scholarly journals Using Participatory Design Methodologies to Co-Design and Culturally Adapt the Spanish Version of the Mental Health eClinic: Qualitative Study

10.2196/14127 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e14127 ◽  
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey Davenport ◽  
Antonio Mendoza Diaz ◽  
Alvaro Navarro-Mancilla ◽  
Elizabeth M Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Professionals ◽  
Help Seeking ◽  
Participatory Design ◽  
Well Being ◽  
Self Report ◽  
User Testing ◽  
Spanish Speaking ◽  
English Speaking

Background The Mental Health eClinic (MHeC) aims to deliver best-practice clinical services to young people experiencing mental health problems by making clinical care accessible, affordable, and available to young people whenever and wherever they need it most. The original MHeC consists of home page with a visible triage system for those requiring urgent help; a online physical and mental health self-report assessment; a results dashboard; a booking and videoconferencing system; and the generation of a personalized well-being plan. Populations who do not speak English and reside in English-speaking countries are less likely to receive mental health care. In Australia, international students have been identified as disadvantaged compared with their peers; have weaker social support networks; and have higher rates of psychological distress. This scenario is acquiring significant relevance as Spanish-speaking migration is rapidly growing in Australia, and the mental health services for culturally and linguistically diverse populations are limited. Having a Spanish version (MHeC-S) of the Mental Health eClinic would greatly benefit these students. Objective We used participatory design methodologies with users (young people aged 16-30 years, supportive others, and health professionals) to (1) conduct workshops with users to co-design and culturally adapt the MHeC; (2) inform the development of the MHeC-S alpha prototype; (3) test the usability of the MHeC-S alpha prototype; (4) translate, culturally adapt, and face-validate the MHeC-S self-report assessment; and (5) collect information to inform its beta prototype. Methods A research and development cycle included several participatory design phases: co-design workshops; knowledge translation; language translation and cultural adaptation; and rapid prototyping and user testing of the MHeC-S alpha prototype. Results We held 2 co-design workshops with 17 users (10 young people, 7 health professionals). A total of 15 participated in the one-on-one user testing sessions (7 young people, 5 health professionals, 3 supportive others). We collected 225 source documents, and thematic analysis resulted in 5 main themes (help-seeking barriers, technology platform, functionality, content, and user interface). A random sample of 106 source documents analyzed by 2 independent raters revealed almost perfect agreement for functionality (kappa=.86; P<.001) and content (kappa=.92; P<.001) and substantial agreement for the user interface (kappa=.785; P<.001). In this random sample, no annotations were coded for help-seeking barriers or the technology platform. Language was identified as the main barrier to getting medical or psychological services, and smartphones were the most-used device to access the internet. Acceptability was adequate for the prototype’s 5 main elements: home page and triage system, self-report assessment, dashboard of results, booking and video visit system, and personalized well-being plan. The data also revealed gaps in the alpha prototype, such as the need for tailored assessment tools and a greater integration with Spanish-speaking services and communities. Spanish-language apps and e-tools, as well as online mental health information, were lacking. Conclusions Through a research and development process, we co-designed and culturally adapted, developed and user tested, and evaluated the MHeC-S. By translating and culturally adapting the MHeC to Spanish, we aimed to increase accessibility and availability of e-mental health care in the developing world, and assist vulnerable populations that have migrated to English-speaking countries.

Using participatory design methodologies to co-design and culturally adapt the Spanish version of the Mental Health eClinic (Preprint)

2019 ◽  
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey Davenport ◽  
Antonio Mendoza Diaz ◽  
Alvaro Andres Navarro-Mancilla ◽  
Elizabeth M Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Professionals ◽  
Help Seeking ◽  
Participatory Design ◽  
Self Report ◽  
User Testing ◽  
Technology Platform ◽  
Spanish Speaking ◽  
English Speaking

