Young People’s Views on Electronic Mental Health Assessment: Prefer to Type than Talk?

Abstract

For mental health professionals to provide personalized early interventions, young people need to disclose sensitive information to a clinician they are unlikely to have yet formed a relationship with. We conducted in-depth qualitative interviews with 129 young people aged 12–25 years from several sites across Australia to gauge views on whether young people thought that an electronic psychosocial assessment tool could help them initially disclose personal information. Additionally, we were interested in whether young people from different demographic groups held similar views around using the e-tool. Results provided support for the use of an e-tool, with most young people stating that it could help in the disclosure of particularly embarrassing problems. The main advantages reported were that the e-tool would support disclosure without fear of judgment by health professionals, and would enable young people greater input in deciding what to focus on. Young people who held a preference to simply talk were most concerned about the clinician missing non-verbal cues. These findings highlight the value of incorporating electronic options within clinical practice, but also the need for health professionals to work within a flexible framework guided by the individual preferences of each of their clients.

Health Professionals’ Attitudes towards Electronic Psychosocial Assessments in Youth Mental Healthcare

“…Participants were also informed of the reasons why young people indicated this as a preference. The full results of this earlier study and the reasons provided by young people are published elsewhere [13].…”

“…The first was a belief that their clients were somehow distinct from other young people. For example, clinicians questioned who the youth participants were in the prior study described to them which found that young people were open to the use of an e-tool [13]. A typical concern was that clinicians would not be able to safely contain the young person's emotions if they became distressed or that they would not be in a position to quickly clarify misunderstandings: In many cases it was also suggested that young people "don't quite know what they're here for" (female, headspace worker); or that they don't have the capabilities to identify their own areas of risk or concern, "I'm not quite sure that they always can figure out where they are at risk" (female, headspace worker).…”

“…This preference for self-administered tools exists because they provide young people with increased control over the help-seeking and treatment process by allowing them to identify the areas they most want to focus on and to structure their thoughts prior to the face-to-face clinical interview [12] [13]. They also allow young people to disclose what is happening for them without the fear of judgment or becoming overwhelmed with emotions [13].…”

“…This preference for self-administered tools exists because they provide young people with increased control over the help-seeking and treatment process by allowing them to identify the areas they most want to focus on and to structure their thoughts prior to the face-to-face clinical interview [12] [13]. They also allow young people to disclose what is happening for them without the fear of judgment or becoming overwhelmed with emotions [13]. While these benefits would likely be seen in any type of self-administered format, psychosocial assessments conducted using information communication technologies (ICT) appear to have better user satisfaction with young people [14] and result in a higher frequency of disclosure than those administered via a pen and paper format [15].…”

Digital psychosocial assessment: An efficient and effective screening tool

“…This framework is internationally recognised and widely adopted, with expansion of domains at each iteration, evolving from HEADS, to HEADSS, to its current form, HEEADSSS . The questions progress from generally less personal items to more sensitive issues and may assist in the establishment of rapport between the interviewer and the young person . HEEADSSS covers many of the domains represented in psychosocial assessments …”