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Digital tools for youth with mental health issues

Wednesday 7 September 2016

Digital tools for youth with mental health issues look promising but caution is needed.

Superu has taken another step towards understanding how we can better support New Zealand’s young people.

Called What Works: Going Digital, Superu’s latest research looks at how digital tools might be used by and for young people (aged under 25 years) to provide user-centred wellbeing support services in safe, effective and engaging ways. Our focus is on youth mental health, noting some developments in online parenting support tools too.

Clare Ward, Superu’s chief executive, says that evidence about digital tools is patchy and of mixed quality, but is rapidly emerging.

"There’s a lot of potential for going digital in delivering services, if done the right way," says Clare.

"Our research shows that, where symptoms are mild to moderate, digital tools can be an effective self-care option for reducing depression and anxiety in young people, and improving parenting and difficult child behaviour."

"Caution is needed as it may be inappropriate to use these tools without the appropriate guidance and support."

The aim of this research is to share what works, and help programme developers, policymakers, providers and funders to make evidence-based decisions when they are looking to harness the potential of technology to deliver services.

"We looked at tools developed overseas and in New Zealand. Overseas programmes tend to lack cultural relevance for New Zealand. Luckily, there is a growing range of tools developed here in New Zealand."

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"This is important because 20-25% of New Zealand teenagers reportedly experience depression. The rate is higher among Mäori and Pacific youth, and New Zealand’s teen (15-19 year olds) suicide rate is among the highest in the OECD. Treatment for mental health remains generally under-accessed by youth."

Technology offers a way of diversifying and extending delivery of mental health and parenting support services, potentially improving reach, filling gaps and providing early interventions.

"Complex social issues need good-quality evidence and decision-makers need to know what works," says Clare. "By providing this research, we are helping to increase the use of evidence by people across the social sector so that they make better decisions."

We focused on tools with peer-reviewed evidence developed in the social sector. We note that there are many commercially-developed tools in the market too that we could also learn from, however these have not been a focus of this piece of work.

What works

- Technology offers a way of diversifying and extending delivery of mental health and parenting support services, potentially improving reach, filling gaps and providing early intervention.

- While rapidly emerging evidence is patchy and of mixed quality, studies generally find that e-therapies can be an effective option for reducing depression and anxiety in young people, and for improving parenting and child behaviour where symptoms are mild to moderate.

- Web-based programmes can be self-guided or offered with additional support (virtual or real, from professionals, peers or administrators), and are more likely to be effective when they are structured, interactive, informed by a theory of change, and teach skills.

- Different strokes for different folks: to maximise the appeal of an intervention, offer users choice to personalise their experience and to access different levels and types of support, depending on what they want or need.

- Intended users should be at the heart of design and actively involved in the process alongside subject matter experts.

- E-therapies may be as effective as conventional face-to-face treatments. They can be used as standalone treatments but are commonly seen as a useful gateway into, or bridge between, other services.

Issues to note

- There are serious risks in the use of digital tools, especially:

o by vulnerable people for whom it might be inappropriate

o in an unguided and socially isolated environment.

- Sustainability beyond pilots and seed funding can be a challenge, due in part to open-ended resourcing requirements, like budgets, capability, infrastructure and updates, for keeping pace with technology.

Further research needed

- Further research is needed into many aspects critical to effectiveness including ‘dosage’ (how much is enough for users to get and/or stay better).

- To help address ‘science-to-service’ lags and roll out piloted tools that are ready for everyday use, there are calls for more real-life feasibility and translational research.

- Learning what works from popular and innovative commercially-developed wellness tools is also imperative.

ENDS


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