BACKGROUND Populations who do not speak English and currently reside in English-speaking countries are less likely to receive mental health care. In Australia, international students have been identified as disadvantaged compared with their peers; have weaker social support networks; and have higher rates of psychological distress. This scenario is acquiring significant relevance as Spanish-speaking migration is rapidly growing in Australia, and the mental health services for culturally and linguistically-diverse populations are limited. Having a Spanish version of the Mental Health eClinic (MHeC-S) would greatly benefit these students. OBJECTIVE Using participatory design (PD) methodologies with users (young people aged 16 to 30 years, supportive others and health professionals) the aims of this study were to: i) conduct workshops with users to co-design and culturally-adapt the MHeC; ii) inform the development of the MHeC-S alpha prototype; iii) perform usability testing of the MHeC-S alpha prototype; iv) translate, culturally-adapt and face-validate the MHeC-S self-report assessment; and v) collect information to inform its beta prototype. METHODS A research and development (R&D) cycle included several iterative PD phases: co-design workshops; knowledge translation; language translation and cultural adaptation; rapid prototyping and user testing of the MHeC-S alpha prototype. RESULTS Two co-design workshops were held with 17 users (young people n=10, health professionals n=7). A total of 15 participated in the one-on-one user testing sessions (young people n=7, health professionals n=5, supportive others n=3). 225 source documents were collected and thematic analysis resulted in five main themes (help-seeking barriers, technology platform, functionality, content, user interface). A random sample of 106 source documents were analyzed by two independent raters revealing an ‘almost perfect’ agreement for the functionality (kappa=0.86; P<0.001) and content (kappa=0.92; P<0.001); and, a ‘substantial’ agreement for the user interface (kappa=0.785; P<0.001). In this random sample, no annotations were coded for help-seeking barriers or the technology platform. Language was identified as the main barrier to get medical or psychological services and smartphones were the most used device to access the Internet. There was adequate acceptability of the prototype’s five main elements: home page and triage system, self-report assessment, dashboard of results, booking and video visit system and personalized well-being plan. The data also revealed gaps in the current alpha prototype, such as the need for tailored assessment tools and a greater integration with Spanish-speaking services and communities; and, a lack of Spanish language apps and etools as well as online mental health information was noted. CONCLUSIONS Through an iterative process of R&D, the MHeC-S was co-designed and culturally-adapted, developed and user-tested, as well as evaluated. By translating and culturally-adapting the MHeC to Spanish, we aimed to increase accessibility and availability of (e)mental health care to the developing world, and assist vulnerable populations that have migrated to English-speaking countries. CLINICALTRIAL The University of Sydney’s Human Research Ethics Committee approved the study Protocol No. 2014/689 and Protocol No. 2016/487

scholarly journals Involving End Users in Adapting a Spanish Version of a Web-Based Mental Health Clinic for Young People in Colombia: Exploratory Study Using Participatory Design Methodologies

10.2196/15914 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e15914
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey A Davenport ◽  
Alvaro Andres Navarro-Mancilla ◽  
Vanessa Wan Sze Cheng ◽  
Andrés Camilo Cardozo Alarcón ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Health Professionals ◽  
Participatory Design ◽  
Self Report ◽  
User Testing ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries

