S60: Innovations in Digital & Blended Service Delivery

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By October 4, 2023 No Comments

Authors: Jennifer Nicholas, Thomas Wren, Lee Valentine, Shane Cross, Shaminka Mangelsdorf, Simon Baker, Zeinab Farahmandpour, John Gleeson, Mario Alvarez-Jimenez, Steph Kershaw, Madeleine Keaveny, Anna Grager, Bronte Speirs, Dara Sampson, Kate Ross, Nicola Newton, Maree Teesson, Hannah Wells, Jessica Wilson, Caitlin Bray, Cath Chapman, Frances Kay-Lambkin, Haylee Zink, Janelle Mackee, Amy Brooks, Shane Ford, Lee Valentine, Sarah Bendall, Sandra Bucci, Nicola Chen & Rory Sorenson

Year: 2023

Event: 2023 The MHS conference - Adelaide

Subject: Innovations in Digital & Blended Service Delivery

Type of resource: Conference Presentations and Papers

Presentation 1: Why change? The value of integrated digital mental health from the perspective of services.
Authors:Jennifer Nicholas, Thomas Wren, Lee Valentine, Shane Cross, Shaminka Mangelsdorf, Simon Baker, Zeinab Farahmandpour, John Gleeson & Mario Alvarez-Jimenez
Australian youth mental health services experience challenges related to capacity to meet demand, service engagement and retention, consistent outcomes, and provision of stepdown or aftercare support. In addition, key to a rights-focused system, is equity of access to programs and supports regardless of local resourcing. Integrated digital mental health solutions have scope to address these challenges and provide location-independent support. However, such integration is rare in practice.
The large research to practice gap indicates that implementation does not simply ‘just happen’ because an intervention demonstrates benefit (1). Largely missing from digital mental health implementation research and efforts is a nuanced understanding of the value of digital mental health intervention integration from the perspectives of those within mental health settings.
Orygen Digital’s Moderated Online Social Therapy (MOST; 2) service is being integrated with over 70 youth mental health services across Victoria, Queensland, and New South Wales. Through data gathered from over 500 routine implementation facilitation notes with services and interviews with service clinicians, this presentation will report on the ways in which different types of youth services (primary and tertiary) across different locations (states, rurality) view the value of integrated digital support.
Learning Objective
The audience will gain a broader understanding of what mental health services value about integrating traditional services with digital interventions, a key policy recommendation (e.g. Victorian mental health royal commission).
1. Bauer, M.S., Damschroder, L., Hagedorn, H. et al. (2015). An introduction to implementation science for the non-specialist. BMC Psychol 3, 32.
2. Alvarez‐Jimenez, M., Koval, P., Schmaal, L., Bendall, S., O'Sullivan, S., Cagliarini, D., ... & Gleeson, J. F. (2021). The Horyzons project: a randomized controlled trial of a novel online social therapy to maintain treatment effects from specialist first‐episode psychosis services. World Psychiatry, 20(2), 233-243.

Presentation 2: Evaluating The Family and Friends Support Program: A Pilot Study.
Authors:Steph Kershaw, Madeleine Keaveny, Anna Grager, Bronte Speirs, Dara Sampson, Kate Ross, Nicola Newton, Maree Teesson, Hannah Wells, Jessica Wilson, Caitlin Bray, Cath Chapman & Frances Kay-Lambkin
Alcohol and drug use (AOD) has an adverse impact on affected friends and family members (AFFMs) who often experience psychological distress, depression, and anxiety due to their loved one’s use. The AOD Family and Friends Support Program (AOD FFSP) is a world first, evidence-informed online intervention for AFFMs. The program was codeveloped with clinical psychologists and people with lived experience.
To evaluate the program, AFFMs were recruited across Australia and completed online surveys at 1) baseline; 2) post-program (10weeks post-baseline); and 3) follow-up (14weeks post-baseline). Participants were encouraged to interact with AOD FFSP online modules. At each timepoint, levels of distress coping skills and social supports were assessed. Post program and follow-up surveys also included assessment of usefulness and usability of the program.
Participants (n=131) were mostly parents (28.2%) or partners (19.8%) and the primary substances being used by their loved one were methamphetamine (48.9%) and alcohol (30.5%). Preliminary results indicate FFSP has good usability and engagement leads to a decrease in psychological distress.
Affected family members and friends often need support to cope with the demands of caring for a loved one who is using alcohol and other drugs and evaluated intervention programs are essential to address this.
Learning Objective
Affected family members and friends often need support to cope with the demands of caring for a loved one who is using alcohol and other drugs. This presentation highlights the importance of evaluating implemented programs to guide and support future implementation and ensure the program is meeting end-user needs
Di Sarno, M., De Candia, V., Rancati, F., Madeddu, F., Calati, R., & Di Pierro, R. (2021). Mental and physical health in family members of substance users: A scoping review. Drug and Alcohol Dependence, 219, 108439–. https://doi.org/10.1016/j.drugalcdep.2020.108439

