How to provide 24/7 support in a 9-5 work day: the benefit of e-mental health tools for young people in rural areas.
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This presentation was presented by Noni Hollonds (Professionals Program Coordinator) at the Rural and Remote Mental Health Symposium in late 2015
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How to provide 24/7 support in a 9-5 work day: the benefit of e-mental health tools for young people in rural areas.
- 1. How to provide 24/7 support in a 9-5 work day: the benefit of e-mental health tools for young people in rural areas. Noni Hollonds Professionals Program Coordinator ReachOut Australia October 2015
- 2. The problem Young people in rural and remote Australia: • Report poorer mental health outcomes • Have limited access to support Professionals in rural and remote Australia: • Have limited capacity • struggle to reach all those in need
- 3. Available 24/7 Evidence-based Rural and remote access e-Mental health services can extend the reach and impact of face-to-face services
- 4. What we know ... about young people who use ReachOut.com 1.2 million Australian visitors (60% are young people) in the past year 21% of young users (150,000) live in rural, regional or remote areas 56% of users indicate they are going through a tough time Source: 2013 ReachOut.com user survey
- 5. What we know ... about young people in rural and remote areas. 60% report “very high distress” on K10 Distance from major cities positively correlates with choosing “tough time and looking for help” as a reason for visiting ReachOut Cited “couldn’t afford the cost” and “too far to travel” as main barriers to seeking help Source: 2013 ReachOut.com user survey
- 6. Access anytime Tools for self-help Easy to find Access anywhere Free or low cost Pathways to support Benefits of e-mental health tools and services for rural and remote young people
- 7. Resources are limited • Work hours are generally Mon-Fri 9-5 but many young people need support outside these hours • Practitioners in rural and remote places cover a larger geographic area and population Source: AIHW 2009
- 8. Extend reach and impact of face-to-face Evidence suggests that e-mental health tools and services can positively impact the mental health outcomes of users, especially when provided in conjunction with face-to-face services3 Benefits of e-mental health tools and services for professionals
- 9. Promoting the use of e-mental health resources Recommending specific e-mental health resources Supporting clients to independently use e-mental health resources Using e-mental health resources in conjunction with other therapies Practitioner involvement increases Using e-mental health tools in-conjunction with face-to-face sessions Clinical Practice Model4
- 10. Promotion of e-mental health tools ● Discuss the option of e-mental health tools or services ● Encourage the client to search for something that suits their own needs
- 11. Specific tool recommendation ● Recommend a specific tool or service that is relevant to their needs ● Highlight the possible benefits of the tool
- 12. Supported access ● Access the tool with them in a face-to-face session ● Discuss the features and options for use and explore the tool ● Fact sheets ● Personal stories ● Forums ● Apps + The Toolbox ● Pathways to support and emergency help
- 13. In conjunction with other therapies ● Use apps based on CBT techniques instead of paper and pen tools ● Encourage clients to use the tool outside regular session when they need a little extra support (e.g. ReachOut Breathe or ReachOut WorryTime)
- 15. Useful tools for professionals ReachOut Professionals - professionals.reachout.com ● Information about using ReachOut.com with young people - Stay up to date with what’s new on ReachOut ● Reviews, tips and information about e-mental health tools and services ● Online professional development training The Toolbox - reachout.com/sites/thetoolbox ● A collection of health and wellbeing apps endorsed by professionals and young people ● Using the MARS (developed by Young and Well CRC) eMHPrac - www.emhprac.org.au ● free e-mental health training and support for health practitioners
- 16. Facebook: facebook.com/ReachOutPro Twitter: @ReachOutPro Or send an email: Professionals@reachout.com Reference list: 1. AIHW 2009. Australia's welfare 2009. Australia's welfare no. 9. Cat. no. AUS 117. Canberra: AIHW. Viewed 21 October 2015 <http://www.aihw.gov.au/publication- detail/?id=6442468304>. 2. Metcalf, A, Blake, V., 2013. ReachOut.com Annual User Survey Results. Sydney: ReachOut Australia. 3. The Royal Australian College of General Practitioners, 2015.e-Mental health: A guide for GPs. 4. Reynolds J, Griffiths KM, Cunningham JA, Bennett K, Bennett A. Clinical practice models for the use of e-mental health resources in primary health care by health professionals and peer workers: a conceptual framework. JMIR Mental Health 2015;2(1):e6. Connect with us
- 17. Thanks!
Editor's Notes
- I would like to acknowledge the Dja Dja Wurrung people who are the traditional custodians of this land. I would also like to pay respect to the elders past and present of the Dja Dja Wurrung nation and extend that respect to other Aboriginal people present. Introduce myself and where I’m from. Engagement activity comment on previous presentation + or ask about their opinion Survey types of professionals - and experience with e-mental health services How many people have actually used an e-mental health service with a client? either referral or in session? Clarify what we mean by e-mental health Learning Outcomes Learn about the impact e-mental health tools can have for young people in rural and remote areas and the ways you can intergrate e-mental health tools like ReachOut.com into your work with young people - and the benefit they can have for you work.
