As with any health service, the overall strategy for dealing with mental health issues includes parents, schools, youth workers and others, it's not just about digital. Although digital is just part of a health provision landscape, however, there are a lot of resources out there. But for younger members of society facing mental health issues even this rich digital landscape appears to be letting them down.
At the recent BCS Health Informatics Scotland conference, Dr Diane Pennington talking about empowerment for those with mental health issues.
She presented with Dr Trevor Lakey, looking at the youth perspective, and set the context with a quote from the British Journal Psychiatry 2013, which showed, as mentioned above, that youth have the worst service access of any age group.
With well over 10,000 apps in the mental health area, quantity is not the problem. It's much more about understanding people’s lives and how they communicate and, of course, it’s about quality. One interesting motivator mentioned is that those with mental health issues often want to help their peers, as they are the first to find out friends’ problems.
Some good exemplars cited were Ayemind, which aims to create a digital platform to support young people in mental wellbeing and create digital resources for it; and the Docready app, which is designed to help with a person's first GP conversation on mental health.
The Ayemind resource page includes a toolkit for workers, which covers all levels of experience, from basic knowledge to practitioner level information.
The ongoing issues in this area are trend watching (keeping an eye open for new things to bring in), getting organisational policies usable, curating resources, developing staff (supporting workflow to include, for example, social media) and so on.
Finding good resources
Dr Pennington looked at the issue of finding good resources, as there is a very broad range and they are not always joined up. They vary very much in approach too - from pages of plain text describing depression, to interactive tests for anxiety and online chat services like Childline.
One interesting approach mentioned was the personal stories from e-mental health charities like mindyourmind, which replaces 'like' buttons with 'fistbumps', uses videos from celebrities and interactive games (although, as Dr Pennington said, it can be difficult to engage people with these when competing against the production values of the likes of Call of Duty...).
Facebook and Twitter can be good for personal stories too. All these things open up conversations and are often instigated by people who have been through the situation.
In apps there are mood trackers, meditation apps, inspirational quote apps and more.
Young people's specific needs from mobile technology include safety, with the idea of confidentiality; avoiding cyberbullying and avoiding stigma. Then comes engagement, functionality, social interaction and accessibility issues. Women use these services more than men, but research shows that they are still not fully trusted.
Searching for help
When facing mental health difficulties people often start with Google, using their own terms (for example, ‘life sucks’, ‘I want to die’), which won't lead them to good resources. But even if a result returned is good it still needs to be appropriately formatted. For example, if a result is too text heavy, people won't read it - they are much more likely to view video, interact with forums, even use light-hearted quizzes and the like.
Another problem is that no-one looks past the first page of a search, which makes some negative resources easier to find. That could include pro-anorexia sites, and even sites that give suicide method recommendations. As Dr Pennington pointed out, ‘we can't compete with what Google returns, so need to set up and encourage the finding of positive information.’
In the BCS role of making IT good for society this raises some interesting questions about the moral role of algorithms and search engines, and those who design them. Can/should they continue to be agnostic about results in areas like this?
A recent study on how online content makes us feel asked participants to search for things to make them feel better, and it showed that these searches are actually quite difficult to articulate.
Explorathon 2016 asked people to search for feelings-oriented services or content, but the end result was that people tended to search for things they already knew would make them feel better - such as an uplifting song - rather than being able to do a search in more general terms that returned helpful results.
There are clearly some excellent resources out there. The sheer number of them indicate that there is a need, and that those in IT are clearly trying to fill it. But there is still work to do.