Longitudinal changes in crisis and broader mental health service use following access to the Brain in Hand digital support service

Purpose Demand for mental health services in the UK has increased, including crisis care. Digital support tools are positioned as adjuncts to existing services, but there is limited real-world longitudinal evidence on how they relate to service use. This study aims to examine changes in crisis and broader mental health service use following access to the Brain in Hand (BiH) digital support service. Design/methodology/approach In this observational cohort study, adults accessing BiH (N = 149 at baseline) self-reported their use of mental health services at baseline, three months and six months. Most participants were autistic, had ADHD, or were students. Crisis and expanded mental health service use were modelled using two-part (hurdle) models to estimate changes in the likelihood and frequency of service contact between baseline and follow-up, with inverse probability weighting to adjust for differential attrition. Findings Reductions in both the probability of accessing services and the frequency of contacts were observed at three and six months. Reductions were concentrated among participants with higher baseline service use. Estimates were imprecise, reflecting modest sample size and variability. As an observational study without a comparator group, these findings describe how service use changed over the period rather than establishing that BiH caused the change. Practical implications Reductions in service use, particularly among higher-use individuals, indicate a pattern of engagement consistent with the intended adjunctive role of digital support tools within mental health services. Originality/value This study provides longitudinal evidence on mental health service use following access to a digital support tool in a real-world setting, and highlights the importance of distributional patterns in understanding service use within high-need populations.