1
|
Alvarez-Jimenez M, Nicholas J, Valentine L, Liu P, Mangelsdorf S, Baker S, Gilbertson T, O'Loughlin G, McEnery C, McGorry PD, Gleeson JF, Cross SP. A national evaluation of a multi-modal, blended, digital intervention integrated within Australian youth mental health services. Acta Psychiatr Scand 2024. [PMID: 39260824 DOI: 10.1111/acps.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/08/2024] [Accepted: 08/17/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Youth mental health (YMH) services have been established internationally to provide timely, age-appropriate, mental health treatment and improve long-term outcomes. However, YMH services face challenges including long waiting times, limited continuity of care, and time-bound support. To bridge this gap, MOST was developed as a scalable, blended, multi-modal digital platform integrating real-time and asynchronous clinician-delivered counselling; interactive psychotherapeutic content; vocational support; peer support, and a youth-focused online community. The implementation of MOST within Australian YMH services has been publicly funded. OBJECTIVE The primary aim of this study was to evaluate the real-world engagement, outcomes, and experience of MOST during the first 32 months of implementation. METHOD Young people from participating YMH services were referred into MOST. Engagement metrics were derived from platform usage. Symptom and satisfaction measures were collected at baseline, 6, and 12 (primary endpoint) weeks. Effect sizes were calculated for the primary outcomes of depression and anxiety and secondary outcomes of psychological distress and wellbeing. RESULTS Five thousand seven hundred and two young people from 262 clinics signed up and used MOST at least once. Young people had an average of 19 login sessions totalling 129 min over the first 12 weeks of use, with 71.7% using MOST for at least 14 days, 40.1% for 12 weeks, and 18.8% for 24 weeks. There was a statistically significant, moderate improvement in depression and anxiety at 12 weeks as measured by the PHQ4 across all users irrespective of treatment stage (d = 0.41, 95% CI 0.35-0.46). Satisfaction levels were high, with 93% recommending MOST to a friend. One thousand one hundred and eighteen young people provided written feedback, of which 68% was positive and 31% suggested improvement. CONCLUSIONS MOST is a highly promising blended digital intervention with potential to address the limitations and enhance the impact of YMH services.
Collapse
Affiliation(s)
- M Alvarez-Jimenez
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - J Nicholas
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - L Valentine
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - P Liu
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - S Mangelsdorf
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - S Baker
- Orygen Digital, Parkville, Australia
| | - T Gilbertson
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| | | | - C McEnery
- Orygen Digital, Parkville, Australia
| | - P D McGorry
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - J F Gleeson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, School of Psychology, The Australian Catholic University, Melbourne, Australia
| | - S P Cross
- Orygen Digital, Parkville, Australia
- Melbourne, Centre for Youth Mental Health, The University of Melbourne, Australia
| |
Collapse
|
2
|
Gossip K, John J, Comben C, Erskine HE, Scott JG, Diminic S. Do Non-Clinical Services Help to Improve Functional Outcomes Among Young Adults With Mental Disorders? A Systematic Review. Early Interv Psychiatry 2024. [PMID: 39212143 DOI: 10.1111/eip.13606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/25/2024] [Accepted: 07/27/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Mental disorders during young adulthood can significantly impair functioning in daily activities. Non-clinical support services aim to improve functioning by helping people to build social and life skills, participate in education and employment and improve physical health. This study aims to examine and synthesise the evidence for non-clinical services on improving functional outcomes for young adults with mental disorders. METHODS A systematic search was undertaken to identify quantitative and qualitative studies reporting on a non-clinical service component (vocational support, peer support, youth development, lifestyle interventions, family and network support) and examining functional outcomes (e.g., outcomes focussed on work and education, life skills, relationships and healthy behaviours). RESULTS Seventeen studies met inclusion criteria. Identified studies focussed on vocational support services (n = 9), lifestyle interventions (n = 6) and family and network support services (n = 2). No studies on peer-support services or youth development services were found. More than half of the vocational support service studies reported increased employment rates among young adults (n = 6). Studies focussing on lifestyle interventions included a combination of physical activity, nutrition education, health coaching and motivation and behaviour change. However, the measures of functioning used across studies were too varied to determine whether lifestyle interventions may be useful in improving functional outcomes for young adults. CONCLUSION Further research is needed to understand the impact of non-clinical services on functioning. This evidence will provide pragmatic guidance for service planners to invest in supports and interventions that make a meaningful difference to the lives of young adults living with mental disorders.