- For young people Young people are searching for information about mental health online. Young people in rural and remote areas don’t have the same access to care For professionals limited capacity services hours location struggle to meet client needs
- e-mental health services can extend the reach and impact of f2f services Provide support outside of service hours or between sessions Accessible when access is limited An evidence based method of providing support There is strong evidence to suggest that e-mental health resources can be effective for the management of mild to moderate mental health issues, especially when provided in conjunction with face-to-face services. (From GP guide) e-Mental Health services e.g. ReachOut can address these issues Makes the work of MH professionals easier Extend the impact of f2f support Extend the ability of MH workers to reach more young people Support at times where MH workers are unavailable
- What we know about young people in rural and remote areas: In the last year: (October 14 - Sept 15) approx 1.2 million Australians accessed ReachOut.com. Based on our most recent user survey we know that approx 21% (or approx 250,000) of users are young people living in rural, regional or remote areas. 56% of users indicate they are going through a tough time. 7% looking for info to help a friend 5% looking for wellbeing tips 720,000 are young people and 150,000 live in rural and remote areas
- Young people in rural or remote areas have worse mental health outcomes than their peers in urban areas. 60% reporting “very high” in Kessler K10 Greater risk factors for developing mental health issues Social and economic context Limited access to services (both location and type) Why? Geographic remoteness - distance from major cities positively correlates with choosing “tough time and looking for help” as a reason for visiting ReachOut Barriers to help seeking for R+R: more YP in R+R areas reported “couldn’t afford the cost” and “Too far to travel” as reasons why they didn’t seek help - than urban YP + many are dependent on parents for transport access to services Location and types of services are limited e.g. perhaps no psychiatrist or specialist drug and alcohol service Confidentiality issues in small towns
- e-mental health tools and services can help young people who struggle to access services or may not know they need help. Quality information can be found via a quick google search (image) No need to travel - access anywhere Free access Pathways to upstream support e.g. ReachOut has links to Headspace and kids helpline. As well as emergency services. Gives access to support without needing to visit a GP or other clinician and builds MH literacy Forums allow young people to talk to others who have experienced a similar thing - feelings of connectedness - peer support Access anytime via internet/smartphone after hours and between sessions 70% of young people access ReachOut.com between 5pm and 6am when face-to-face services are often closed. (Quote from user survey) Tools to use when they’re in distress (e.g. late at night) without having to go anywhere. ReachOut Breathe and WorryTime
- MH professionals and support workers are a limited resource both physically Getting around to different clients when they are in different areas range of services available can be limited due to funding and time wise Work hours are 9-5, many young people (as we know) need support outside these hours. Stats about professionals as a limited resources (graph) Less services are available for young people Significant gap between metro and rural This cause poblems with travel e-mental health tools are often not seen as an effective intervention for young people very new resource and way of working
- How professional work can benefit from e-mental health tools Extend reach + impact of f2f services support 24/7 in their own homes When they need it most can be tailored to specific client needs - there is no one size fits all a range of options: websites forums webchat programs/courses tools to assist with f2f support apps There is now an increasing number of e-mental health services that are accessible after hours and from anywhere with access to the internet. There is strong evidence to suggest that e-mental health resources can be effective for the management of mild to moderate mental health issues, especially when provided in conjunction with face-to-face services. (From GP guide)
- How can health professionals and support workers tap in to e-mental health resources, like ReachOut.com, to support young people in-between face-to-face sessions? Overview of stepped-care clinical practice model (based on eMHPrac guide for GPs but adapted for a broader professional audience): Promotion of e-mental health Recommendation or referral to specific tool or service Supported access to a specific tool or service Using e-mental health tools in conjunction with traditional services. Practitioners should choose a level of involvement that is appropriate for the young person they are working with.
- 10. General e-Health Promotion. Suggest to the young person that e-mental health tools can help them practice resilient behaviours in-between sessions or when they don’t have face-to-face support. Suggest where or how to search for appropriate tools and what features to look for. You can even ask them to share their searches and recommendations with you. Promote self-help behaviours.
- 11. Specific Tool recommendation. When recommending ReachOut.com you could suggest they could use it to learn more about certain feelings they have or ask a question in the forums. Use it as a way for them to take control of learning about their mental health. You may suggest one of the ReachOut apps, i.e. Breathe or WorryTime, if they have access to a smartphone. Highlight the benefits of connecting to the forum community Search for fact-sheets and personal stories Talk to peers on the forums or participate in a Q&A with a professional Use apps to manage symptoms or moods
- 12. Supported access In a session with a young person, show them the ReachOut.com website and explore it’s features and articles. Discuss the content of the website and ways that they could use the site if they need support between sessions e.g. fact-sheets, forums, apps and stories etc.
- 13. e-Mental health tools as part of clinical treatment - within f2f sessions Use or prescribe the breathe or worrytime apps as tools for anxiety based CBT. These tools can be used both in sessions and when the young person is on their own - extending the support beyond face-to-face sessions.
- 14. Before and after slide Without e-mental health - young people remain isolated and excluded from essential support services with e-mental health - Increased connectedness, mental health literacy, pathways to support, tools to use when F2F support is unavailable. Increased support and feelings of connectedness
- eMHPrac is the organisation the developed the clinical practice model. 15. Some really useful tools for professionals the toolbox - for mobile apps The pro website - and EMHPD package eMHPrac website
- 17. final slide My contact info Pro website/twitter/facebook references e-Mental health tools can help you to extend the reach and impact of your support. The clinical practice model is a great guide to help you do so If you’re unsure about how, then do a course or research online - there’s plenty out there