Background Health information technologies (HITs) hold enormous promise for improving access to and providing better quality of mental health care. However, despite the spread of such technologies in high-income countries, these technologies have not yet been commonly adopted in low- and middle-income countries. People living in these parts of the world are at risk of experiencing physical, technological, and social health inequalities. A possible solution is to utilize the currently available HITs developed in other counties. Objective Using participatory design methodologies with Colombian end users (young people, their supportive others, and health professionals), this study aimed to conduct co-design workshops to culturally adapt a Web-based Mental Health eClinic (MHeC) for young people, perform one-on-one user-testing sessions to evaluate an alpha prototype of a Spanish version of the MHeC and adapt it to the Colombian context, and inform the development of a skeletal framework and alpha prototype for a Colombian version of the MHeC (MHeC-C). Methods This study involved the utilization of a research and development (R&D) cycle including 4 iterative phases: co-design workshops; knowledge translation; tailoring to language, culture, and place (or context); and one-on-one user-testing sessions. Results A total of 2 co-design workshops were held with 18 users—young people (n=7) and health professionals (n=11). Moreover, 10 users participated in one-on-one user-testing sessions—young people (n=5), supportive others (n=2), and health professionals (n=3). A total of 204 source documents were collected and 605 annotations were coded. A thematic analysis resulted in 6 themes (ie, opinions about the MHeC-C, Colombian context, functionality, content, user interface, and technology platforms). Participants liked the idea of having an MHeC designed and adapted for Colombian young people, and its 5 key elements were acceptable in this context (home page and triage system, self-report assessment, dashboard of results, booking and video-visit system, and personalized well-being plan). However, to be relevant in Colombia, participants stressed the need to develop additional functionality (eg, phone network backup; chat; geolocation; and integration with electronic medical records, apps, or electronic tools) as well as an adaptation of the self-report assessment. Importantly, the latter not only included language but also culture and context. Conclusions The application of an R&D cycle that also included processes for adaptation to Colombia (language, culture, and context) resulted in the development of an evidence-based, language-appropriate, culturally sensitive, and context-adapted HIT that is relevant, applicable, engaging, and usable in both the short and long term. The resultant R&D cycle allowed for the adaptation of an already available HIT (ie, MHeC) to the MHeC-C—a low-cost and scalable technology solution for low- and middle-income countries like Colombia, which has the potential to provide young people with accessible, available, affordable, and integrated mental health care at the right time.

scholarly journals Involving End Users in Adapting a Spanish Version of a Web-Based Mental Health Clinic for Young People in Colombia: Exploratory Study Using Participatory Design Methodologies (Preprint)

2019 ◽  
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey A Davenport ◽  
Alvaro Andres Navarro-Mancilla ◽  
Vanessa Wan Sze Cheng ◽  
Andrés Camilo Cardozo Alarcón ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Health Professionals ◽  
Participatory Design ◽  
Self Report ◽  
User Testing ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries

BACKGROUND Health information technologies (HITs) hold enormous promise for improving access to and providing better quality of mental health care. However, despite the spread of such technologies in high-income countries, these technologies have not yet been commonly adopted in low- and middle-income countries. People living in these parts of the world are at risk of experiencing physical, technological, and social health inequalities. A possible solution is to utilize the currently available HITs developed in other counties. OBJECTIVE Using participatory design methodologies with Colombian end users (young people, their supportive others, and health professionals), this study aimed to conduct co-design workshops to culturally adapt a Web-based Mental Health eClinic (MHeC) for young people, perform one-on-one user-testing sessions to evaluate an alpha prototype of a Spanish version of the MHeC and adapt it to the Colombian context, and inform the development of a skeletal framework and alpha prototype for a Colombian version of the MHeC (MHeC-C). METHODS This study involved the utilization of a research and development (R&amp;D) cycle including 4 iterative phases: co-design workshops; knowledge translation; tailoring to language, culture, and place (or context); and one-on-one user-testing sessions. RESULTS A total of 2 co-design workshops were held with 18 users—young people (n=7) and health professionals (n=11). Moreover, 10 users participated in one-on-one user-testing sessions—young people (n=5), supportive others (n=2), and health professionals (n=3). A total of 204 source documents were collected and 605 annotations were coded. A thematic analysis resulted in 6 themes (ie, opinions about the MHeC-C, Colombian context, functionality, content, user interface, and technology platforms). Participants liked the idea of having an MHeC designed and adapted for Colombian young people, and its 5 key elements were acceptable in this context (home page and triage system, self-report assessment, dashboard of results, booking and video-visit system, and personalized well-being plan). However, to be relevant in Colombia, participants stressed the need to develop additional functionality (eg, phone network backup; chat; geolocation; and integration with electronic medical records, apps, or electronic tools) as well as an adaptation of the self-report assessment. Importantly, the latter not only included language but also culture and context. CONCLUSIONS The application of an R&amp;D cycle that also included processes for adaptation to Colombia (language, culture, and context) resulted in the development of an evidence-based, language-appropriate, culturally sensitive, and context-adapted HIT that is relevant, applicable, engaging, and usable in both the short and long term. The resultant R&amp;D cycle allowed for the adaptation of an already available HIT (ie, MHeC) to the MHeC-C—a low-cost and scalable technology solution for low- and middle-income countries like Colombia, which has the potential to provide young people with accessible, available, affordable, and integrated mental health care at the right time.

