Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

Abstract

Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

Ownership, Use of, and Interest in Digital Mental Health Technologies Among Clinicians and Young People Across a Spectrum of Clinical Care Needs: Cross-sectional Survey

“…Furthermore, research supports young people’s interest in blending technology with standard treatment as a way of increasing accessibility, continuity, and consolidation of treatment, as well as a means of accessing posttherapy support and strengthening the face-to-face relationship between clients and therapists [ 23 ]. However, there is a lack of evidence-based web-based therapies and smartphone apps currently available to support youth mental health [ 36 ], with some key exceptions [ 24 , 37 ], highlighting a critical area for further research and development.…”

Using Digital Technologies to Facilitate Care Coordination Between Youth Mental Health Services: A Guide for Implementation

“…Once the technology has been implemented, quantitative and qualitative data are gathered to evaluate and monitor changes within participating services that are using the technology. These methods for evaluation and monitoring have been previously developed by researchers at The University of Sydney's Brain and Mind Centre, and utilised in other University of Sydney-sponsored research studies implementing the InnoWell Platform (41). The methods include: online surveys, semi-structured interviews, and group workshops with service staff, as well as implementation logs completed by the on-the-ground implementation officer.…”

Digital Mental Health Amid COVID-19

“…A German longitudinal study on the mental health and coping behavior of university students before and after the onset of COVID-19 found the pandemic had a moderate overall effect [74]. A protocol for impact evaluation of an Australian digital mental health model of care for youth (headspace) outlined that there are ongoing poor mental health outcomes for young people (12-25 years of age) [75]. The Asian Pacific, German, and Australian studies found vulnerable subgroups among youth may be at high risk of negative mental health impacts.…”

“…Significant subgroups of American youth (particularly those who live in low-income and rural areas) are also experiencing marginalization because of inadequate access to the Internet, resulting in a gap during COVID-19 which is widening pediatric mental health differences [76]. Stigmatizing attitudes, accessibility, and affordability issues are experienced by Australian youth in non-urban areas, resulting in higher self-harm, suicidal ideation, and suicide attempt rates [75]. The German study found an accumulation of negative issues (i.e., preexisting stress, anxiety, depression, overexertion, and burnout) and suggested identifying those at risk to promote mental health in significant subgroups [74].…”