Slide outline: Logging in: Using technology in practice to improve young people's mental health

CFCA webinar - 20 October 2015

  1. Using technology to improve young people's mental health
    • Dr Michael Carr-Gregg PhD MAPS Managing Director, Young and Well CRC
    • Australian Department of Industry and Science
    • Business Cooperative Research Centres Programme
  2. Image: Thank You Road sign
  3. Image: Astronaut on the moon with USA flag
  4. Voyager 1
  5. Blind Willie Johnson
  6. The Young and Well CRC
    • Victorian-based, international research centre
    • Working in very close partnership with young people
    • 75+ partner organisations, including governments & universities
    • Exploring new technologies to promote mental health and wellbeing
    • Researchers, practitioners, policy-makers and innovators across the academic, non-for-profit, government and corporate sectors
  7. Image: Young and Well website
  8. Current situation
    • Mental health problems are common in young people. There is evidence that the current generation has more difficulties than previous generations in coping, resilience and wellbeing.
  9. 28 per cent report "moderate" psychological distress, despite reporting generally good health (Burns, Davenport, Christensen et al., 2013)
    • Suicide is the leading cause of death for young people aged 15 to 24 (Australian Bureau of Statistics [ABS], 2009)
  10. The Mental Health of Children and Adolescents
    • Report on the second Australian child and adolescent survey of mental healh and wellbeing
  11. Current situation
    • Webpage with headine: Quarter of teen girls self-harm: study
  12. Current situation
    • Only a small number of young people actively manage their wellbeing or engage in early help-seeking behaviour.
  13. Youth Survey 2014, Mission Australia
  14. Results: Issues of personal concern to young people 2013
    • Diagram: More than 50 per cent of young people are either extremely concerned, very concerned or somewhat concerned about coping with stress, school and study problems, body image and depression
  15. Results: Issues of personal concern to young people 2014
    • Diagram: A higher percentage of young people in 2014 were either extremely concerned, very concerned or somewhat concerned about coping with stress, school and study problems, body image and depression than in 2013.
  16. Current situation
    • The not so good news: The healthcare system is under strain and youth mental health services are unable to meet the demand.
    • The good news: Australia is a world leader in developing online, evidence-based mental health services, many of which are available for young people. These services aim to encourage wellbeing and help-seeking.
  17. What are e-mental health programs?
    • It has long been recognised that the internet provides enormous potential for health care delivery – particularly mental health care resources
  18. E-mental health – research evidence
    • Over 40 studies show e-mental health interventions are better than placebo
    • Many studies show that they are as good as therapist intervention
    • One size does not fit all, but many consumers like e-mental health interventions
    • If they suit a particular person’s way of getting information they can be highly effective
  19. Image: Time magazine cover with Headline: Never offline
    • 90% of yp have internet access in the home
    • 69% of yp use a smartphone
    • 56% use their mobile phone to go online
    • Diagram: The frequency of teenagers going online is increasing... 72% go online more than once daily
    • Source: 15 July 2014
  20. Technology such as smartphone apps, web-based programs and wearable devices are an effective way of engaging young people, because they are anonymous, confidential, cheap and appealing.
  21. Associate Professor Leanne Hides
    • "…The sheer penetration of smartphone use and apps provides an unprecedented opportunity to provide real-time standardised health information and treatment directly to young people in their natural environment."
  22. Uses of mobile apps in practice with young people
    • Psychoeducation
    • Screening and feedback
    • Decision making, problem solving and goal setting
    • Self monitoring and tracking of treatment progress,
    • Medication adherence
    • Homework
    • Skills training
    • Self-management
    • Help seeking
  23. Advantages of technology in mental health
    • Can help the 70% of Australians with mental health problems who do not seek help (McGorry 2012)
    • A need to develop more accessible, empowering and sustainable models of mental health care. (Christensen 2009)
    • E-health technologies have potential efficiencies and advantages in the domains of health promotion, prevention, early intervention and prolonged treatment.
    • Lower overall delivery costs
    • Reduce demands on the clinical workforce
    • Allows people to avoid stigma
    • Allows people to be anonymous & what they do is confidential
    • Self-paced learning
    • Opportunities to collaborate with peers
    • Cheap for consumers who are price sensitive
  24. Why recommend e-Mental Health programs to young people?
    • Simple, easy to use and require no particular expertise.
    • Easy to access, and most are anonymous and free.
    • For clinical professionals, provide content and reports which can guide sessions with patients and the overall treatment plan.
  25. Technology can improve and augment existing assessment, diagnosis and treatment for young people.
  26. The headspace psychosocial assessment interview
  27. The Centre of Excellence adapted the American HEEADSSS assessment interview.
    • This included:
      • changing the language to suit the Australian context
      • extending the domains covered to allow the detection of more serious mental disorders.
  28. The headspace psychosocial assessment interview
    • The tool consists of a set of 'screening' and 'probing' questions.
    • Practitioners who do not feel confident to conduct the full interview with a young person should choose only to complete the screening questions they feel competent to address.  If these screening questions suggest the need, refer on to another experienced practitioner for a full assessment.
  29. Sally Bradford…
  30. A solution: MyAssessment
  31. Results: Increased disclosure
    • Diagram: In the current study, young people were much happier to disclose information via the iPad than to directly to a clinician. The rates of disclosure via iPad were up to 10 times higher than face-to-face interviews.
  32. Potential outcomes
    • Greater potential for prevention and early intervention
    • Improved help-seeking and self-disclosure
    • Reduced medical, carer and welfare costs
    • Reduction in suicide, self-harm and accidental death
  33. E-mental health portals
  34. Advantages of mental health websites
    • Initial or more in-depth information about mental health issues
    • Specific information on signs, symptoms and diagnosis
    • Information about services and programs
    • Information about medication and potential side effects
  35. Advantages of mental health websites
    • Access to other people’s experiences of mental health issues or services
    • Validation of experiences and concerns
    • Strategies for young people to guide their own recovery
    • Encouragement for further help seeking
    • Mental health literacy
    • Anonymity
  36. Major Australian Mental Health Portals
    • www.mindhealthconnect.org.au
    • https://beacon.anu.edu.au
    • http://au.reachout.comu
    • https://www.healthonnet.org
  37. Image: Mindhealthconnect website
  38. Image: Mindhealthconnect website
  39. Image: Beacon website
  40. Image: Beacon website
  41. Apps and online tools are designed to assist with depression
  42. Apps and online tools are designed to assist with anxiety
  43. Apps and online tools are designed to assist with wellbeing
  44. Apps and online tools are designed to assist with wellbeing
  45. Case study - Toby
    • Toby, 19, has been smoking cannabis and drinking alcohol since he was in Year 9. He lives at home with his mother, father and sister. He dropped out of school after Year 10 but is now attending TAFE to complete Year 12. Both of his parents are unemployed.