scholarly journals Developing a Mental Health eClinic to Improve Access to and Quality of Mental Health Care for Young People: Using Participatory Design as Research Methodologies (Preprint)

2017 ◽  
Author(s):  
Laura Ospina-Pinillos ◽  
Tracey A Davenport ◽  
Cristina S Ricci ◽  
Alyssa C Milton ◽  
Elizabeth M Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Young People ◽  
Health Professionals ◽  
Participatory Design ◽  
Research Team ◽  
Well Being ◽  
End Users ◽  
Evidence Based ◽  
Youth Health

BACKGROUND Each year, many young Australians aged between 16 and 25 years experience a mental health disorder, yet only a small proportion access services and even fewer receive timely and evidence-based treatments. Today, with ever-increasing access to the Internet and use of technology, the potential to provide all young people with access (24 hours a day, 7 days a week) to the support they require to improve their mental health and well-being is promising. OBJECTIVE The aim of this study was to use participatory design (PD) as research methodologies with end users (young people aged between 16 and 25 years and youth health professionals) and our research team to develop the Mental Health eClinic (a Web-based mental health clinic) to improve timely access to, and better quality, mental health care for young people across Australia. METHODS A research and development (R&D) cycle for the codesign and build of the Mental Health eClinic included several iterative PD phases: PD workshops; translation of knowledge and ideas generated during workshops to produce mockups of webpages either as hand-drawn sketches or as wireframes (simple layout of a webpage before visual design and content is added); rapid prototyping; and one-on-one consultations with end users to assess the usability of the alpha build of the Mental Health eClinic. RESULTS Four PD workshops were held with 28 end users (young people n=18, youth health professionals n=10) and our research team (n=8). Each PD workshop was followed by a knowledge translation session. At the conclusion of this cycle, the alpha prototype was built, and one round of one-on-one end user consultation sessions was conducted (n=6; all new participants, young people n=4, youth health professionals n=2). The R&D cycle revealed the importance of five key components for the Mental Health eClinic: a home page with a visible triage system for those requiring urgent help; a comprehensive online physical and mental health assessment; a detailed dashboard of results; a booking and videoconferencing system to enable video visits; and the generation of a personalized well-being plan that includes links to evidence-based, and health professional–recommended, apps and etools. CONCLUSIONS The Mental Health eClinic provides health promotion, triage protocols, screening, assessment, a video visit system, the development of personalized well-being plans, and self-directed mental health support for young people. It presents a technologically advanced and clinically efficient system that can be adapted to suit a variety of settings in which there is an opportunity to connect with young people. This will enable all young people, and especially those currently not able or willing to connect with face-to-face services, to receive best practice clinical services by breaking down traditional barriers to care and making health care more personalized, accessible, affordable, and available.

scholarly journals Mental health and domestic violence in LGB+ persons during lockdown measures in Belgium

2021 ◽  
Vol 24 (2) ◽  
pp. 143-160
Author(s):  
Lotte De Schrijver ◽  
Stefanie De Buyser ◽  
Kasia Uzieblo ◽  
Christophe Vandeviver ◽  
Ines Keygnaert
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Suicidal Ideation ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Well Being ◽  
Self Report ◽  
Physical Contact ◽  
Help Seeking Behaviour ◽  
Alcohol And Drug Abuse

