scholarly journals Centering Lived Experience in Developing Digital Interventions for Suicide and Self-injurious Behaviors: User-Centered Design Approach

10.2196/31367 ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. e31367
Author(s):  
Kaylee Payne Kruzan ◽  
Jonah Meyerhoff ◽  
Candice Biernesser ◽  
Tina Goldstein ◽  
Madhu Reddy ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Lived Experience ◽  
Suicide Attempts ◽  
Methodological Approach ◽  
Research Process ◽  
User Centered Design ◽  
Health Crisis ◽  
Digital Interventions ◽  
User Centered

Background The prevalence of self-injurious thoughts and behaviors (SITB) signals a growing public health crisis. Despite a recognized need for improved and scalable interventions, the field of SITB intervention faces several challenges: existing interventions are often time and resource intensive, most individuals with SITB do not seek formal mental health care, and efficacious treatments are characterized by small effects. Combined, these challenges indicate a need for improved SITB interventions for individuals in formal treatment and those who are not treatment engaged but are at high risk of worsening mental health and future suicide attempts. Objective We present a methodological approach and set of techniques that may address these challenges by centering the lived experience of individuals with SITB in the process of developing needed services: user-centered design (UCD). Methods We highlight the value of UCD in the context of digital interventions for SITB by describing the UCD approach and explicating how it can be leveraged to include lived experience throughout the development and evaluation process. We provide a detailed case example highlighting 3 phases of the early development process that can be used to design an intervention that is engaging and meets end-user needs. In addition, we point to novel applications of UCD to complement new directions in SITB research. Results In this paper, we offer a 2-pronged approach to meet these challenges. First, in terms of addressing access to effective interventions, digital interventions hold promise to extend the reach of evidence-based treatments outside of brick-and-mortar health care settings. Second, to address challenges related to treatment targets and engagement, we propose involving individuals with lived experience in the design and research process. Conclusions UCD offers a well-developed and systematic process to center the unique needs, preferences, and perceived barriers of individuals with lived SITB experience in the development and evaluation of digital interventions.

scholarly journals Centering Lived Experience in Developing Digital Interventions for Suicide and Self-injurious Behaviors: User-Centered Design Approach (Preprint)

2021 ◽  
Author(s):  
Kaylee Payne Kruzan ◽  
Jonah Meyerhoff ◽  
Candice Biernesser ◽  
Tina Goldstein ◽  
Madhu Reddy ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Lived Experience ◽  
Suicide Attempts ◽  
Methodological Approach ◽  
Research Process ◽  
User Centered Design ◽  
Health Crisis ◽  
Digital Interventions ◽  
User Centered

BACKGROUND The prevalence of self-injurious thoughts and behaviors (SITB) signals a growing public health crisis. Despite a recognized need for improved and scalable interventions, the field of SITB intervention faces several challenges: existing interventions are often time and resource intensive, most individuals with SITB do not seek formal mental health care, and efficacious treatments are characterized by small effects. Combined, these challenges indicate a need for improved SITB interventions for individuals in formal treatment and those who are not treatment engaged but are at high risk of worsening mental health and future suicide attempts. OBJECTIVE We present a methodological approach and set of techniques that may address these challenges by centering the lived experience of individuals with SITB in the process of developing needed services: user-centered design (UCD). METHODS We highlight the value of UCD in the context of digital interventions for SITB by describing the UCD approach and explicating how it can be leveraged to include lived experience throughout the development and evaluation process. We provide a detailed case example highlighting 3 phases of the early development process that can be used to design an intervention that is engaging and meets end-user needs. In addition, we point to novel applications of UCD to complement new directions in SITB research. RESULTS In this paper, we offer a 2-pronged approach to meet these challenges. First, in terms of addressing access to effective interventions, digital interventions hold promise to extend the reach of evidence-based treatments outside of brick-and-mortar health care settings. Second, to address challenges related to treatment targets and engagement, we propose involving individuals with lived experience in the design and research process. CONCLUSIONS UCD offers a well-developed and systematic process to center the unique needs, preferences, and perceived barriers of individuals with lived SITB experience in the development and evaluation of digital interventions.

