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Using technology to support youth mental health - Dr Michael Carr-Gregg


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Professional development presentation by Dr Michael Carr-Gregg in Newcastle for the Hunter Institute of Mental Health and Centre for Brain and Mental Health Research, University of Newcastle.

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Using technology to support youth mental health - Dr Michael Carr-Gregg

  1. 1. Using technology to support youth mental health Dr Michael Carr-Gregg Child and Adolescent Psychologist
  2. 2. Been an Apple computer user since 1984
  3. 3. iPad 3 iPad iPad Mini iPad 2 iPad Pro
  4. 4. For Father’s Day
  5. 5. Can technology be a solution?
  6. 6. More people are using it • 3 billion people online • 43% of the world’s population • 69% of people on earth will be covered by broadband
  7. 7. And it’s getting faster
  8. 8. Around the world… 31/08/201612 • E-mental health is being used: • in mass delivery • cost effective • very effective • more accessible • stay in control • private • Engaging • Stigma reducing
  9. 9. Its transforming childhood
  10. 10. A reconfiguring of Maslow for young people `
  11. 11. • 98% of students have a mobile • 94.9% have a smart phone • 91.89% of students have downloaded an app
  12. 12. ‘Screenagers’ Born early 2000’s ‘Millenials’ Born 1980-1990 Born early 1960’s to early 80’s Post WW2 born 1946-1964
  13. 13. Why technology matters to young people? Their real world is both off and online It is how they communicate They have never known a world without computers It provides them with flexibility and confidentiality Removes geographical, attitudinal & financial barriers
  14. 14. The average 18- 25 year old • Checks their phone 56 times a day • Once every 15 minutes
  15. 15. What else do we know? 9 out of 10 teenagers tell us that they are using their phone while spending ‘quality time’ with their parents
  16. 16. What else do we know? 7 out of 10 teenagers tell us that they are using their phone while hanging out with friends
  17. 17. What else do we know? 5 out of 10 teenagers tell us that they are using their phone while eating at restaurants
  18. 18. What else do we know? 3 out of 10 teenagers tell us that they are using their phone while crossing the road
  19. 19. What else do we know? 1 out of 10 teenagers tell us that they are using their phone while having sex
  20. 20. A device weighing 155 gms Has infiltrated virtually every aspects of their lives
  21. 21. This gives us an unprecedented opportunity to provide real-time, standardised health and wellbeing information and treatment directly to young people in their natural environment using their smartphones
  22. 22. So how might technology help the wellbeing of a young person?
  23. 23. Meet ‘Georgie’
  24. 24. Georgie’s Hx 16 years old Attends local High School Presents with a long Hx of anxiety dating back to primary school when she was bullied by a group of girls Never really recovered Now smoking cannabis on weekends
  25. 25. Georgie’s developmental tasks Identity Formation Peers Emancipation from adult carers School/Vocation
  26. 26. Georgie’s Anxiety She describes her worry as ‘out of control’ and has started to interfere with her life. She often feels fear or worry She often can’t concentrate because of worry or fear She often feels on edge or nervous She sometimes panics or get upset easily when nervous
  27. 27. Her symptoms can be short lived, or stay for a long time. It can cause her to: Become worried or constantly feel ‘something bad’ is going to happen Often ask unnecessary questions, or need constant reassurance Get upset when a mistake is made, or if there is a change of routine Be a perfectionist, care too much about things being ‘just right’ Become irritable or constantly in a bad mood
  28. 28. Common ways anxiety affects her physically Having dry mouth or difficulty swallowing Experiencing nightmares, difficulty sleeping Having difficulty concentrating Experiencing muscle aches and pains (especially neck, shoulders, back) Feeling restless, or trembling and shaking Having a rapid heart and breathing rate, sweating, dizziness, headache Feeling sick – nauseous, vomiting, or having diarrhoea
  29. 29. Diagnosis
  30. 30. How Reach Out can help
  31. 31. CBCL and YSR (Achenbach)
  32. 32. The Centre of Excellence adapted the American HEEADSSS assessment interview. This included: changing the language to suit the Australian context extending the domains covered to allow the detection of more serious mental disorders.
