NICEDAY: TECHNOLOGY MAKES MENTAL HEALTHCARE MORE PERSONAL AND MORE EFFECTIVE

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‘Innovations are still held back by the system all too often’

The mental healthcare waiting lists are getting longer, while the number of people with mental health problems is increasing. NiceDay offers a concept for personal (online) treatment. ‘Continuous contact between the therapist and client, that’s NiceDay’s strength.’

Suppose you have an anxiety disorder, but you have to go shopping this afternoon. You may well want to call your psychologist to alleviate that anxiety. But he or she is fully booked up with appointments all day long. And your appointment isn’t for another week and a half… ‘So that isn’t particularly helpful. And yet that’s exactly how the traditional treatment works,’ says Esther Janknegt, NiceDay’s managing director, which has decided to break with the traditional working method. The company does this through an app, which gives clients the opportunity to receive support when it really matters. Esther: ‘So in this case, the morning before you go shopping. You can simply call or chat with your therapist and subsequently leave the house with sufficient confidence.’

Psychologist of NiceDay having a video call with a NiceDay client

SPACE IN THE CALENDAR

This is made possible because therapists affiliated with NiceDay haven’t completely filled up their diaries with physical appointments on the sofa. This creates space for the remote monitoring of clients. And to be in a position to help, as and when it’s truly needed. Practitioners subsequently have a real-time insight into their clients’ progress, as a result of the registrations completed in the NiceDay app. Clients keep their own diaries and share emotions, feelings or accomplished activities with their therapist. ‘Therapists use existing, proven, cognitive behavioural therapy,’ Esther says. ‘Just not at specific set times, but when it’s going to have the most impact. Constantly being able to be in touch with each other, that’s NiceDay’s strength. Whereby online isn’t a goal, but a means, part of the solution. It’s also possible to combine physical treatments with the NiceDay app.’

Client of NiceDay is journalling his emotions and feelings in the NiceDay app

36,000 TREATMENTS IN 2020

Anyone who wants to gain a better insight into their mental health can download the NiceDay app and keep track of how things are going. You will need a referral from your GP if you want to be linked to a psychologist. NiceDay works closely together with a number of large mental health organisations. More than 1,000 practitioners throughout the Netherlands are now working with NiceDay’s online treatments. A total of 36,000 treatments were carried out in 2020. More and more employers are now also using NiceDay within their sustainable employability policy to (preventively) safeguard their employees’ mental well-being.

SHORTER, MORE EFFECTIVE, MORE PERSONAL

The initial results are very promising, according to Esther. ‘Lead times are at least 25% shorter with us. We also see fewer relapses, which allows us to conclude that the treatment is more effective. It was exciting for us to see whether the so-called therapeutic relationship between the therapist and client could also be developed via a screen. What we have managed to establish from both sides is that remote treatment is sometimes experienced as even more personal. Clients are sat at home, in their own familiar environment and will often talk more easily and freely than in a somewhat clinical treatment room. It also allows you to maintain a natural distance between the therapist and client. The bonding can sometimes be too great in traditional treatment, resulting in the treatments taking longer than necessary.’

CHANGE WILL RESULT IN RESISTANCE

The satisfaction scores are also higher compared to traditional therapy. Definitely with the clients, but also with the practitioners who have completed the special training. ‘Therapists who haven’t completed the training rate the NiceDay app somewhat lower,’ Esther admits. ‘Of course that makes sense, because this isn’t just digitising the work you were already doing. It’s a very different way of working. You must be facilitated in this with both training and coaching. But you’ll also need time from your employer in order to be able to adapt to this. That bit’s quite difficult, as the pressure on the mental healthcare institutions is so incredibly high. The waiting lists are huge, budgets are low and public opinion is strained. And any kind of change will always result in initial resistance, especially if you’re used to working in a certain way.’

Psychologist of NiceDay having a video call with a NiceDay client

SYSTEM LIMITATIONS 

And then there is “the system”, which is not cooperating. Mental healthcare mainly works with diagnosis-treatment combinations (DTC’s), the denominator under which healthcare products are declared to health insurers.  Health insurers often reimburse a maximum number of clients and in many cases only where it involves face-to-face appointments. Esther: ‘NiceDay will generally allow therapists to treat more clients more effectively in a one year period. But that’s not quite the case right now, as health insurers set limits in terms of the number of clients. And because online activities are not always reimbursed. While we can actually see that the interim contact has a major effect on the treatment and that clients genuinely like being treated and helped online. The fact that our technology allows for more effective treatments is therefore currently seen as a disadvantage, rather than an advantage. That’s obviously quite bizarre.’

CONVINCING PRACTITIONERS

‘We don’t let the system hold us back,’ Esther continues. ‘We have agreed a temporary payment title for healthcare innovation with the Nza, making sure care is reimbursed via NiceDay. And in the meantime we’re trying to convince as many practitioners of our concept as possible. Mental healthcare will also be switching across to the care performance model in 2022. The care performance level will reflect the care which has actually been provided, regardless of location and duration, and is recognisable and verifiable for the client. Interim and digital contact will soon also be included in so-called settings. The rates are in line with the treatment effort and treatment setting. At least that’s a step forward.’

FIGHTING THE SYSTEM IN TRUE ROTTERDAM-STYLE

NiceDay also hopes to collaborate with partners from the LSH010 network. NiceDay is part of the Almende group, which has been based in Rotterdam for thirty years. Innovation is in the DNA of all the companies affiliated with Almende. We would be very happy to be given the opportunity to work together with companies which provide similar or complementary services. This could include organisations involved with matching, front office or digital counters. But also GP’s or other healthcare institutions; after all, they are the ones doing the referring. We’re now also conducting studies into stress measurements via wearables, the use of VR in an online treatment setting and emotion recognition in text, as well as AI and decision support systems. In short: truly anything which can permanently change healthcare in the long term. But we can only bring about that change if we work together. The stronger we are, the more effectively we can fight that system. In true Rotterdam-style. Actions speak louder than words’.

Esther Janknegt, managing director of NiceDay

Would you like to know more about NiceDay? Please visit the website for more information, or contact managing director Esther Janknegt direct. You can do so via LinkedIn or email: esther@nicedaynederland.nl. You can also contact Jan Peter Larsen, CEO at Almende and founder of NiceDay: jp@almende.com.

Date: 11 March 2022