Collapse
Affiliation(s)
- Kate Gossip
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Julie John
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Charlotte Comben
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| | - Holly E Erskine
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - James G Scott
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, Queensland, Australia
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, Brisbane, Queensland, Australia
| |
Collapse
|
3
|
Gibson K, Stubbing J. Commentary: What young people want from psychotherapy. Psychol Psychother 2024. [PMID: 39096003 DOI: 10.1111/papt.12542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
In recent times there has been increasing acknowledgement of the importance of attending to the agenda of people with lived experience in psychotherapy research. In particular, young people's voices have been recognised as central to the design and development of psychotherapies that work for them. It is important to recognise the limits of professional agendas and make sure that young people's own priorities are represented in the indicators against which we measure change in research evaluations of psychotherapy. This requires an extension of evaluation research indicators from psychiatric symptomatology, to include aspects of wellbeing that matter to young people themselves. This article joins others in calling for a shift from the focus on symptom change in the evaluation of psychotherapy with youth, to acknowledge subjective indicators identified through research conducted with young people. New indicators might, for example, be centred on the degree to which young people experience increased capacity for acceptance of their emotions, a comfortable sense of identity, improved relational trust, and a stronger sense of their own agency. If psychotherapy is to be meaningful to young people, it is vital that we tailor it to young people's own needs and priorities and evaluate it against the aspects of change that matter to them.
Collapse
Affiliation(s)
- Kerry Gibson
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Jessica Stubbing
- Koi Tū: Centre for Informed Futures, University of Auckland, Auckland, New Zealand
| |
Collapse
|
4
|
Bechdolf A, Hanser S, Baumgardt J, Brose A, Jäckel D, Döring S, Holzner L, Aliakbari N, von Hardenberg L, Shmuilovich O, Gencaggi D, Schellong M, Izat Y, Leopold S, Ituarte BP, Leopold K. soulspace: Integrated youth mental health care in Berlin, Germany-An introduction to the program and a description of its users. Early Interv Psychiatry 2024; 18:571-577. [PMID: 38486399 DOI: 10.1111/eip.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/04/2024] [Indexed: 07/11/2024]
Abstract
AIM A substantial gap between young people's need for mental health care services and their actual access to such services led worldwide organizations (e.g., the WHO) to recommend the implementation of early intervention programs and youth mental health services. Some countries around the world have established structures to meet this recommendation. In this paper, we describe soulspace as the first integrated youth mental health service for young people aged between 15 and 35 years in Berlin, Germany. METHODS We introduce soulspace as easily accessible mental health care for young people, and we characterize soulspace along the lines of the internationally established eight key principles of integrated youth mental health services (Killackey, et al., 2020, World Economic Forum). Soulspace is a cooperation between clinical outpatient units of psychiatric clinics for adolescents and young adults as well as a community-based counselling service. It provides initial contact, counselling, diagnostics, and treatment. RESULTS Our analyses of the pathways to soulspace and the characteristics of the soulspace users suggest that the low threshold is a facilitator to help finding for young people in comparison to more conventional early intervention models. That is, having transferred the early intervention center in a youth-facing counselling service as was done in soulspace seems to have reduced the threshold to seek help for families and for young people in need for support. CONCLUSIONS In summary, with soulspace, an easily accessible mental health care service was established that integrates counselling and specialized psychiatric treatment if needed.
