Young People, Mental Health and Digital in Islington… learning and iterating.
Our ‘Widening Digital Participation’ pathfinder in Islington has provided us with some great insights into how to approach digital for young people with mental health problems.
Context
From our Co-Design sessions with Islington CCG, young people and the organisations that provide support to young people (these organisations are referred to as Universal Care) we designed a model to test.
The central idea for this was to design a ‘hub’ (points 3,4 and 5) that could slot into the normal route for young people with mental health issues. The normal route was;
Our model suggested if the professionals in Universal Care could direct young people to a Hub that contained face-to-face, live chat and signposting provision/apps for lower level mental health issues, then this could give a better service and also make sure that referrals to CAMHS (Child and Adolescent Mental Health Services) were appropriate. If Universal Care Professionals had any reservations they could still refer directly to a GP or CAMHS, as safety of the Young Person is paramount.
We have learned…
- Islington has an existing ecosystem
The 40 (and counting) organisations and providers in Islington that help Young People and their mental health is staggering… and ultimately confusing for everyone as ‘where do you start?’ . This isn’t a negative by any means… in fact it means the sustainability of the pathfinder is in good hands. We are operating within an existing eco-system and trying to organise it to realise it’s potential — not design a new one.
2. Digital Champion Training needs to be tailored
We have provided Digital Champion training at Good Things Foundation for the longest time. However, the professionals who will be proponents of digital health need the training to be condition specific — in this instance young people and mental health. Islington have commissioned and provided this specific training.
3. Culture is the biggest barrier
The Young People who have tested the Apps have had positive experiences with 59% saying they would recommend to a friend and 18% disagreeing. Professionals acceptance of information from Apps or the validity of their usefulness varies depending on area (South West Yorkshire CAMHS service are huge advocates of this whereas other areas are reticent — for a variety of reasons)
4. Waiting doesn’t mean dormant
There is a 15 week waiting period for CAHMS referrals. The new iteration of the model — below- shows that the Young Person doesn’t have to be dormant in that time, they can use the Apps etc to help (potentially realising that they don’t need CAMHS — if it’s lower level mental health issues). The proof will be in CAMHS acceptance of the information contained within the APP for those who attend their first session (linked to point 3 above)
5. Take a step back
The Hub’s development was postponed due to the amount of effort it has taken to get parties on board with Digital. Consequently, we need to ensure that Universal Care professionals are comfortable referring to preferred things that they find themselves before providing a specific place that has more stuff.
6. Models are timely — take a step forward
The narrative that we put to the models for Widening Digital Participation is becoming increasingly important. E.g. we have iterated the Islington model to remove the Hub (for now) and replace it with a signposting place that shows Professionals and Users the variety of provision in the area.
7. Models end but journeys don’t
Our model ended with a referral to CAMHS. However, this isn’t where the journey ends for the User (in fact it probably is only just beginning). CAMHS use a paper product called a ‘Crisis Care Plan’. Essentially this is a document that outlines actions to be taken if you the User is feeling a heightened level of anxiety, dangerous thoughts and/or stress. We are looking to digitise this as the plans ‘aren’t there when you need them.’ Our hypothesis is that a downloaded version of this on a person’s phone means it is always with them — at the right moment — and also will provide continuity in the the use of digital from first referral through continued support.
With all this in mind, here is the iterated model that is currently live in Islington.
Iteration notes
- The professionals in Universal Care are trained up to signpost to relevant Apps as well as refer to GP/CAMHS if they see fit
- At point 3 the user is shown appropriate apps, this means they can gain benefit from them in the 15 weeks waiting time before point 7.
- Crisis care plans are trialled as digitised (initial testing will be a simple PDF of the paper versions just to test the concept)
If you have any queries or would like to chat about any of the Widening Digital Participation Programme then please don’t hesitate to contact me pete@goodthingsfoundation.org
