Learning About the Current State of Digital Mental Health and Addictions Services for Canadian Youth to Inform Future Decision-Making (Preprint)

2021 ◽  
Author(s):  
Jessica Kemp ◽  
Jill Chorney ◽  
Iman Kassam ◽  
Julie MacDonald ◽  
Tara MacDonald ◽  
...  

BACKGROUND The coronavirus disease (COVID-19) pandemic has increased the demand for youth mental health services in Canada as disruptions to care continue to persist due to risk of transmission and exposure to the virus. Digital mental health interventions, including web-based resources and mobile apps, have provided opportunities to support youth mental health remotely across Canada. There is a need to better understand the ways in which these digital interventions are being selected, recommended, and used in various regions across Canada. OBJECTIVE A national jurisdictional scan was completed to 1) determine what online programs, apps and websites are promoted and/or licensed in Canada for youth mental health, 2) identify criteria and/or decision-making processes that Canadian jurisdictions use to select online programs, apps and websites for youth mental health, and 3) identify upcoming trends, innovations and digital mental health possibilities that are emerging in the youth sector. METHODS The aims of the jurisdictional scan were addressed through a review of related academic and grey literature, stakeholder interviews including individuals involved in various areas of the youth mental health sector, and a social media review of pertinent Twitter content. RESULTS A total of 66 web-based resources and apps were identified for use by youth in Canada. 16 stakeholder interviews were completed and included discussions with researchers, clinicians, youth organizations, and others involved in digital interventions for youth mental health. Over a 4-week period, 2,184 tweets were reviewed to identify global trends and innovations involving digital mental health and youth. CONCLUSIONS As organizations begin to plan for the delivery of mental healthcare post-pandemic, there are some concerns about the sustainability of these digital mental health interventions as well as need for services to be more informed by experiences and preferences of youth.

2016 ◽  
Vol 11 (1) ◽  
pp. 92 ◽  
Author(s):  
Gwen Katheryn Healey ◽  
Jennifer Noah ◽  
Ceporah Mearns

<p><strong><em>Objective:</em> </strong>This study responded to a community-identified need to form an evidence base for interventions to promote mental health and wellness among youth in Nunavut. <strong><em>Methods: </em></strong>A literature review was conducted using the terms <em>adolescence </em>and <em>Inuit</em> and <em>intervention </em>or <em>program </em>or <em>camp </em>or <em>land-based</em>. PubMed and Google Scholar databases were used to find peer-reviewed and grey literature on community-based youth programs. The literature review was presented to parents, elders, and youth for discussion over several months in 2009-2010. <strong><em>Results:</em></strong> Key themes included: self-esteem, physical activity, stress and coping, positive peer relationships, Inuit identity, mental health and well-being, and the effects of intergenerational trauma on youth in Nunavut. Themes were incorporated into a model for youth mental health interventions based on Inuit terminology, philosophy, and societal values—the Eight <em>Ujarait</em>/Rocks Model. The model was implemented as a camp program in 6 pilots in 5 communities from 2011 to 2013. Data were collected before and after the camp. Results indicated that the program fostered physical, mental, emotional, and spiritual wellness among youth. Parent observations of participants included an improvement in behaviour and attitude, strong cultural pride, greater confidence in identity, and improved family and community relationships. <strong><em>Conclusion: </em></strong>Evidence-based, community-driven models for youth mental health interventions in the North hold promise. The application of one such model through a camp program had a lasting impact on the individuals involved, beyond their immediate participation. Long-term monitoring of the participants, and ongoing evaluations of camps as they continue to unfold across Nunavut, are needed to contribute to the robust evidence base for this program over time.</p>


2019 ◽  
Author(s):  
Gustav Petersen ◽  
Jakob Hyldig Nielsen ◽  
Johannes Verner Olsen ◽  
Robin Niels Kok

Background: Even though problems with usability constitute a major challenge to the implementation of new eHealth technology, the field web-based interventions is lacking usability guidelines for development and evaluation of web-based intervention platforms. Objective: The aim of present study is to create a set of eHealth-specific usability guidelines for the development and evaluation of web-based mental health interventions. Methods: Knowledge about usability was gathered from peripheral fields of e-learning, emotional design, and human-computer interaction in a top-down approach. This knowledge was synthesized into usability guidelines for web-based interventions, which were then case-tested on an existing web-based intervention for patients with health anxiety, using the heuristic evaluation method. Results: Nine broad guidelines were developed. The subsequent case-test of the web-based intervention showed that application of the guidelines was feasible and was able to identify several important usability issues with the intervention. Conclusions: Health professionals should be included in intervention design. Future usability assessment should focus on the different usability attributes. The relationship between usability and adherence needs further investigation.