Collapse
Affiliation(s)
- Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Germany
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
| | - Sinah Hanser
- Department of Neoantology and Child and Adolescent Medicine, Bülach Hospial, Bülach, Switzerland
| | - Johanna Baumgardt
- Research Institute of the Local Healthcare Funds (WIdO), Berlin, Germany
| | - Annette Brose
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Dorothea Jäckel
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Germany
| | - Sophia Döring
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Laura Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Navid Aliakbari
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Laura von Hardenberg
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Olga Shmuilovich
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Dilek Gencaggi
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Mario Schellong
- ajb gmbh - Gemeinnützige Gesellschaft für Jugendberatung und psychosoziale Rehabilitation, Berlin, Germany
| | - Yonca Izat
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Stephanie Leopold
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Begoña Petuya Ituarte
- Bezirksamt Friedrichshain-Kreuzberg, Planungs- und Koordinierungsstelle Gesundheit, Berlin, Germany
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatics including FRITZ am Urban and soulspace, Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
5
|
Boonstra A, van Amelsvoort TAMJ, Klaassen RMC, Popma A, Grootendorst-van Mil NH, Veling W, de Winter RFP, Boonstra N, Leijdesdorff SMJ. Evaluating changes in functioning and psychological distress in visitors of the @ease youth mental health walk-in centres. BJPsych Open 2024; 10:e101. [PMID: 38699887 PMCID: PMC11094437 DOI: 10.1192/bjo.2024.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/08/2024] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Highly accessible youth initiatives worldwide aim to prevent worsening of mental health problems, but research into outcomes over time is scarce. AIMS This study aimed to evaluate outcomes and support use in 12- to 15-year-old visitors of the @ease mental health walk-in centres, a Dutch initiative offering free counselling by trained and supervised peers. METHOD Data of 754 visitors, collected 2018-2022, included psychological distress (Clinical Outcomes in Routine Evaluation 10 (CORE-10)), social and occupational functioning (Social and Occupational Functioning Assessment Scale (SOFAS)), school absenteeism and support use, analysed with change indicators (first to last visit), and mixed models (first three visits). RESULTS Among return visitors, 50.5% were female, 79.4% were in tertiary education and 36.9% were born outside of The Netherlands (one-time visitors: 64.7%, 72.9% and 41.3%, respectively). Moreover, 29.9% of return visitors presented with suicidal ideations, 97.1% had clinical psychological distress levels, and 64.1% of the latter had no support in the previous 3 months (one-time visitors: 27.2%, 90.7% and 71.1%, respectively). From visit 1 to 3, psychological distress decreased (β = -3.79, 95% CI -5.41 to -2.18; P < 0.001) and social and occupational functioning improved (β = 3.93, 95% CI 0.51-7.36; P = 0.025). Over an average 3.9 visits, 39.6% improved reliably and 28.0% improved clinically significantly on the SOFAS, which was 28.4% and 8.8%, respectively, on the CORE-10, where 43.2% improved in clinical category. Counselling satisfaction was rated 4.5/5. CONCLUSIONS Reductions in psychological distress, improvements in functioning and high counselling satisfaction were found among @ease visitors, forming a basis for future research with a control group.
Collapse
Affiliation(s)
- Anouk Boonstra
- Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, The Netherlands
| | | | | | - Arne Popma
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, The Netherlands
| | | | - Wim Veling
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Remco F. P. de Winter
- Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, The Netherlands; Mental Health Institute Rivierduinen, Leiden, The Netherlands; and Section Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
| | - Nynke Boonstra
- Department of Healthcare, NHL Stenden University of Applied Sciences, The Netherlands; KieN VIP Metal Health Care Services, Friesland, The Netherlands; and Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | | |
Collapse
|
6
|
van Doorn M, Monsanto A, Wang CL, Verfaillie SCJ, van Amelsvoort TAMJ, Popma A, Jaspers MWM, Öry F, Alvarez-Jimenez M, Gleeson JF, Nieman DH. The Effects of a Digital, Transdiagnostic, Clinically and Peer-Moderated Treatment Platform for Young People With Emerging Mental Health Complaints: Repeated Measures Within-Subjects Study. JMIR Mhealth Uhealth 2023; 11:e50636. [PMID: 38090802 PMCID: PMC10753424 DOI: 10.2196/50636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/19/2023] [Accepted: 10/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND To address the growing prevalence of youth mental health problems, early intervention is crucial to minimize individual, societal, and economic impacts. Indicative prevention aims to target emerging mental health complaints before the onset of a full-blown disorder. When intervening at this early stage, individuals are more responsive to treatment, resulting in cost-effective outcomes. The Moderated Online Social Therapy platform, which was successfully implemented and proven effective in Australia, is a digital, peer- and clinically moderated treatment platform designed for young people. The Netherlands was the first country outside Australia to implement this platform, under the name Engage Young People Early (ENYOY). It has the potential to reduce the likelihood of young people developing serious mental health disorders. OBJECTIVE This study aims to investigate the effects on young people using the ENYOY-platform in relation to psychological distress, psychosocial functioning, and positive health parameters. METHODS Dutch-speaking young people with emerging mental health complaints (N=131) participated in the ENYOY-platform for 6 months in a repeated measures within-subjects study. Psychological distress, psychosocial functioning, and positive health parameters were assessed at baseline and 3, 6, and 12 months. Repeated measures ANOVA was conducted and adjusted for age, sex, therapy, and community activity. The Reliable Change Index and Clinically Significant Index were computed to compare the baseline with the 6- and 12-month measurements. The missing data rate was 22.54% and the dropout rate 62.6% (82/131). RESULTS The primary analysis (77/131, 58.8%) showed that psychological distress decreased and psychosocial functioning improved over time with large effect sizes (P<.001 in both cases; ηp2=0.239 and 0.318, respectively) independent of age (P=.76 for psychological distress and P=.48 for psychosocial functioning), sex (P=.24 and P=.88, respectively), therapy activity (P=.49 and P=.80, respectively), or community activity (P=.59 and P=.48, respectively). Similarly, secondary analyses (51/131, 38.9%) showed significant effects of time on the quality of life, well-being, and meaningfulness positive health parameters (P<.05; ηp2=0.062, 0.140, and 0.121, respectively). Improvements in all outcome measures were found between baseline and 3 and 6 months (P≤.001-.01; d=0.23-0.62) and sustained at follow-up (P=.18-.97; d=0.01-0.16). The Reliable Change Index indicated psychological distress improvements in 38% (39/102) of cases, no change in 54.9% (56/102) of cases, and worsening in 5.9% (6/102) of cases. Regarding psychosocial functioning, the percentages were 50% (51/102), 43.1% (44/102), and 6.9% (7/102), respectively. The Clinically Significant Index demonstrated clinically significant changes in 75.5% (77/102) of cases for distress and 89.2% (91/102) for functioning. CONCLUSIONS This trial demonstrated that the ENYOY-platform holds promise as a transdiagnostic intervention for addressing emerging mental health complaints among young people in the Netherlands and laid the groundwork for further clinical research. It would be of great relevance to expand the population on and service delivery of the platform. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-021-03315-x.