Abstract Background: To contain the COVID-19 pandemic, governments worldwide restricted social and physical contact by issuing lockdown and social-distancing measures. Yet, lockdown measures may induce mental health problems and increase the occurrence of domestic violence (DV). We examine mental health and DV in lesbian, gay, bisexual, pansexual, and asexual (LGB+) persons under lockdown. Methods: An online self-report questionnaire on relationships, stress, and aggression was administered to a non-probabilistic sample of participants living in Belgium. Participants were sampled through national media, social media, and snowballing procedures. Occurrence of DV including psychological, physical, and sexual violence, stress, alcohol and drug use, suicidal ideation, suicide attempt, self-harming behaviour, and help-seeking behaviour in LGB+ persons during the first four to six weeks of the hygiene and lockdown measures in Belgium were assessed. Results: 383 LGB+ participants were included in the analysis. In addition to high levels of stress, alcohol and drug abuse, suicidal ideation, and self-harming behaviour, a third of LGB+ participants reported at least one incident of DV under lockdown. Conclusion: LGB+ persons have been exposed to DV and experienced lower mental health and well-being during the lockdown related to the COVID-19 pandemic. These findings highlight the possible need for public health measures and sociocultural changes preventing DV and improving mental health during lockdown in LGB+ persons.

Intentional music use to reduce psychological distress in adolescents accessing primary mental health care

2018 ◽  
Vol 23 (4) ◽  
pp. 567-581 ◽  
Author(s):  
Katrina Skewes McFerran ◽  
Cherry Hense ◽  
Asami Koike ◽  
Debra Rickwood
Keyword(s):  
Mental Health ◽  
Young People ◽  
Feasibility Study ◽  
Well Being ◽  
Small Sample ◽  
Self Report ◽  
Music Preferences ◽  
Mixed Methods Approach ◽  
Case Examples ◽  
Insight Into

Rationale: Many young people turn to music as a way of exploring and managing their moods and emotions. The literature is replete with studies that correlate music preferences and mental health, as well as a small but increasing interest in uses of music to promote well-being. Recent studies have shown that music use is often unconscious, thus difficult to influence without therapeutic conversations. No study has yet tested whether it is feasible to increase awareness of music use in young people who tend to ruminate with music, and test whether increased awareness can reduce distress. Design: This feasibility study aimed to determine whether involvement in a brief music-based intervention was engaging and acceptable to a small sample of young people, and whether their levels of distress decreased and insight into music uses increased. A mixed methods approach was adopted, merging scores of distress and self-reported experience of the intervention to foster interpretation. Results: Convergent analysis of the different data forms suggests that at least some of the measurable decreases in distress captured for all of the participants were related to participation in the sessions, according to the self-report of a number of the young people in interviews. This is demonstrated through descriptive data compiled under two key themes (Agency and Changed Uses) and illustrated through three case examples that were drawn largely from the words of the young people. Conclusion: This feasibility study suggests that young people’s relationship with music provides a powerful platform for leveraging engagement in services and improvements in distress, when well timed and carefully scaffolded.

scholarly journals Exploring Mental Health Professionals’ Perspectives of Text-Based Online Counseling Effectiveness With Young People: Mixed Methods Pilot Study (Preprint)

2019 ◽  
Author(s):  
Pablo Navarro ◽  
Jeanie Sheffield ◽  
Sisira Edirippulige ◽  
Matthew Bambling
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Young People ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Help Seeking ◽  
Online Counseling ◽  
Semistructured Interview ◽  
Therapeutic Benefits ◽  
Selection Factors

