Revolutionising OCD Treatment: Uspace and MindSkiller® Pioneer Diagnosis-Specific Program and Innovative Interventions
Despite impacting more than 500,000 Australians, Obsessive Compulsive Disorder (OCD) is widely misunderstood. Whether it's labelling an organisational habit as "being a little OCD" or suggesting a certain level of perfectionism is "so OCD," people tend to co-opt and minimise the lived experiences of those suffering with this diagnosis. But, the real-life effects and struggles of OCD should not be trivialised.
Symptoms of OCD tend to cause substantial disruption in everyday life, with individuals experiencing both obsessions and compulsions.
Obsessions, marked by persistent intrusive thoughts, images, or impulses, induce considerable distress and feelings of guilt or fear. While the scope of obsessions is broad, some of the most common include fears of contamination or harming a loved one. Meanwhile, compulsions are repetitive behaviours or thoughts that a person uses to neutralise their obsessions. In other words, these rituals might be carried out to prevent undesirable outcomes, alleviate anxiety, or to simply make things feel "right."
Though compulsions may offer short-term relief from stress and discomfort, they ultimately heighten anxiety. And as these rituals intensify, they demand more time and effort, making the obsessions harder to control. Individuals with OCD soon find themselves trapped in a distressing cycle, making it increasingly challenging to live life.
Not only is OCD misunderstood, but it is also under-researched, misdiagnosed and under-treated. Approximately 60% of people report OCD symptoms before the age of 20, yet global research indicates that it takes around seven years for people to access "effective pharmacological interventions." That being said, even when a patient receives evidence-based treatments, such as cognitive behaviour therapy (CBT) with exposure and response prevention, around 40-60% of people fail to show signs of improvement.
Senior lecturer Iain Perkes (et al., 2023) offers insight into this problem in a piece for The Conversation , noting, "There are no Australian clinical treatment guidelines, nor state or national clinical service plans for OCD." Without some sort of standardised approach, determining the appropriate treatment for specific patients becomes challenging for clinicians. Such delays limit opportunities for early intervention, making it increasingly difficult to address particular obsessions and compulsions as they become more ingrained over time.
Introducing Uspace's OCD Program
MindSkiller® is hoping to address some of these concerns by collaborating with Uspace - St Vincent's Private Hospital's young adult mental health service.
Uspace is currently developing a tailored inpatient OCD program for people aged 16 to 30. While the program is still in its foundational stages, it will run consistently year-round, with inpatient admission for up to three weeks. A diverse team of psychiatrists, allied health professionals and mental health nurses have worked to develop the program's key clinical care pathways and protocols - with Dr Gary Galambos, Uspace's Medical Director and the founder of MindSkiller® and Professor Vlasios Brakoulias, a global expert in OCD, at the helm.
MindSkiller® is helping support this inpatient model of care by bridging novel interventions, like Virtual Reality (VR) devices and MRI-guided Transcranial Magnetic Stimulation (TMS), with digital mental health tools.
Virtual Reality
Considering the immersive capabilities of VR, these devices serve a dual purpose: as an exposure therapy aid and a mindfulness tool.
Research has shown that exposure therapy is beneficial in treating OCD, where it systematically exposes individuals to feared thoughts or situations, helping them build resilience, reduce anxiety, and eventually gain better control over obsessive-compulsive patterns. Given the labour-intensive nature of exposure therapy, introducing it in an inpatient setting is often challenging; however, the extensive capabilities of VR present a promising alternative.
While Virtual Reality Exposure Therapy (VRET) is still in development, MindSkiller® is actively working towards creating tailored VRET online modules. Together with Uspace, this initiative will be an accessible, scalable and person-centred approach to delivering exposure therapy to people in need.
Meanwhile, VR has already proven to be a powerful mindfulness tool. Uspace recently introduced VR as a non-pharmacological solution for inpatients facing distress, with feedback indicating calming and promising outcomes.
MRI-Guided Transcranial Magnetic Stimulation
Alongside VR, MRI-guided TMS is also proving to be a significant part of the program.
MRI-guided TMS first involves a brain scan, where neuronavigation equipment is used to identify the target on the brain's surface associated with the disorder. Then, the treatment begins by placing a magnetic coil on the patient's scalp, directing magnetic fields on the area of the brain.
For the past 12 months, Uspace has been offering its inpatients and outpatients MRI-guided TMS for depression - a service also available via Vision XRAY on the MindSkiller® PLUS directory. Now, having recently received a magnetic coil specifically designed for OCD, TMS is available for Uspace inpatients in the program.
Ultimately, with MindSkiller® creating VRET modules and partnering with Vision XRAY, the platform seamlessly integrates all aspects of the OCD program while enhancing the continuity of care. Not only can patients learn about their diagnosis on the platform, but they can also conveniently track their recovery with follow-up measures and access other relevant mental health services.
With the ever-changing landscape of Australia's mental health system, it becomes clear that the development of diagnosis-specific treatment programs is crucial. This approach ensures that the care delivered by mental health services remains efficient and patient-centred, no matter the players involved. Integrating a digital platform like MindSkiller® only enhances accessibility and ensures that patients, even those suffering from the most under-researched and misdiagnosed conditions, receive the best mental health care available.
Read more about the Uspace OCD program here .
Resources:
https://www.healthdirect.gov.au/obsessive-compulsive-disorder-ocd
https://www.nature.com/articles/mp200894
https://www.tandfonline.com/doi/full/10.1080/00050067.2023.2189003
https://www.sciencedirect.com/science/article/pii/S0005796722001413?via%3Dihub
https://theconversation.com/obsessive-compulsive-disorder-is-more-common-than-you-think-but-it-can-take-9-years-for-an-ocd-diagnosis-196651 https://theconversation.com/people-with-obsessive-compulsive-disorder-have-an-imbalance-of-brain-chemicals-our-discovery-could-mean-a-treatment-breakthrough-208549
https://www.unsw.edu.au/newsroom/news/2023/03/obsessive-compulsive-disorder-is-more-common-than-you-think--but https://themelbourneclinic.com.au/internal-pages/ocd-anxiety-and-depression
https://www.svph.org.au/patient-news/uspace-obsessive-compulsive-disorder-(ocd)-program