Time flies.

Acalma.online was born from the realization that the state of “mental emergency” would go hand in hand with the state of emergency. Mitigating the effects of containment, through specialized psychological support and with a simple and accessible tool, was the goal of Casa do Impacto, in creating this national platform for mental health support.

Find out more about acalma.online here.

After 3 months of activity of the platform, which Casa do Impacto developed within the Tech4covid19 movement and with the support of the Impact Start-ups ZenKlub, Doctorino and Hug-a-Group and in partnership with WithCompany and DoctorSpin, we now release some data from the report made based on the satisfaction and impact assessment survey, carried out by Casa do Impacto, which focused on the platform’s main stakeholder, the patients.

As of 23 June 2020, 943 consultations had been carried out, with a monthly average of 309 consultations. An average of 3.4 consultations per month was offered by the 90 psychologists involved, on a voluntary basis, with support from the other partners involved, also on a voluntary basis by individuals and organizations. Compared to the 1,326 successfully scheduled consultations, the completion rate was 71% and the dropout rate was 29% (228 absences + 155 cancellations).

In relation to the platform’s impact assessment and satisfaction survey, the response rate and respective sample was 20%, and 184 valid responses were received (corresponding to 142 people supported), which allowed the following characterization of the platform’s beneficiaries:

• 27 people who benefited from two to six consultations (23% of 142 patients);
• Average of 39 years of age (from 17 to 74);
• 68% were women;
• 67% had attended higher education;
• 67% were employed (TCO; PCT; Mixed; Student Workers);
• 19% were unemployed;
• 11% were students;
• 4% were retired

It should be noted that, in all 35 OECD countries, Portugal is among the five with the highest percentage of the population with some kind of mental health problem (18.4%, based on a 2016¹ study) and that, in our country, the challenges of mental health are mostly related to the most common problems, linked to anxiety and depression.

At the time of the first consultation we obtained the following indicators regarding the entry profile of the beneficiary:

• Level of severity (diagnosis): the majority of people (62.7%) were at the “moderate” level, followed by the group with a “severe” diagnosis (24.6%);
• The platform was supporting those most in need because the sum of the moderate level and the severe level of the risk scale corresponds to 87.3% of those supported;
• The labour situation was very different, ranging from 7.1 points out of 35. The most serious situations are those of the unemployed (26 out of 35) and then the workers who accumulate TCO and TCP, as well as students (both categories with 23 out of 35).

Psychological support in a crisis context is aligned with a target 3.4 (specific to SDG 3) related to the promotion of mental health and well-being. This target is measured nationally and globally by reducing the suicide rate, which we consider to be beyond the scale and mission of a platform for psychological support in a crisis context. We have chosen to adapt good WHO practice of psychological support in the context of adversity.

According to a study by DGS² (Women N = 2,217; Men N = 1,632) and according to the OECD (Health at a Glance: Europe 2018: 2016 data), the percentage of women (48.8%) and men (27.6%) who used psychological support services of some kind throughout their lives, including non-specialised services, represented around 723,735 people in Portugal in 2013, corresponding to 38.2% of the total population in need of psychological support. To put this figure in perspective we have 61.8% or 1,174,076 people who, according to the OECD, we know are in need of psychological support (18.4% of the Portuguese population in 2016) but who have never received any kind of support of this nature.

The project adopted as a theory of change³ the central hypothesis that immediate psychological relief results in greater adaptive capacity and the development of emotional skills that can help prevent an even greater mental health crisis, with all the negative impacts that can result from it, and thus seeks to achieve the following direct results:

1. Immediate relief and stabilization of psychopathological symptoms;
2. Support in resolving the disadaptive response to the event that creates disorganization at the time;
3. Promotion of skills for the resolution of the situation causing unease.

What better way to say thank you for the work done if not with the demonstration of the positive impact of acalma.online on the lives of the people supported:

• 8 out of 10 (N=142) showed high satisfaction with the service;
• 4 out of 10 (N=142) reported high impact of the support on improving immediate individual well-being
• In the benchmarking, on life satisfaction (OECD/Gallup), the population supported (N=142) was 5 (on a scale from 1 to 10) in the first consultation, 1 point below the national average (6 out of 10 | in 2018) and also 2 points below the OECD average (7 out of 10, 2018);
• The main indicators were designed with the intention of capturing change in the people supported in two or more consultations. On all 27 people (who had access to two or more consultations), we know that:

4. The level of risk fell by 2 points in the second consultation for all 27 people (from 23 to 21 on a scale of 0 to 35) and by 4 points, from 23 to 18, for a subset of 8 people who had three and four consultations;
5. Life satisfaction (OECD/Gallup) increased by 1.1 points (from 5.0 to 6.1 on a scale of 1 to 10) for the 27 people, reaching the national benchmark for this indicator;
6. When asked whether the platform acalma.online improves the well-being of those supported, there was an increase of 0.9 points (from 7.9 to 8.8 on a scale of 1 to 10); level of satisfaction with the platform as a service remained high with an increase of 0.9 points from 8.5 to 9.4 out of 10.

• In the subset of 7 people with a serious level of risk (27 to 35) there was a remarkable evolution:

7. The level of risk rose from 30 to 24, from “serious” to “moderate”;
8. Their life satisfaction reached 6.8 out of 10 placing them above the benchmarks (6.0 out of 10 in Portugal and 6.6 out of 10 in the OECD plan);
9. The impact of acalma.online on well-being rose 3.1 points (from 6.4 to 9.5 out of 10);
10. Satisfaction with the platform went from 7.0 to a maximum score of 10.0 out of 10.

• As part of the indicator of change that measures the impact of acalma.online on the increase in well-being, in the IMP – Impact Management Project benchmark, online is positioned among similar projects with a positive contribution to the solution, taking into account the high result compared to the percentage of total change possible in this indicator: 83% (136 out of 142 people) responded > 4 on a scale of 1 to 10.

References:

¹ OECD/European Union (2018), Health at a Glance: Europe 2018: State of Health in the EU Cycle, OECD Publishing, Paris/European Union, Brussels

² Andrade de Carvalho, A & Mateus, P & Xavier, M (revisão) et al (2014) PORTUGAL, Saúde Mental em números – 2014, Programa Nacional para a Saúde Mental, Direção-Geral da Saúde, Direção de Serviços de Informação e Análise

³ Dembek, K et al (2017)

acalma.online