scholarly journals Listening to Mental Health Crisis Needs at Scale: Using Natural Language Processing to Understand and Evaluate a Mental Health Crisis Text Messaging Service

2021 ◽  
Vol 3 ◽  
Author(s):  
Zhaolu Liu ◽  
Robert L. Peach ◽  
Emma L. Lawrance ◽  
Ariele Noble ◽  
Mark A. Ungless ◽  
...  

The current mental health crisis is a growing public health issue requiring a large-scale response that cannot be met with traditional services alone. Digital support tools are proliferating, yet most are not systematically evaluated, and we know little about their users and their needs. Shout is a free mental health text messaging service run by the charity Mental Health Innovations, which provides support for individuals in the UK experiencing mental or emotional distress and seeking help. Here we study a large data set of anonymised text message conversations and post-conversation surveys compiled through Shout. This data provides an opportunity to hear at scale from those experiencing distress; to better understand mental health needs for people not using traditional mental health services; and to evaluate the impact of a novel form of crisis support. We use natural language processing (NLP) to assess the adherence of volunteers to conversation techniques and formats, and to gain insight into demographic user groups and their behavioural expressions of distress. Our textual analyses achieve accurate classification of conversation stages (weighted accuracy = 88%), behaviours (1-hamming loss = 95%) and texter demographics (weighted accuracy = 96%), exemplifying how the application of NLP to frontline mental health data sets can aid with post-hoc analysis and evaluation of quality of service provision in digital mental health services.

Author(s):  
Rita Vaičekauskaitė ◽  
Jurgita Babarskienė ◽  
Jūratė Grubliauskienė

With the COVID-19 pandemic and its restrictions, many countries face an unprecedented mental health crisis, which is being addressed in various ways, including the use of remote mental health services. Lithuania faced two quarantines: in March-June of 2020 and starting November 2020 up to Spring of 2021.  The aim of this study is to explore the experiences of Lithuanian psychologists providing mental health services during the pandemic.  Using the qualitative content analysis method, the following categories were made: from shock to discovery of new opportunities (differences in two lockdowns, better accessibility of services, help-seeking during the pandemic, and the importance of self-care) and contextual challenges (confidentiality, computer literacy, and blurred home/work boundaries). Implications for addressing psychological service issues are discussed, with an emphasis on self-care, setting boundaries, and finding new ways to enhance mental health via mediated communication as well as to reach out to vulnerable groups.


2020 ◽  
Author(s):  
Natasha Chilman ◽  
Nicola Morant ◽  
Brynmor Lloyd-Evans ◽  
Jane Wackett ◽  
Sonia Johnson

BACKGROUND Analyzing Twitter posts enables rapid access to how issues and experiences are socially shared and constructed among communities of health service users and providers, in ways that traditional qualitative methods may not. OBJECTIVE To enrich the understanding of mental health crisis care in the United Kingdom, this study explores views on crisis resolution teams (CRTs) expressed on Twitter. We aim to identify the similarities and differences among views expressed on Twitter compared with interviews and focus groups. METHODS We used Twitter’s advanced search function to retrieve public tweets on CRTs. A thematic analysis was conducted on 500 randomly selected tweets. The principles of refutational synthesis were applied to compare themes with those identified in a multicenter qualitative interview study. RESULTS The most popular hashtag identified was <i>#CrisisTeamFail</i>, where posts were principally related to poor quality of care and access, particularly for people given a <i>personality disorder</i> diagnosis. Posts about CRTs giving unhelpful self-management advice were common, as were tweets about resource strains on mental health services. This was not identified in the research interviews. Although each source yielded unique themes, there were some overlaps with themes identified via interviews and focus groups, including the importance of rapid access to care. Views expressed on Twitter were generally more critical than those obtained via face-to-face methods. CONCLUSIONS Traditional qualitative studies may underrepresent the views of more critical stakeholders by collecting data from participants accessed via mental health services. Research on social media content can complement traditional or face-to-face methods and ensure that a broad spectrum of viewpoints can inform service development and policy. CLINICALTRIAL