  33. 33. Like 98% of her friends, Georgie has a smartphone
  34. 34. What are Georgie’s current issues?
  35. 35. Problem 1. Sleep
  36. 36. Sleep The single most important behavioural experience that we have is sleep Average person spends 36% of their life sleeping
  37. 37. Psychoeducation in Sleep
  38. 38. Inform and educate
  39. 39. She gets guidelines
  40. 40. EXPLAINS THE PSYCHOLOGY OF SLEEP VIA A FACT SHEET FROM ORYGEN 57 u/files/factsheets/oyh_sleep_fac tsheet.pdf
  41. 41. Offers Georgie a Prof Russell Foster Ted Talk
  42. 42. App Intervention - Recharge (free)
  43. 43. // RESEARCH PROGRAM THREE: USER DRIVEN AND EMPOWERED RECHARGE • practical tips to improve her sleep/wake routine and wellbeing • Get daily reports to track her mood, energy, exercise and sleep • View graphs to help monitor her progress which can be reviewed in each session
  44. 44. Wearable Device/App intervention for her Insomnia: JawboneUP 24 (A$149.95)
  45. 45. SLEEP TRACKING 62 62
  46. 46. Georgie has a jawbone tracker
  47. 47. Light sleep REM sleep
  48. 48. Fitbit dashboard
  49. 49. Georgie’s Mum is worried about her snoring
  50. 50. Problem 2. Georgie’s Mum is worried about her not eating breakfast
  51. 51. Georgie gets directed to a website on breakfast
  52. 52. Problem 3. Eating too much junk food
  53. 53. diets high in processed foods, soft drinks and sweets to an increased risk of behaviour and emotional problems
  54. 54. What is a Mediterranean diet? Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts. Replacing butter with healthy fats, such as olive oil Using herbs and spices instead of salt to flavour foods.
  55. 55. Problem 4. How do we address her Anxiety?
  56. 56. Georgie is offered a fact sheet
  57. 57. Offered a free, evidence based online treatment program to do on her own time
  58. 58. What about psychoeducation for Georgie’s parents?
  59. 59. Georgie is offered a link to a pamphlet from beyondblue for her parents
  60. 60. How do we deal with Georgie’s panic attacks?
  61. 61. Georgie is offered an app to help her deal with her panic attacks
  62. 62. Georgie is invited to do some evidence based online treatment
  63. 63. Georgie is offered an app that uses ACT to help deal with her anxiety
  64. 64. Solution: Mindfulness
  65. 65. 88 Georgie is offered an app that helps with stress
  66. 66. New website
  67. 67. Georgie can download the app
  68. 68. Lovely ambassadors
  69. 69. 8 week mindfulness course - 27 minutes per day Massachusetts General Hospital MRI scans documented how meditation produced massive changes inside the brain’s gray matter A major increase in gray matter density in the hippocampus Decreased gray-matter density in the amygdala Gets info on mindfulness
  70. 70. 95
  71. 71. 96
  72. 72. 97
  73. 73. measurement curves, video display
  74. 74. 100
  75. 75. 101
  76. 76. Solution Increase Exercise – not getting 10,000 steps
  77. 77. Georgie gets a fact sheet on exercise
  78. 78. 104 Georgie is offered an app that helps with exercise
  79. 79. Georgie gets an encouraging message when she has completed a session or week of 3 sessions…
  80. 80. • an ultra-immersive running game and audio adventure • Every run becomes a mission where you’re the hero, with our immersive audio drama putting you at the centre of your very own zombie adventure story. • While you run to the perfect mix of heart-pumping audio drama and pulse-pounding songs from your own playlist, you’ll collect supplies to grow your base back home.
  81. 81. Problem 7. Georgie is worried about a friend
  82. 82. Georgie is offered an app to help her approach her friend
  83. 83. Problem 8. Georgie wants to cut down her cannabis use
  84. 84. Problem 9. Georgie’s relationship breaks up
  85. 85. Georgie is offered an app that helps her cope
  86. 86. Problem 10. Georgie’s mate is self harming
  87. 87. 119 been developed by mental health nurses offers alternatives to deliberate self harm. Practical easy steps to distract, displace and seek help, all at the touch of a button and with you at all times
  88. 88. Georgie decides to get some counseling
  89. 89. She is offered a smorgasbord of choices
  90. 90. She is offered a smorgasbord of choices
  91. 91. She is offered a smorgasbord of choices
  92. 92. She is offered a smorgasbord of choices Visit local General Practitioner
  93. 93. She is offered a smorgasbord of choices Visit a local headspace centre
  94. 94. School Counseling Service
  95. 95. Georgie has suicidal thoughts
  96. 96. Gets a digital safety plan
  97. 97. Georgie gets some medication
  98. 98. An app to help her remember her medication
  99. 99.
  100. 100. Questions and Thanks