      Toby’s new friends at TAFE are heavy drinkers and users of cannabis and ‘‘ecstasy’’, and his use of alcohol and cannabis has increased lately. His parents suspect episodes of injecting other drugs, but Toby refuses to confirm this. He has been missing classes and his motivation to study has decreased rapidly. There is conflict at home and Toby has been interviewed by the police, and issued with a caution

  46. Case study - Toby
    • Web-based intervention: Clear Your Vision
    • Involves 19 steps, commencing with him choosing which of four characters he most closely identifies with, and moving through to changes he wants to make and how
  47. Case Study - Toby
    • YoDAA is a smartphone app designed to help Toby reflect on drug- and alcohol-related needs. It plays the role of a digital drug and alcohol counsellor, encouraging help-seeking and offering next steps
  48. Case Study - Toby
    • Ray’s night out smartphone app is designed to increase the knowledge of harm minimisation strategies for alcohol consumption among people aged 16-25.
    • Participatory workshops with young people were used in design phase
  49. The World Health Organization states that suicide is the 13th leading cause of death world- wide, and is the leading cause of death among those aged between 15 and 39.
    • Image: Cover of WHO report - Preventing suicide: A global imperative, Executive summary
  50. Current situation
    • Australia lacks an agreed national program of action on suicide.
    • Evidence suggests that the most effective suicide prevention response involves:
      • a simultaneous systems-based approach that includes all relevant medical, health and community agencies within a region
      • all of whom implement a specific set of evidence-based procedures.
  51. The role of social media in suicide
    • "…Social media gets demonized quite a lot when it comes to suicide." Dr Jo Robinson, Orygen
  52. Question…
    • Is it possible to transform social media into a therapeutic tool to provide services and connect and empower teens?
  53. The role of social media in suicide
    • Suicide and Social Media paper: http://www.youngandwellcrc.org.au/wp-content/uploads/2014/07/Robinson_2014_Suicide-and-Social-Media_Findings-from-the-Literature-Review.pdf
  54. Why is social media demonized regarding suicide?
    • In the wake of suicides, online memorial pages, photos and comments often spring up and can glorify the incident in a way that is thought to contribute to a contagion.
    • Image: Webpage with heading - Tormented by trolling: The vile web craze that taunted family of bullied Natasha even after her suicide.
  55. Proof that social media has a role
    • Image: Webpage with heading - Facebook youth suicide prevention group needs government funding.
  56. The reality is:
    • Social media is not going anywhere
    • Young people actually prefer using social media than seeing professionals
    • How can we actually engage in a positive and constructive way with social media to work with young people and provide a service to them?
  57. Why use e-mental health strategies in suicide prevention?
    • Internet-based treatment has become an increasingly popular way to deliver health programs across the board,
    • Cognitive behavioral therapy (CBT), a method considered one of the most effective ways to treat adolescents with depression, anxiety or suicidal ideation.
    • Online program shouldn't replace face-to-face treatment, but can be a beneficial "adjunct" treatment for teenagers in particular.
  58. New media and suicide prevention
    • Text only hotlines
    • Social media prevention and Anti-stigma campaigns
    • New feature on Facebook that allows users to report suicidal posts or content
  59. What about smart phone apps?
    • There are currently hundreds of suicide prevention apps that have been created for specific populations, such as:
      • My3
      • Ask
      • Guard Your Buddy
      • iBobbly
    • There is a paucity of appropriately designed, properly evaluated smartphone apps or web-based programs to address issues of suicide
  60. My3
    • http://www.my3app.org
    • Image of My3 app: My3 lets you stay connected when you are having thoughts of suicide
  61. My3
    • Your safety plan
  62. My3
    • Get help now, Call 911
  63. My3
    • Create your support system
    • Build your safety plan
    • Access Important Resources
    • Get support at times of greatest risk
    • Access the National Suicide Prevention Lifeline 24/7
  64. Young and well webpage
    • Our tools and insights

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