2021 ◽  
Vol 1 (2) ◽  
pp. 191-213
Author(s):  
Lu Wang ◽  
Joseph Ariwi

Abstract: Mental illness includes a wide range of disorders that affect mood, thinking, behaviour and overall wellbeing. One in five Canadians has mental health care needs, many of which are unmet. Within the City of Toronto, the provision of specialized mental health care is delivered by over 100 public and private community service organisations and over 700 physicians with a psychiatric specialization - each providing community-based general or specialised care to residents in need. Research has shown that travel distance is an enabling factor of health service utilisation, thus equitable spatial access to services remains a key priority. Using spatial quantitative methods, this study examines potential spatial accessibility to both general and specialized mental health services within the City of Toronto, and levels of statistical association between access to care and prevalence of mental health crisis events. The main datasets analyzed including geo-referenced Census data and occurrence data on mental health crisis (represented by apprehensions under the Mental Health Act undertaken by the Toronto Police Service). The enhanced two-step floating catchment area (E2SFCA) method is used to model spatial accessibility to mental health services based four modes of transportation: driving, walking, cycling and public transit. Areas that are underserved by mental health specialists and mental health community services are identified and shown to have different socioeconomic characteristics. The study reveals spatially explicit patterns of access to various mental health services in Toronto, providing detailed data to inform the planning of and policy on mental health care delivery concerning severe mental health crisis.


2021 ◽  
Vol 5 (1) ◽  
pp. e001116
Author(s):  
Monika Gorny ◽  
Sarah Blackstock ◽  
Arun Bhaskaran ◽  
Imogen Layther ◽  
Mimoza Qoba ◽  
...  

Direct risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new ‘hubs’ were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children’s hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings.


10.2196/25742 ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. e25742
Author(s):  
Natasha Chilman ◽  
Nicola Morant ◽  
Brynmor Lloyd-Evans ◽  
Jane Wackett ◽  
Sonia Johnson

Background Analyzing Twitter posts enables rapid access to how issues and experiences are socially shared and constructed among communities of health service users and providers, in ways that traditional qualitative methods may not. Objective To enrich the understanding of mental health crisis care in the United Kingdom, this study explores views on crisis resolution teams (CRTs) expressed on Twitter. We aim to identify the similarities and differences among views expressed on Twitter compared with interviews and focus groups. Methods We used Twitter’s advanced search function to retrieve public tweets on CRTs. A thematic analysis was conducted on 500 randomly selected tweets. The principles of refutational synthesis were applied to compare themes with those identified in a multicenter qualitative interview study. Results The most popular hashtag identified was #CrisisTeamFail, where posts were principally related to poor quality of care and access, particularly for people given a personality disorder diagnosis. Posts about CRTs giving unhelpful self-management advice were common, as were tweets about resource strains on mental health services. This was not identified in the research interviews. Although each source yielded unique themes, there were some overlaps with themes identified via interviews and focus groups, including the importance of rapid access to care. Views expressed on Twitter were generally more critical than those obtained via face-to-face methods. Conclusions Traditional qualitative studies may underrepresent the views of more critical stakeholders by collecting data from participants accessed via mental health services. Research on social media content can complement traditional or face-to-face methods and ensure that a broad spectrum of viewpoints can inform service development and policy.


AERA Open ◽  
2021 ◽  
Vol 7 ◽  
pp. 233285842110286
Author(s):  
Kylie L. Anglin ◽  
Vivian C. Wong ◽  
Arielle Boguslav

Though there is widespread recognition of the importance of implementation research, evaluators often face intense logistical, budgetary, and methodological challenges in their efforts to assess intervention implementation in the field. This article proposes a set of natural language processing techniques called semantic similarity as an innovative and scalable method of measuring implementation constructs. Semantic similarity methods are an automated approach to quantifying the similarity between texts. By applying semantic similarity to transcripts of intervention sessions, researchers can use the method to determine whether an intervention was delivered with adherence to a structured protocol, and the extent to which an intervention was replicated with consistency across sessions, sites, and studies. This article provides an overview of semantic similarity methods, describes their application within the context of educational evaluations, and provides a proof of concept using an experimental study of the impact of a standardized teacher coaching intervention.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  

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.


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