Digital technologies could be a viable option to help spot worsening mental health in young people.
The study, which is one of the first of its kind, looked at the acceptability and feasibility of using smartphones, wearables and other technologies such as social media, to detect worsening mental health in young people. By training young people with a history of severe mental ill-health to conduct the research, the work offers unique insight that could guide the development of technologies and digital services aimed at addressing rising mental health needs.
Slipping through the system
In the UK, one in eight children and young people have a mental health disorder (NHS Digital). But ensuring that these groups get the care they need is problematic. This is in part because mental health conditions can often go undetected.
“Around 35% of young people with mental health problems do not engage with mental health services,” said Dr Dewa, research associate at the Institute’s NIHR Imperial Patient Safety Translational Research Centre. “This creates limited opportunities to detect issues, and can result in a reliance on individuals’ parents and family instead. We’ve also found from our research that many people can deliberately and successfully hide their conditions.”
Young people who do engage with mental health services can also face difficulty when transitioning to adult care when they pass the age of 18. This means that deteriorating conditions can be missed by the system, the outcomes of which can be severe.
Finding an appropriate way to interact with young people and their mental health is key to discovering a solution to these challenges. With the increasing use of wearable devices, such as Apple Watches and Fitbits, and smartphone apps in healthcare, these new technologies have begun to show great promise in a variety of settings. The researchers, therefore, wanted to explore young people’s perceptions of using these tools to spot early warning signs of worsening mental health in this demographic.
Shaping future solutions
For the study, 16 participants aged between 19 and 24 who had a history of severe mental ill-health, were interviewed. They were asked a series of questions to understand their attitudes towards technology both in general, and in relation to mental health deterioration.
Published in PLoS ONE, the research found that wearables and smartphones are generally acceptable to young people and could be feasible to detect deteriorating mental health. The work also highlighted that future solutions should concentrate on monitoring sleep, mood and activity levels, as participants identified these as key indicators of worsening mental health.
“Wearables can pick up abnormal patterns in these measurables and then respond by asking the user how they are feeling,” explains Dr Dewa. “This allows you to intervene at the time they are not well.”
But for these new technologies to be truly impactful to young people, the study recommended that immediate action was needed after discovering signs of deterioration. The authors stated that potential interventions should be designed with the input of young people to address issues of safeguarding and patient preference, ensuring that technologies meet the needs of those that they are designed to benefit.
Co-producing for better results
While there has been much research on young people’s mental health, there is a lack of focus on the deterioration of those already experiencing severe mental disorders. The authors also highlighted that existing research often fails to incorporate the opinions of young people themselves. It was for this reason that the researchers conducted their study in a co-produced way, involving young people with previous mental health difficulties in every stage of the research.
From planning the interviews and processes, to interviewing the young participants, co-production was crucial to the study:
“It changed the dynamic of the whole project,” said Dr Dewa. “The results were enhanced because of the involvement from the young people. We were in constant communication to bounce ideas off from their perspective as people who have experienced various mental health conditions.”
For Dr Dewa, using co-production in this study has changed the way she plans to conduct her future research: “I wouldn’t do it any other way now,” she says. “I feel it is the way forward for research. Working with people who have lived experience of illness can mean better results, better outputs, better communication with the participants, and better data.”
Read the study, “Young adults’ perceptions of using wearables, social media and other technologies to detect worsening mental health: A qualitative study” here.
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Institute of Global Health Innovation