Valuing the voice of lived experience of eating disorders in the research process: Benefits and considerations

2021 ◽  
pp. 000486742199879
Author(s):  
Selma Musić ◽  
Rosiel Elwyn ◽  
Grace Fountas ◽  
Inge Gnatt ◽  
Zoe M Jenkins ◽  
...  
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Lived Experience ◽  
Health Research ◽  
Research Process ◽  
Mental Health Research ◽  
Direct Involvement ◽  
The Voice ◽  
Process Benefits

Although the inclusion of individuals with lived experience is encouraged within the research process, there remains inconsistent direct involvement in many mental health fields. Within the eating disorders field specifically, there is a very strong and increasing presence of lived experience advocacy. However, due to a number of potential challenges, research undertaken in consultation or in collaboration with individuals with lived experience of an eating disorder is scarce. This paper describes the significant benefits of the inclusion of individuals with lived experience in research. The specific challenges and barriers faced in eating disorders research are also outlined. It is concluded that in addition to existing guidelines on working with lived experience collaborators in mental health research, more specific procedures are required when working with those with eating disorders.

Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Forensic Mental Health ◽  
Content Type ◽  
Self Injury ◽  
Forensic Psychiatric ◽  
The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

scholarly journals Mobile Mental Health Technologies: Unique Challenges and Solutions for an effective User Centered Design Methodology

2019 ◽  
Vol 63 (1) ◽  
pp. 1908-1909
Author(s):  
Amanda J. Johnson ◽  
Ann M. Bisantz ◽  
Amy L. Reynolds ◽  
Scott T. Meier
Keyword(s):  
Mental Health ◽  
Research Protocol ◽  
User Centered Design ◽  
Health Issues ◽  
Health Concerns ◽  
Health Technologies ◽  
Mental Health Issues ◽  
Mental Health Concerns ◽  
Usability Research ◽  
User Centered

Mobile technologies are rapidly becoming a tool for collaborative health care and increasing access to health information and treatment. Mental health is one area of healthcare that may be particularly suited to mobile health technologies because of barriers including insufficient numbers of providers and access concerns such as lack of insurance coverage. Previous research has found that many people are interested in utilizing mobile health technologies for mental health (Shand, Ridani, Tighe, & Christensen, 2013; McManama, LeCloux, Ross, Gironda, & Wharff, 2017; Pauwels et al., 2017). Many mental health applications currently available have been found to be unengaging, difficult to use, and some may even be detrimental to the user (Aguirre, McCoy, & Roan, 2013; Larsen, Nicholas, and Christensen, 2016). Research has also shown that traditional usability standards and guidelines for design do not apply to persons with mental health concerns (Rotondi, et al., 2007). The most effective way to develop mobile applications for mental health that are both effective and user friendly is to take a user centered design approach incorporating those with mental health issues into the design process. One barrier to this has been the perception that those with mental health concerns are incapable of participating in research or that it may be harmful for them to do so. More recent research has shown that not only is it possible for those with even severe mental health issues to participate in research, but that it can be beneficial to those participants (Gibson, Boden, Benson, & Brand, 2014; Hutchinson, Wilson, & Wilson 1994, Biddle, et al., 2013). Involving individuals with mental health concerns in application development has become increasingly prevalent and important, thus making it appropriate to consider, the special needs of the population and the potential adaptations that may need to be made to traditional research protocols and user centered design methods. Population While the population of those with mental health concerns is as diverse as the general population at large, certain characteristics are over-represented in the population of those with mental health concerns. These can include a lower than average amount of education, lower socio-economic status, and diminished cognitive functioning (Yu and Williams, 1999; Vick, Jones, & Mitra, 2012, Rock, Rosier, Riedel, & Blackwell, 2014). These characteristics can impact participation in usability research in several ways that necessitate adaptations to commonly used design methods and research practices. Additionally, due to the high levels of stigma and increased needs for privacy present with this population further considerations are warranted. Methods Recommended adaptations include both adaptations to the overall research protocol as well as those pertaining to specific methods. One example of an adaptation to the overall research protocol is a reduced expectation for duration and frequency of participation because of decreased frustration tolerance related to mental health concerns (Ellis, Vanderlind, & Beevers 2013). Another example would be adjustments to the consent process such as ongoing assessment of ability to consent (Tee & Lathlean, 2004) due to changes in intensity of mental health symptomology. Other general considerations include use of collaborative and culturally sensitive language (Kelly, Wakeman, & Saitz, 2015; Granello & Gibbs, 2016; Bonevski, et al. 2014), avoiding the use of content that may be insensitive or may unnecessarily exacerbate symptoms, (Bonevski, et al., 2014), and paying attention to the layout and content of study materials so as to meet the need of those who are experiencing cognitive difficulties resulting from their mental health symptoms (Friedman and Bryen, 2007; Rotondi, et al., 2013, and Rotondi, et al., 2007). An example of an adaptation more specific to method would be considering one on one interview instead of a focus group due to increased privacy concerns and potential for anxiety related to disclosing in groups. Conclusion Taking into consideration the unique needs of the population of those with mental health concerns will allow for the design of applications that better serve them. This will improve the utility, accessibility, and propagation of such applications and has the potential to both improve existing services and to expand access. Acknowledgements: We would like to acknowledge Capstone Behavioral Healthcare for their ongoing support of usability research with those with mental health concerns.