BACKGROUND Population-based studies show that the risk of mental ill health is highest among young people aged 10 to 24 years, who are also the least likely to seek professional treatment because of a number of barriers. Electronic mental (e-mental) health services have been advocated as a method for decreasing these barriers for young people, among which text-based online counseling (TBOC) is a primary intervention used at many youth-oriented services. Although TBOC has shown promising results, its outcome variance is greater in comparison with other electronic interventions and adult user groups. OBJECTIVE This pilot study aimed to explore and confirm e-mental health professional’s perspectives about various domains and themes related to young service users’ (YSUs) motivations for accessing TBOC services and factors related to higher and lower effectiveness on these modalities. METHODS Participants were 9 e-mental health professionals who were interviewed individually and in focus groups using a semistructured interview. Thematic analysis of qualitative themes from interview transcripts was examined across the areas of YSU motivations for access and factors that increase and decrease TBOC effectiveness. RESULTS A total of 4 domains and various subthemes were confirmed and identified to be related to YSUs’ characteristics, motivations for accessing TBOC, and moderators of service effectiveness: user characteristics (ie, prior negative help-seeking experience, mental health syndrome, limited social support, and perceived social difficulties), selection factors (ie, safety, avoidance motivation, accessibility, and expectation), and factors perceived to increase effectiveness (ie, general therapeutic benefits, positive service-modality factors, and persisting with counseling despite substantial benefit) and decrease effectiveness (ie, negative service-modality factors). CONCLUSIONS Participants perceived YSUs to have polarized expectations of TBOC effectiveness and be motivated by service accessibility and safety, in response to several help-seeking concerns. Factors increasing TBOC effectiveness were using text-based communication, the online counselor’s interpersonal skills and use of self-management and crisis-support strategies, and working with less complex presenting problems or facilitating access to more intensive support. Factors decreasing TBOC effectiveness were working with more complex problems owing to challenges with assessment, the slow pace of text communication, lack of nonverbal conversational cues, and environmental and connectivity issues. Other factors were using ineffective techniques (eg, poor goal setting, focusing, and postcounseling direction) that produced only short-term outcomes, poor timeliness in responding to service requests, rupture in rapport from managing service boundaries, and low YSU readiness and motivation.

scholarly journals Capturing the impact of adolescent inpatient admissions: The Social Connectedness Scale

2018 ◽  
Vol 24 (3) ◽  
pp. 631-641 ◽  
Author(s):  
Katy Phillips ◽  
Bridie Lawler Whatson ◽  
Emma Wells ◽  
Gordon Milson ◽  
Samantha Hartley
Keyword(s):  
Mental Health ◽  
Young People ◽  
Social Connectedness ◽  
Outcome Measurement ◽  
Well Being ◽  
Self Report ◽  
Subjective Well Being ◽  
Health Service Provision ◽  
The Social ◽  
The Impact

Background: Outcome measurement is central to health service provision. In child and adolescent mental health services (CAMHS), there are established tools used to assess symptoms and track progress. However, there is a relative dearth of assessments of subjective well-being or recovery. Social connectedness is a concept linked with well-being and risk in young people. We sought to evaluate the utility and acceptability of a measure of social connectedness in inpatient CAMHS. Method: As part of routine clinical practice, we asked 92 young people (mean age 16 years old) on two inpatient CAMHS wards to complete the Social Connectedness Scale, alongside other assessments, and also comment on its acceptability. We repeated the measure on discharge from the unit. Results: The findings showed that the measure was internally consistent (α = .910) and sensitive to change in this population. Scores also correlated with another self-report measure focusing on well-being and mental distress, but not with clinician-rated measures. Ratings of relevance and ease of understanding were reasonable and young people value social connection. Conclusion: The Social Connectedness Scale might offer an appropriate method of exploring this element of young peoples’ experience and progress, as part of inpatient mental health admissions.

scholarly journals Alienated and unsafe: Life through the Covid-19 lockdown for vulnerable young people (aged 11-24 years) as revealed in web-based therapeutic sessions with mental health professionals

2021 ◽  
Author(s):  
Charlotte Mindel ◽  
Crystal Oppong ◽  
Louisa Salhi ◽  
Joanna Lockwood
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Participatory Design ◽  
Web Based ◽  
Study Approach ◽  
Increased Risk ◽  
Poor Outcomes ◽  
The Impact