2007 ◽  
Vol 16 (4) ◽  
pp. 294-298 ◽  
Author(s):  
David McDaid

AbstractTo provide an overview of the economic impact of poor mental health in the workplace and assess the extent to which economic evaluation has been used to further the case for investment in workplace based mental health programmes. Rapid scoping review of published and grey literature. The socio-economic costs of poor mental health in the workplace are substantial but conservative, as few studies have included productivity losses from work cutback, as well as absenteeism. While few economic evaluations of workplace based mental health interventions were identified, the available evidence base suggests that they have the potential to be highly cost effective. Much of this evidence may be from the US and be less applicable elsewhere; it may also have been solely published in company documents making assessment of methodological quality difficult. The potential economic case for workplace based mental health interventions appears good. More collaboration between policy makers and the private sector would help facilitate rigorous and transparent economic evaluations. A number of evaluations are planned. The challenge is to build on these initiatives, in order to address what remains a major gap in our knowledge on the economics of mental health.


Author(s):  
Ragaviveka Gopalan ◽  
C Sangeetha ◽  
P Ramakrishnan ◽  
Vijaya Raghavan

BACKGROUND About 70% of mental disorders emerge in late childhood and young peo-ple bear the burden of these disorders throughout life. Yet, to date there has been com-paratively little research on mental health interventions for young people in India and not many attempts have been made to collate the existing literature. This systematic review aims to synthesize the available evidence on school- and community-based mental health interventions for young people in India. METHODS A range of major electronic databases were searched systematically, and the abstracts of relevant papers were independently examined for possible inclusion. Selected papers were read in full text and a standardized set of data items were extracted. RESULTS Four papers met inclusion criteria for the analysis; two studies of school-based interventions for adolescents and two studies evaluating out-of-school community interventions for youth were reviewed. The quality of evidence from the interventions in Indian school and community settings were poor. While two studies evidence the effectiveness of a school-based life skills programme and a community based multicomponent intervention designed to promote youth health, two other studies do not offer sufficient data. CONCLUSION The review findings indicate that the number of interventional studies conducted in India to address youth mental health issues are very limited. Hence, it is extremely difficult to ensure the feasibility and effectiveness of school and community-based interventions in India. Further research is warranted to establish whether interventions promoting youth mental health people can be implemented effectively in Indian settings with positive mental health outcomes. Given the possibility of a huge population of young people at-risk or experiencing mental disorders, evidence for the efficacy of youth mental health interventions is crucial.


2021 ◽  
Author(s):  
Calista Leung ◽  
Julia Pei ◽  
Kristen Hudec ◽  
Farhud Shams ◽  
Richard Munthali ◽  
...  

BACKGROUND Digital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (i.e. psychologists, physicians) into digital mental health interventions has been common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other non-clinicians) can help reduce costs and increase accessibility. OBJECTIVE This systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of non-clinician guided digital mental health interventions. METHODS Four databases (MEDLINE, EMBASE, CINAHL, and PSYCInfo) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals focused on digital intervention were also hand searched and grey literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane Risk of Bias Tool 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Non-clinician guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions. RESULTS Thirteen studies qualified for inclusion. Results indicate that non-clinician guided interventions yielded higher post-treatment effectiveness outcomes when compared to conditions involving control programs (e.g. online psychoeducation, monitored attention control) or waitlist controls (k=7, Hedges g=-0.73 (95% CI -1.08 to -0.38)). There are significant differences between non-clinician guided interventions and unguided interventions as well (k=6, Hedges g=-0.17 (95% CI -0.23 to -0.11)). In addition, non-clinician guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08 (95% CI -0.01 to 0.17)). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualification, and that the presence of a non-clinician guide improves effectiveness outcomes more than no guidance. Non-clinician guided interventions did not yield significantly different effects on adherence outcomes when compared with unguided interventions (k=3, OR 1.58 (95% CI 0.51 to 4.92)), although a general trend of improved adherence was observed within non-clinician guided interventions. CONCLUSIONS Integrating paraprofessionals and non-clinicians appear to improve outcomes of digital mental health interventions, and may also enhance adherence outcomes (though the trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (i.e. psychosocial support, therapeutic alliance, technical augmentation) and their associated outcomes. CLINICALTRIAL The protocol is preregistered on PROSPERO (CRD42020191226).


2021 ◽  
Author(s):  
Alexis Estelle Whitton ◽  
Rebecca Hardy ◽  
Kate Cope ◽  
Chilin Gieng ◽  
Leanne Gow ◽  
...  

