Can digital tools help to improve the mental wellbeing of children & young people?
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Digital has opened up a world of opportunity for those suffering mental illness, one in four adults in the UK, to access the help and support they need and most importantly to better manage the daily stress and anxiety that can often act as a trigger.
But what about children and young people? According to the Mental Health Foundation, nearly one in 10 children and young people aged five to 16 are affected by a mental health problem. It is also known that ‘50% of mental illness in adult life (excluding dementia) starts before age 15 and 75% by age 18’. This is particularly alarming when you consider that adults are, generally, much better equipped to recognise and ask for the help they need when they need it most and that many teens are therefore likely to miss out on the early intervention support they so need.
In early 2016 The Independent reported that rates of depression and anxiety among teenagers had increased by ‘70 per cent in the past 25 years’. Though we understand the difference between correlation and causation, it is unlikely to be a coincidence that the mid-1990s saw the rise of near-instant communication, with email and instant messaging, and the early internet having a revolutionary impact on our social culture and technology.
Unthinkable is currently working with Leap, an award-winning national youth charity that provides inspirational conflict management training and support to young people and the professionals working with them. The work they do is vital and includes a range of programmes that support young people to manage conflict in their lives and achieve their goals. They also train the adults who work with young people, to build skills and confidence for direct use in helping young people deal with challenging emotions.
‘Conflict is something we all experience in our lives but badly managed youth conflict can have a devastating and wide reaching impact on society.’
As part of our research for Leap we encountered a wide range of digital services and applications all aiming to help children and young people (CYP) approach issues and questions relating to their mental health and wellbeing in a more youth-friendly, accessible, way.
Can young people use, and significantly benefit from, digital technologies to improve their mental health and wellbeing?
We think YES, and many others, of course, agree. However the digital approaches that we came across were of such hugely varying quality that it also raised the question about the potentially detrimental effects of an ill-conceived application, especially as many often appear to lack the foundation of scientific and/or extensive user research.
‘The potential for E-therapy and dynamic patient management for CYP is significant but must be developed in a way that ensures apps and other technology are safe, reliable and evidence based before GPs and other doctors can feel confident in Digital approaches to mental health for children and young people.’
RCGP report (PDF)
‘There have been strides towards the use of digital health for mental health as a way to use IT to support and improve mental health, including the use of online resources, social media and smartphone applications’.
Mental Health Network NHS Confederation (2013). E-mental health: what’s all the fuss about? (PDF)
There is some evidence that empirically based, well-designed mental-health apps can improve outcomes for patients, the vast majority remain unstudied. They may or may not be effective, and some may even be harmful. Scientists and health officials are now beginning to investigate their potential benefits and pitfalls more thoroughly, but there is still a lot left to learn and little guidance for consumers.
Nature, April 2016
With this in mind, we felt it worth highlighting some of the more successful approaches we came across, the majority targeting under 25s and reassuringly supported by both a solid evidence base and through partnership with key players in UK health circles.
The website Frank, established by the Department of Health and on the scene for 14 years now, is still going strong. Frank continues to be one of the most successful digital teen campaigns, offering an approachable big-brother-style advice service, highlighting the facts about drugs to over 35.5 million teens and revealing how different drugs can impact your mind and overall wellbeing.
Recently rebranded Aye Mind is a great example of a collaborative project in Scotland, initiated by NHS Greater Glasgow and Clyde and local partners including MHF.
Partners worked directly with young people to explore the potential of digital technologies to improve their mental health and wellbeing. Aye Mind continues to work collaboratively to bring together a suite of positive digital resources and methods, for widespread use. The Aye Mind toolkit has been developed and co-designed with young people ‘to assist youth workers in using digital approaches to youth mental health’ and includes practical information, case studies, online resources and reflection material for anyone interested in learning more about new technology, health and wellbeing.
MindEd for families
MindEd for families offers a wide range of e-learning support for parents to better understand and manage a child in crisis.
MindEd for families builds on the success of the MindEd e-learning portal, developed in partnership with e-Learning for Healthcare (e-LfH), part of Health Education England (HEE). All of the MindEd for Families content was developed in a close partnership between expert professionals and parents who have become experts by experience in child and adolescent mental health.
Big White Wall
Big White Wall (BWW), though not specifically targeted to young people – you have to be aged 16 or over – is a digital support and recovery service for people who are stressed, anxious, low or not coping.
At the heart of BWW is a community of members, who support and help each other share what’s troubling them in a safe and anonymous environment, with the guidance of trained professionals, who are online 24/7. People can access the site either with a free referral via their local NHS provider, or by choosing to pay a subscription of £24 per month. BWW is supported by the NHS and backed by wide ranging scientific research.
‘70% of members from local health contracts reported that using Big White Wall improved their wellbeing in at least one way’
BWW user survey
The Mix is the result of the recent merger of two of the UK’s leading youth support charities and currently reaches 1.7 million people under 25 in the UK. It combines YouthNet’s extensive digital research and Get Connected’s telephone helpline and counselling service. The Mix offers multi-issue support, with a particular focus on mental wellbeing as well as creating positive opportunities for young people through volunteering.
The Mix have released a growing number of apps designed to complement the information and support services for under 25s that they have their website. One that stands out is their LoveSmart app offering approaches to help young adults navigate relationships for healthier outcomes.
MindTech 'Innovation Labs' applications
In 2015 Comic Relief funded a study supported by MindTech and the NHS, through the Innovation Labs initiative, to evaluate how young people use particular digital tools (Apps and websites) and what impact this has on their mental health – the final report is available to download in full here.
The Innovation Labs initiative connected partnerships of young people, designers and mental health organisations to create seven apps and websites to improve young people’s mental health. The Labs’ approach was founded on consultation, co-design and co-production with young people and the resulting applications include Doc Ready, In Hand, HeadMeds and Madly in Love. Evaluation of their use so far has proved hugely encouraging; for example 108 of the 131 user respondees who participated in the In Hand evaluation were able to clearly demonstrate ways in which the app gave them, in some cases instantaneously effective, support for their mental wellbeing on a daily basis.
MindWell (one to watch)
As a slight aside note on the topic of co-design. mHabitat, who support digital innovation in the NHS and wider public sector, are huge advocates for the potential of co-design to bridge the chasm between digital health and the reality of practice as outlined by Victoria Betton’s in her recent post.
mHabitat are currently working with NHS Leeds, facilitating the development of a new mental health information site ‘MindWell’ – currently at the user testing stage. The platform is being produced with and for the users of Leeds MIND’s peer support service and features themed group rooms, live update feeds and peer moderation.
Other apps to highlight
SAM: Self Help for Anxiety Management, developed in collaboration with a research team from UWE, Bristol (awarded best anxiety app in 2016). SAM aims to help people of all ages understand the causes of their anxiety, monitor anxious thoughts and behaviour over time and offers self-help exercises and private reflection to help with management.
And finally, one of my personal favourites, the Headspace meditation app, which although ultimately subscription-based, also has much to offer for free and now includes Headspace for Kids with targeted activities for 5 and under, 6-8 and 9-12 years. Headspace Kids is specifically to teach children from an early age, alongside their parents, how to manage their emotions and the basics of meditation. Headspace is backed by research partners from around the world.
It’s almost as though meditation was designed for kids. They just ‘get it’ – there is this elasticity and freedom in their minds which allows them to be present in the moment and free from any external thoughts or pressures. By introducing meditation and mindfulness at an early age, not only can we build on this and help nurture their mind development, but we are also making meditation simple and accessible.
Andy Puddicombe, Co-Founder, Headspace