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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
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
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)
14.
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
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