Using the Internet to integrate peer stories and self-management ...

Using the Internet to integrate peer stories and self-management resources into mental health services

The Self Management and Recovery Technology (SMART) Program

Victorian Department of Health Mental Illness Research Fund

SMART Research Program Team Investigators Steering group Neil Thomas Michael Kyrios John Farhall David Castle Susan Rossell Cassy Nunan Leon Sterling Sue Farnan Ellie Fossey Greg Murray Emma Ladd (MI Fellowship) Cathy Mihalopoulos Lisa Brophy (Mind) Jayashri Kulkarni (Alfred) Denise Meyer

Project manager Fiona Foley

Software developers Fidget Friend

Research Staff Nuwan Leitan Katrina Lindblom Friedericke Wahl-Thomas Yu-Chen Lee Rosie Frankish Tara Smark

Multimedia developers Rybazoid

PhD Students Bronte McLeod Anne Williams

Centre for Design Innovation Alessandro Antonio Lopez Lorca Maheswaree Kissoon Curumsing Sonja Pedell

Swinburne collaborators National eTherapy Centre Robert Shaw Jo Anne Abbott

Peer educators Reference groups Consumer reference group Worker reference group Carer reference group

Advisory group John Katsourakis (VICSERV) Richard Newton (Austin) Rosemary Callandar (VMHCN) Wayne Weavell (VMIAC)

How can Internet-based resources be developed and used by mental health services?

SMART: initial ideas

- Able to integrate with practice of mental health staff - Across clinical and community-managed mental health sectors

- Promoting: - Mental health self-management skills - Personal recovery - Capitalise on potentials of the Internet - Multimedia - Communication

What processes are important in recovery?

Leamy, Bird, Le Boutiller, Williams & Slade (2011). Br J Psychiatry, 199, 445-452.

Online resources for severe mental illness Can we promote personal recovery? Example: MI Recovery - 8 session peer-facilitated course on personal recovery - Significant improvements relative to a stable 3 month baseline on measures of: - Empowerment p < .001 - Social connectedness p < .001 - Internalised stigma p < .001 - In both completer and intention-to-treat analyses - Maintained at 3 month follow-up

Thomas et al, in prep.

Peer stories

www.ted.com/talks/eleanor_longden_the_voices_in_my_head

What do people get from peer contact?

Walker & Bryant (2013) meta-synthesis of qualitative studies on peer support: experiences of people in recovery include - Peers as positive role models - Increased hope and motivation - Extend social network - Facilitate building rapport

Walker & Bryant (2013). Psychiatr Rehab J, 36, 28-34.

Potentials of online format

Use of video: - Positive recovery stories

- Illustrating and modelling skills Use of forums/commenting: - Promote connection with others with shared experiences - Able to use lived experience to give to others

SMART Research Program Overall aim: to examine the therapeutic use of Internet-based technology in mental health services Development and trialling of: -

Single online portal for mental health workers to use with clients and consumers and carers to access directly

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Therapeutic materials on mental health self-management and personal recovery

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Videos featuring peers discussing lived experience

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Designed for tablet use by mental health staff across clinical and CMMH sectors

Use of the Internet to promote recovery

Multimedia

• Peer modelling of hope • Challenging negative stereotypes

Interaction with other users

• Reducing isolation • Promoting group identity

Client owned content

• Empowering • Promoting collaboration

What do consumers and workers want?

Key themes from focus groups with consumers and workers: Positive about:

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Availability of an accessible trustworthy online resource

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Multimedia, online tools, etc. rather than text

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Lived experience

Design considerations -

Flexibility

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Engaging

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Balancing realism and optimism

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Integration with mental health work: familiarity, integration

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Consumer confidence with/access to computers queried Williams, Fossey, Foley, Farhall & Thomas, in prep.

What Internet access to consumers have?

Survey of 100 continuing care team mental health service users -

The majority: …had access to Internet at home or via their mobile phone … felt confident using the Internet with no more than occasional assistance … browsed the Web at least weekly

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For mental health information, general websites and video streaming sites were used more often than forums or social networks

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65% felt positively about mental health workers using a tablet computer to view mental health information together during appointments (vs 11% negatively)

Thomas, Foley, Lee & Lindblom, in prep.

Peer video development process Identification of consumers -

Willing to discuss personal experiences

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To cover range of genders, age-range and ethnicities

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Mainly people already in a peer educator role

Interviewing process

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Organising themes based on coping and recovery literature (e.g. Leamy et al., 2011)

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Interview questions based on each theme

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Discussion process with peer educator in advance what to focus on

Identification of organising themes -

Aim for video clips of 2-3 minutes each, comprising 4-6 educators discussing a topic

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Team editing process to identify optimal segments for an organising theme

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Transcripts sent to professional editors to develop videos

Trialling phase

Main projects 1.

SMART-Therapy – randomised controlled trial contrasting 8 sessions with a worker using SMART on a tablet computer versus a befriending-based control intervention in addition to routine care (N = 148)

2.

SMART-Service – RCT examining use on tablet computers by mental health workers as part of routine practice over six months (N = 28 workers, 168 clients)

3.

SMART-Direct – independent use by mental health consumers via Internet

4.

Experimental examination of immediate impact of peer videos

Projects will incorporate examinations of outcomes, subjective experience and economic analysis

Project timelines

Year 1 (2013-14)

Year 2 (2014-15)

Year 3 (2015-16)

DEVELOPMENT PHASE Framework developed Content written for pilot. Peer filming completed. To complete expert videos. Site ready Sept 2014

SMART-THERAPY Commencing Jan 2015.

SMART-SERVICE Commencing Apr 2015.

SMART-DIRECT Commencing Jan 2015.

Year 4 (2016-17)

[email protected]