Abstract Background The Covid-19 pandemic and subsequent lockdowns have detrimentally and disproportionately affected young people, with those who are considered vulnerable due to their experiences or life circumstances disadvantaged further still. In this study, we seek to understand the experiences of vulnerable young people accessing web-based therapeutic support during the pandemic and early lockdown, as revealed through the observations of mental health professionals. Methods Four focus groups with twelve web-based mental health professionals from the service Kooth were conducted on Zoom, and data analysed using thematic analysis. Participatory workshops with young people with diverse experiences supplemented the study approach and design and involved young people in the co-design of the focus group topic guide and the interpretation and validation of analysis. Results Four main themes and additional sub-themes were identified relating to the experiences of vulnerable young people on a web-based mental health platform. These were Escalation of risk, The Experience and Consequence of Loss, Feeling Supported and Empowered, and Feeling Separate and Isolated. Conclusions Findings broadly reflect early data that suggests that those with existing vulnerability face increased risk of poor outcomes through the pandemic and the restrictions of lockdown, but evidence is also provided of positive outcomes from lockdown and its function as a catalyst for change. Results reinforce that focused support for vulnerable young people is a priority as we emerge from lockdown and points to support and protective factors of relevance to online and offline support provision. The study uniquely contributes qualitative insight from web-based mental health professionals who have provided continuity of care to vulnerable youth from pre-pandemic and during lockdown and are therefore well-positioned to understand the impact of lockdown on the lives of service users. The robust youth-based participatory design is an additional study strength.

scholarly journals Exploring Mental Health Professionals’ Perspectives of Text-Based Online Counseling Effectiveness With Young People: Mixed Methods Pilot Study

10.2196/15564 ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e15564
Author(s):  
Pablo Navarro ◽  
Jeanie Sheffield ◽  
Sisira Edirippulige ◽  
Matthew Bambling
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Young People ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Help Seeking ◽  
Online Counseling ◽  
Semistructured Interview ◽  
Therapeutic Benefits ◽  
Selection Factors

Background Population-based studies show that the risk of mental ill health is highest among young people aged 10 to 24 years, who are also the least likely to seek professional treatment because of a number of barriers. Electronic mental (e-mental) health services have been advocated as a method for decreasing these barriers for young people, among which text-based online counseling (TBOC) is a primary intervention used at many youth-oriented services. Although TBOC has shown promising results, its outcome variance is greater in comparison with other electronic interventions and adult user groups. Objective This pilot study aimed to explore and confirm e-mental health professional’s perspectives about various domains and themes related to young service users’ (YSUs) motivations for accessing TBOC services and factors related to higher and lower effectiveness on these modalities. Methods Participants were 9 e-mental health professionals who were interviewed individually and in focus groups using a semistructured interview. Thematic analysis of qualitative themes from interview transcripts was examined across the areas of YSU motivations for access and factors that increase and decrease TBOC effectiveness. Results A total of 4 domains and various subthemes were confirmed and identified to be related to YSUs’ characteristics, motivations for accessing TBOC, and moderators of service effectiveness: user characteristics (ie, prior negative help-seeking experience, mental health syndrome, limited social support, and perceived social difficulties), selection factors (ie, safety, avoidance motivation, accessibility, and expectation), and factors perceived to increase effectiveness (ie, general therapeutic benefits, positive service-modality factors, and persisting with counseling despite substantial benefit) and decrease effectiveness (ie, negative service-modality factors). Conclusions Participants perceived YSUs to have polarized expectations of TBOC effectiveness and be motivated by service accessibility and safety, in response to several help-seeking concerns. Factors increasing TBOC effectiveness were using text-based communication, the online counselor’s interpersonal skills and use of self-management and crisis-support strategies, and working with less complex presenting problems or facilitating access to more intensive support. Factors decreasing TBOC effectiveness were working with more complex problems owing to challenges with assessment, the slow pace of text communication, lack of nonverbal conversational cues, and environmental and connectivity issues. Other factors were using ineffective techniques (eg, poor goal setting, focusing, and postcounseling direction) that produced only short-term outcomes, poor timeliness in responding to service requests, rupture in rapport from managing service boundaries, and low YSU readiness and motivation.

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