Presentation 3: ‘Let’s Talk About Voices’– an engaging online toolkit for voice hearers, supporting workers and families.
Authors:Haylee Zink & Janelle Mackee
The medical model continues to dominate ways of supporting people experiencing persistent and distressing voices, where pharmacological treatments tend to be the primary approach. This can contribute to further disadvantage of an already marginalised group.
The Specialist Rehabilitation Service (SRS) have been delivering the Hearing Voices Recovery Support Group for 10 years with documented positive outcomes. The group utilises the principles of the hearing voices movement which takes a humane and compassionate approach, viewing the experience of voice hearing as a meaningful phenomenon to be explored. It is a space to share stories, build connections, learn new ways of coping and make sense of voices.
There are however barriers to engaging in a group program, along with service delivery gaps such as limited resources and capacity both from an environmental and staffing perspective.
With this in mind, the SRS set out to create opportunities for voice hearers to better access recovery-oriented psychological support. The Let’s Talk About Voices online toolkit was developed, bringing humanity and human rights to the centre. Drawing on the wisdoms of voice hearing and clinical experience, this new and innovative resources is for voice hearers, supporting workers, family and carers.
Learning Objective
The presentation will highlight the hearing voices approach, how the online toolkit came to be and how it can be used. There will be an exploration of how the resource functions as a self-help guide, a therapeutic intervention and how this can improve access to voice hearing information and support.

Presentation 4: The Lived Experience Telephone Support Service Five Years On: Realising Consumer Voice and LEW Practice
Authors:Amy Brooks & Shane Ford
The Lived Experience Telephone Support Service (LETSS) utilised co-design to create and implement a mental health support service that was authentic and accessible. Since implementation, the LETSS has continued to use co-design to refine and deliver a service that genuinely engages with users to lessen their experience of mental distress. 
   All staff within LETSS have their own lived experience, and this Lived Experience Workforce (LEW) is a key component of the LETSS. The LEW offer support to individuals as professionals with an intimate understanding of the consumer experience. Their knowledge and feedback on the LETSS enables the service to continue developing and delivering a high standard of support, with positive outcomes for service users. Concurrently, the synergetic relationship between users and LEW serves to inform and enhance LEW practice.
This presentation will illuminate the statistical outcomes and consumer feedback that has occurred as a direct result of co-design and LEW that is central to the LETSS service provision. It will reflect on, and highlight the importance of, co-design and the LEW within the LETSS, and how valuable these can be within other services in the mental health sector. Subsequently, audience members are able to consider different ways in which they may be able to incorporate co-design and a LEW into their own services. 
Learning Objective
1: Recognising the importance of positioning co-design as an integral, ongoing practice for continued mental health service relevance and uptake.
2: Recognising the unique and reciprocal relationship between users and the LEW, and the key role this can play in enhancing services, LEW practice and user/LEW experiences.
Repper, J. & Carter, T. (2011) A review of the literature on peer support in mental health services, Journal of Mental Health, 20(4), 392-411, doi: 10.3109/09638237.2011.583947
Grey F and O’Hagan M. The effectiveness of services led or run by consumers in mental health: rapid review of evidence for recovery-oriented outcomes: an Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Mental Health Commission of New South Wales.

Presentation 5: Enhancing Young People's Engagement with a Digital Mental Health Platform
Authors:Lee Valentine, Jennifer Nicholas, Sarah Bendall, Simon Baker, Zeinab Farahmandpour, Shaminka Mangelsdorf, Sandra Bucci, John Gleeson, Mario Alvarez-Jimenez, Nicola Chen & Rory Sorenson
With three-quarters of all mental health problems emerging during adolescence and young adulthood, access to timely, evidence-based mental health care is crucial. However, complicated pathways to treatment, ever-growing waitlists, restrictive eligibility, and fragmented care often prevent young people from accessing timely and effective mental health care.
Digital mental health intervention presents an opportunity to extend the reach of face-to-face services to many more people, while bypassing the current challenges of accessing mental health care. Orygen Digital has developed the MOST (moderated online social therapy) platform, integrates online therapy, peer-to-peer online social networking, and peer, career, and clinical support. Although digital intervention for youth mental health is both appealing and efficacious, low engagement rates with digital interventions have emerged as a key challenge in the field. Unfortunately, our understanding of the drivers of engagement is still limited.
Through a mixed-methods study including interviews with 40 young people with different engagement patterns, we aim to identify factors associated with high and low levels of engagement with digital intervention. We will further examine how these identified factors and persuasive design can be leveraged to minimize barriers and maximize facilitators to enhance engagement of young people with digital interventions, resulting in greater clinical benefit.
Learning Objective
This presentation will provide a strong understanding of factors associated with engagement, and how persuasive design strategies can be purposefully matched to engagement determinants to enhance engagement.
Valentine, L., McEnery, C., O’Sullivan, S., Gleeson, J., Bendall, S., & Alvarez-Jimenez, M. (2020). Young people’s experience of a long-term social media–based intervention for first-episode psychosis: Qualitative analysis. Journal of medical Internet research, 22(6), e17570.
Fleming, T., Bavin, L., Lucassen, M., Stasiak, K., Hopkins, S., & Merry, S. (2018). Beyond the trial: systematic review of real-world uptake and engagement with digital self-help interventions for depression, low mood, or anxiety. Journal of medical Internet research, 20(6), e199.

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