scholarly journals Maximizing the impact of E-Therapy and Serious Gaming: Time for a paradigm shift

2020 ◽  
Author(s):  
Theresa Fleming ◽  
D de Beurs ◽  
Y Khazaal ◽  
A Gaggioli ◽  
G Riva ◽  
...  
Keyword(s):  
Mental Health ◽  
Paradigm Shift ◽  
User Centered Design ◽  
Online Programs ◽  
Serious Gaming ◽  
Internet Interventions ◽  
Evidence Based Treatments ◽  
Population Mental Health ◽  
The Impact ◽  
User Centered

© 2016 Fleming, de Beurs, Khazaal, Gaggioli, Riva, Botella, Baños, Aschieri, Bavin, Kleiboer, Merry, Lau and Riper. Internet interventions for mental health, including serious games, online programs, and apps, hold promise for increasing access to evidence-based treatments and prevention. Many such interventions have been shown to be effective and acceptable in trials; however, uptake and adherence outside of trials is seldom reported, and where it is, adherence at least, generally appears to be underwhelming. In response, an international Collaboration On Maximizing the impact of E-Therapy and Serious Gaming (COMETS) was formed. In this perspectives' paper, we call for a paradigm shift to increase the impact of internet interventions toward the ultimate goal of improved population mental health. We propose four pillars for change: (1) increased focus on user-centered approaches, including both user-centered design of programs and greater individualization within programs, with the latter perhaps utilizing increased modularization; (2) Increased emphasis on engagement utilizing processes such as gaming, gamification, telepresence, and persuasive technology; (3) Increased collaboration in program development, testing, and data sharing, across both sectors and regions, in order to achieve higher quality, more sustainable outcomes with greater reach; and (4) Rapid testing and implementation, including the measurement of reach, engagement, and effectiveness, and timely implementation. We suggest it is time for researchers, clinicians, developers, and end-users to collaborate on these aspects in order to maximize the impact of e-therapies and serious gaming.

scholarly journals El duelo en medicina desde la visión y piel del profesional sanitario

2021 ◽  
Vol 2 (1) ◽  
pp. 92-100
Author(s):  
Erik Gabriel Díaz Avila ◽  
Marcela Fernández-Carrera Muchova ◽  
Teresa Sánchez Villanueva ◽  
Vega Sánchez Calvo ◽  
Jesús Francisco Mesonero Robles
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Professionals ◽  
Health Personnel ◽  
Natural Process ◽  
Future Health ◽  
Health Crisis ◽  
Loved One ◽  
Scientific Databases ◽  
Salud Mental