Collapse
Affiliation(s)
- Marilon van Doorn
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Anne Monsanto
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
- Antes, Rotterdam, Netherlands
| | - Chen Lu Wang
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | - Sander C J Verfaillie
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | | | - Arne Popma
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | - Monique W M Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - John F Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Dorien H Nieman
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| |
Collapse
|
7
|
McKenna S, Piper S, Capon W, Crowley A, Lira L, LaMonica HM, Chong MK, Scott E, Hickie I, Iorfino F. The Polarization of Clinician and Service Staff Perspectives After the Use of Health Information Technology in Youth Mental Health Services: Implementation and Evaluation Study. JMIR Hum Factors 2023; 10:e42993. [PMID: 37490321 PMCID: PMC10410532 DOI: 10.2196/42993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/30/2023] [Accepted: 04/30/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Highly personalized care is substantially improved by technology platforms that assess and track patient outcomes. However, evidence regarding how to successfully implement technology in real-world mental health settings is limited. OBJECTIVE This study aimed to naturalistically monitor how a health information technology (HIT) platform was used within 2 real-world mental health service settings to gain practical insights into how HIT can be implemented and sustained to improve mental health service delivery. METHODS An HIT (The Innowell Platform) was naturally implemented in 2 youth mental health services in Sydney, Australia. Web-based surveys (n=19) and implementation logs were used to investigate staff attitudes toward technology before and after implementation. Descriptive statistics were used to track staff attitudes over time, whereas qualitative thematic analysis was used to explore implementation log data to gain practical insights into useful implementation strategies in real-world settings. RESULTS After the implementation, the staff were nearly 3 times more likely to agree that the HIT would improve care for their clients (3/12, 25% agreed before the implementation compared with 7/10, 70% after the implementation). Despite this, there was also an increase in the number of staff who disagreed that the HIT would improve care (from 1/12, 8% to 2/10, 20%). There was also decreased uncertainty (from 6/12, 50% to 3/10, 30%) about the willingness of the service to implement the technology for its intended purpose, with similar increases in the number of staff who agreed and disagreed with this statement. Staff were more likely to be uncertain about whether colleagues in my service are receptive to changes in clinical processes (not sure rose from 5/12, 42% to 7/10, 70%). They were also more likely to report that their service already provides the best mental health care (agreement rose from 7/12, 58% to 8/10, 80%). After the implementation, a greater proportion of participants reported that the HIT enabled shared or collaborative decision-making with young people (2/10, 20%, compared with 1/12, 8%), enabled clients to proactively work on their mental health care through digital technologies (3/10, 30%, compared with 2/12, 16%), and improved their response to suicidal risk (4/10, 40% compared with 3/12, 25%). CONCLUSIONS This study raises important questions about why clinicians, who have the same training and support in using technology, develop more polarized opinions on its usefulness after implementation. It seems that the uptake of HIT is heavily influenced by a clinician's underlying beliefs and attitudes toward clinical practice in general as well as the role of technology, rather than their knowledge or the ease of use of the HIT in question.
Collapse
Affiliation(s)
- Sarah McKenna
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Sarah Piper
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - William Capon
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | | | - Lucas Lira
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Haley M LaMonica
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Min Kyung Chong
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Elizabeth Scott
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Ian Hickie
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Frank Iorfino
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| |
Collapse
|