rest of the system for frontline teams is so important – sharing learnings and helping to catalyse service development.

    Igoche

    My reflections as an expert by experience remain fresh in my mind every day. I keep thinking about the best ways to improve mental health services in a more compassionate and humane way, while also ensuring safety.

    My visit to Ruby Ward felt like diving into the unknown, and from the moment I began the series of security checks to enter, I knew it was different to anywhere we had visited as part of our project so far.

    I believe that walking into such an environment and interacting with members of staff must be done in a person-centred way. My thought process focused on showing more compassion and kindness through communication to demonstrate that we are truly there to support, listen and learn.

    One of the things that struck me was the physical space. We know that having the right physical environment is important for service user recovery and reduces the need for restrictive practice. Well-designed spaces can reduce stress and anxiety, promote social interaction and support a sense of normalcy and autonomy. They can also support the efforts of staff, for example designing clear sight lines throughout the unit so that service users can be monitored and situations can be identified early and de-escalated before restrictive practice becomes the only option.

    Ruby Ward’s current setting included some recreational spaces and a gym, but it also had features that were less than optimal, such as a lack of natural light in some areas. The overall footprint of the unit is fairly small, meaning that personal space for service users could feel limited.

    It was great to hear from Toheeb that the Ward will be moving to a more well-suited location. I am sure that this new space will make a real difference to service users and staff, and I think it is important to reflect on the commitment that it has taken to make this happen. Some interventions can be straightforward to implement – such as the daily planning exercises Ayo has discussed – but others may take months or even years of work to bring to fruition. It is important that we provide the practical support and knowledge required to help teams make changes of all sizes which can improve care.

    My main takeaway from visiting the ward was that quality improvement support needs to be offered in a way which demonstrates kindness and compassion. Services such as forensic units care for extremely vulnerable people who are often very unwell. This is not easy work, especially when combined with external factors such as the shortage of mental health professionals across the NHS. We must recognise that the staff of these wards are striving to do the best they can in challenging circumstances, and that our efforts need to be led by love and humanity if we want to build relationships which will allow us to help them on their journey.

    Toheeb

    Ruby Ward is an extremely busy and complex environment to work in. We care for patients who can be very unwell and we operate with greater restrictions than many other services because we must maintain a secure environment.

    As such, it is perhaps unsurprising that the staffing pressures affecting the whole mental health sector have had a particularly pronounced impact on forensic wards like ours.

    Despite these challenges, I am proud of the quality of care we deliver and the spirit in which we deliver it.

    The visit of Ayo and Igoche was a welcome chance to take a step back and gain additional perspective on how we might be able to continue to reduce the use of restrictive practices on our ward. We discussed interventions that had worked in our setting (such as the daily planning exercises) and we also talked about other ideas from the Mental Health Safety Improvement Programme, such as safety crosses.

    Since the visit, our work on reducing restrictive practice has continued on a positive trajectory; there were no uses of restrictive practice in March and April 2023. We have also made positive progress on recruitment, and in the longer term we have a move to a new ward to look forward to.

    Regardless of the setting or service, quality improvement does not happen in theory or in textbooks. It is about making a real difference to real patients. Sometimes that means we must strive to make things better in challenging situations or with limited resources. I hope that our own progress on Ruby Ward helps to remind staff in similar scenarios that with dedication and access to the support, positive progress is always possible.

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    Transforming Mental Health Care: A Journey to Reduce Restrictive Practices

    Published and last updated by Sharon Farnley
    A sign showing different ward names

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    Post Title

    Restrictive practices are techniques such as physical restraint, seclusion and rapid tranquilisation used to limit a person’s liberties, movements or freedom to act independently in potentially dangerous situations.

    The inappropriate or overuse of restrictive practice in mental health services has been identified as an area of concern in healthcare since at least 2015, and our ongoing work to reduce restrictive practices was highlighted as part of our celebration of World Patient Safety Day in September.

    Following on from her visit to an acute female psychiatric ward in August, HIN Patient Safety Project Manager Ayobola Chike-Michael visited Tolworth Hospital’s Jasmines Ward in South West London to see how they are working to reduce restrictive practices and create a compassionate and supportive environment for all patients.

    In the ever-evolving landscape of mental health care, the Mental Health Safety Improvement Programme has been making significant strides since its inception in 2021. With a strong focus on reducing restrictive practices, the programme aims to reduce occurrences of physical restraints, seclusion, and rapid tranquilisation across participating wards. During my visit to Tolworth Hospital's Jasmines Ward in South West London, I had the opportunity to meet Hannah McCarthy, the new ward manager, and gain valuable insights into their innovative approach to care. The commitment and dedication of the Jasmines Ward staff to create a safe and compassionate environment were evident from the moment I stepped in.

    Jasmines ward, a 16-bed mental health ward for older adults presented a unique set of challenges and requirements. A large proportion of the patients on the ward are living with dementia. While incidents of restrictive practices were explained to me as rare due to the frailty and older nature of the patients, the ward manager and her team seem prepared to handle any situation that might arise. The staff focus on providing personalised care, ensuring everyone’s needs were met. One notable practice was the "This is me" profile on the door of each patient, fostering a sense of identity and promoting a person-centered approach acknowledging each individual’s cultural and family background, as well as their interests and achievements.

    The success of Jasmines Ward in providing comprehensive care can be attributed to its robust Multidisciplinary Team (MDT). Comprising of doctors, occupational therapists, physiotherapists, a dietician, an activity coordinator, an exercise therapist, the pharmacist and, upon request, visits from a chiropodist. The MDT works seamlessly to address the diverse needs of the patients. This collaborative approach ensures that the care provided is holistic, focusing not only on mental health but on physical wellbeing too.

    The team working on Jasmines Ward recognises the importance of maintaining the dignity and pride of their patients, even during moments of potential restraint. Incidences of restrictive practice are handled sensitively, ensuring safety whilst minimising distress.

    Like any healthcare setting, Jasmines Ward faces its own set of challenges; ensuring staff have time and are trained to lead on person-centred care remains a priority. To address this issue the ward is actively seeking long-term solutions; a recent recruitment drive has been successful and the ward are expecting the arrival of five new nurses to join the team in the near future. Flexibility with shifts and a focus on work-life balance are expected to create a more sustainable and fulfilling work environment.

    The Mental Health Safety Improvement Programme has introduced several tools to monitor and track restrictive practices effectively. One such tool, the safety cross, is a simple visual representation that enables staff to identify patterns at a glance

    In addition to their existing use for falls, the ward is encouraged to also implement safety crosses specifically for restrictive practices. This tool has proven invaluable in other participating wards to shape discussions around frequency of restrictive practices, de-escalation techniques, and proactive interventions.

    Stepping into Jasmines Ward, I was greeted by a fast-paced atmosphere catering for patients’ needs constantly. Each patient's door bore a simple profile, offering a personal touch that goes a long way in making patients feel comfortable. The ward faces challenges related to the space available, particularly around storage, but despite this the staff remain dedicated to finding solutions and putting patient well-being at the centre of everything they do.

    Image of a poem about Jasmines Ward

    Jasmines Ward recognises the importance of feedback from service users and their carers. Verbal feedback is consistently positive, and I was shown an example of handwritten feedback that further exemplified the impact of the compassionate care provided.

    A poignant poem displayed on the ward about dementia served as a reminder to both staff and visitors about the ongoing need for kindness and empathy towards patients.

    Using the poem as an active reminder and not just part of the wallpaper would be part of my advice to pass on. I believe with their multidisciplinary approach, dedication to feedback, and continuous drive for improvement, Jasmines Ward will remain dedicated to reducing restrictive practices.

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