El duelo es un proceso natural que han de pasar las personas tras la pérdida de un ser querido. Durante la actual pandemia COVID-19 los profesionales sanitarios han sido víctimas, pues se han tenido que enfrentar a una situación sin precedentes en la que se ha puesto en juego su propia salud mental. El objetivo principal del estudio ha sido analizar el duelo en los profesionales sanitarios durante la actual pandemia COVID-19. Se realizó una revisión de la literatura, no sistemática, en las diferentes bases de datos científicas para analizar el duelo en el ámbito de la medicina ligado al duelo vivido por los profesionales sanitarios, centrado en la situación actual de crisis sanitaria, así como los problemas que añadió la pandemia COVID-19. La pandemia COVID-19 ha puesto de manifiesto la importancia del duelo y la despedida justa, la cual no se pudo dar en la mayoría de los casos. Es imperiosa la preparación que han de recibir los profesionales sanitarios para enfrentar dicho proceso e incluso, los futuros profesionales sanitarios. Queda de manifiesto la importancia de la capacitación y cuidado de la salud mental, tanto en pacientes, familiares, personal sanitario y futuros profesionales de la salud. A la vez que, se ha de garantizar la resiliencia enfocada a los aspectos relacionados con el duelo. Grief is a natural process that people go through after the loss of a loved one. During the current COVID-19 pandemic, health professionals have been victims, as they have had to face an unprecedented situation in which their own mental health has been put at stake. The main objective of the study has been to analyze the grief in health professionals during the current COVID-19 pandemic. A literatura review, non-systematic was carried out in the different scientific databases to analyze the grief in the field of medicine linked to the grief experienced by health professionals, focused on the current situation of health crisis, as well as the problems added by the COVID-pandemic. 19. The COVID-19 pandemic has highlighted the importance of mourning and a fair farewell, which could not be given in most cases. The preparation that health professionals must receive to face this process and even future health professionals is imperative. The importance of training and mental health care is evident, both in patients, relatives, health personnel and future health professionals. At the same time, resilience focused on aspects related to grief must be guaranteed.

scholarly journals Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System

10.2196/25148 ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. e25148
Author(s):  
Ahmed Umar Otokiti ◽  
Catherine K Craven ◽  
Avniel Shetreat-Klein ◽  
Stacey Cohen ◽  
Bruce Darrow
Keyword(s):  
Health Care ◽  
Data Analysis ◽  
Electronic Health Record ◽  
Health Record ◽  
User Centered Design ◽  
Pilot Phase ◽  
Direct Input ◽  
Electronic Health ◽  
The Impact ◽  
User Centered

Background Up to 60% of health care providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on health care quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide. Objective This project aims to improve the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies via user-centered design has the potential to improve usability, thereby increasing satisfaction by reducing EHR-induced burnout. Methods Quantitative and qualitative data will be obtained from clinician EHR users. The input will be received through a form built in a REDCap database via a link embedded in the home page of the EHR. The REDCap data will be analyzed in 2 main dimensions, based on nature of the input, what section of the EHR is affected, and what is required to fix the issue(s). Identified issues will be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a Plan-Do-Study-Act (PDSA) manner every 4-6 weeks. Results The pilot phase of the study began in October 2020 in the Gastroenterology Division at Mount Sinai Hospital, New York City, NY, which includes 39 physicians and 15 nurses. The pilot is expected to run over a 4-6–month period. The results of the REDCap data analysis will be reported within 1 month of completing the pilot phase. We will analyze the nature of requests received and the impact of rectified issues on the clinician EHR user. We expect that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by evaluation survey and other qualitative methods where possible. Conclusions The project aims to improve user-centered design of the EHR by soliciting direct input from clinician EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics expertise to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement. International Registered Report Identifier (IRRID) PRR1-10.2196/25148

Hispanics, Mental Health, and Suicide: Brief Report

2019 ◽  
Vol 17 (3) ◽  
pp. 133-136 ◽  
Author(s):  
Francisco Brenes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Hispanic Americans ◽  
Social Issues ◽  
The United States ◽  
Health Concern ◽  
Care Providers ◽  
Provider Attitudes ◽  
Health Crisis

A global health crisis exists surrounding suicide. In the United States, suicide rates have increased by nearly 30% in most states since 1999. Although the suicide rate among Hispanic Americans is significantly lower than non-Hispanic Whites, reasons for the lower rate are unclear. Current literature suggests that the lower rate may be due to underreporting, a lack of suicide screening and a number of complex social issues, including the stigma surrounding suicide in Hispanic culture. Health care provider attitudes toward suicidal individuals may also negatively affect mental health outcomes. This brief report focuses on suicide as a public health concern, addresses key issues arising from the phenomenon, and provides a perspective on health care providers’ attitudes toward suicide. Recommendations for future research, as well as implications for clinical practice and policy, are suggested.

scholarly journals 109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Mitchell ◽  
Cornelius Ani ◽  
James Irvine ◽  
Claude Cyr ◽  
Ari Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Suicide Attempt ◽  
Mental Health Care ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Suicide Mortality ◽  
Prevention Interventions ◽  
History Of ◽  
Self Harm

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

Sign in / Sign up

Export Citation Format

Share Document