BACKGROUND Digital mental health interventions will play a critical role in managing the mental health impacts of the COVID-19 pandemic. Thus, enhancing their uptake is a key priority. General Practitioners (GPs) are well-positioned to facilitate access to digital interventions, but tools that assist GPs in identifying suitable patients are lacking. OBJECTIVE This study evaluated the effectiveness of a web-based mental health screening and treatment-recommendation tool (‘StepCare’) for improving the detection of anxiety and depression in general practice, and subsequently, uptake of digital mental health interventions. METHODS StepCare screens patients for symptoms of depression (PHQ-9) and anxiety (GAD-7) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for mild-to-moderate symptoms. Patients (n=5,138) from 85 general practices across Australia were invited to take part in screening. RESULTS Depression and/or anxiety was detected in 43.1% of patients screened (one quarter were previously undiagnosed/untreated). The majority (89.5%) of previously undiagnosed/untreated patients had mild-to-moderate symptoms and were candidates for digital mental health interventions. Although less than half were prescribed a digital intervention by their GP, when a digital intervention was prescribed, over two thirds of patients used it. CONCLUSIONS Implementing mental health screening in general practices can increase patient access to digital mental health interventions. Although GPs prescribed digital interventions less frequently than in-person psychotherapy or medication, the promising rates of uptake by GP-referred patients suggests that GPs can play a critical role in championing digital interventions and maximising the associated benefits.


2017 ◽  
Vol 8 ◽  
Author(s):  
Derek de Beurs ◽  
Inge van Bruinessen ◽  
Janneke Noordman ◽  
Roland Friele ◽  
Sandra van Dulmen

2016 ◽  
Vol 50 (5) ◽  
pp. 636-658 ◽  
Author(s):  
Rebecca J. Haines-Saah ◽  
Carla T. Hilario ◽  
Emily K. Jenkins ◽  
Cara K. Y. Ng ◽  
Joy L. Johnson

This article is based on findings from a qualitative study with 27 adolescents in northern British Columbia, Canada. Our aim was to explore youths’ perspectives on the sources of emotional distress in their lives and how these are connected to peer-based aggression and victimization within their community. Our analysis of narrative findings suggests that youths’ narratives about bullying reflect intersecting and socially embedded configurations of “race,” neocolonialism, and place. We argue that mainstream approaches to addressing bullying as a relationship-based problem must be re-oriented to account for the role of the social or structural contexts of youths’ lives. By applying an intersectional lens, we make the case for a widening of the focus of interventions away from individual victims and perpetrators, toward a contextual approach that addresses how adolescents experience bullying as a site of health and social inequities in their community.


2018 ◽  
Vol 5 (3) ◽  
pp. e50 ◽  
Author(s):  
Michael Jae Song ◽  
John Ward ◽  
Fiona Choi ◽  
Mohammadali Nikoo ◽  
Anastasia Frank ◽  
...  

Background Despite the increasing amount of research on Web-based mental health interventions with proven efficacy, high attrition rates decrease their effectiveness. Continued process evaluations should be performed to maximize the target population’s engagement. Google Analytics has been used to evaluate various health-related Web-based programs and may also be useful for Web-based mental health programs. Objective The objective of our study was to evaluate WalkAlong.ca, a youth-oriented mental health web-portal, using Google Analytics to inform the improvement strategy for the platform and to demonstrate the use of Google Analytics as a tool for process evaluation of Web-based mental health interventions. Methods Google Analytics was used to monitor user activity during WalkAlong’s first year of operation (Nov 13, 2013-Nov 13, 2014). Selected Google Analytic variables were overall website engagement including pages visited per session, utilization rate of specific features, and user access mode and location. Results The results included data from 3076 users viewing 29,299 pages. Users spent less average time on Mindsteps (0 minute 35 seconds) and self-exercises (1 minute 08 seconds), which are important self-help tools, compared with that on the Screener tool (3 minutes 4 seconds). Of all visitors, 82.3% (4378/5318) were desktop users, followed by 12.7 % (677/5318) mobile phone and 5.0% (263/5318) tablet users. Both direct traffic (access via URL) and referrals by email had more than 7 pages viewed per session and longer than average time of 6 minutes per session. The majority of users (67%) accessed the platform from Canada. Conclusions Engagement and feature utilization rates are higher among people who receive personal invitations to visit the site. Low utilization rates with specific features offer a starting place for further exploration of users in order to identify the root cause. The data provided by Google Analytics, although informative, can be supplemented by other evaluation methods (ie, qualitative methods) in order to better determine the modifications required to improve user engagement. Google Analytics can play a vital role in highlighting the preferences of those using Web-based mental health tools.


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