Characterising variability in youth mental health service populations: A detailed and scalable approach using digital technology

Capon, William; Hickie, Ian B.; McKenna, Sarah; Varidel, Mathew; Richards, Mark; LaMonica, Haley M; Röck, Daniel; Scott, Elizabeth; Iorfino, Frank

doi:10.1177/10398562231167681

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…Their work highlights the potential of digital MH services when assessment, triage, and care pathways are created to ensure that young people are matched to the care they need [ 15 ]. More recently, the Innowell eMH platform has been used to compare the needs of clients among services and across geographic regions, which can be used to understand the needs of a heterogeneous population and plan services accordingly [ 80 ]. This highlights the potential of eMH tools to ensure that youth are accessing the right care at the right time and promoting the continuity of care to avoid the fragmentation of services [ 81 ].…”

Section: Discussionmentioning

confidence: 99%

Implementation of an Electronic Mental Health Platform for Youth and Young Adults in a School Context Across Alberta, Canada: Thematic Analysis of the Perspectives of Stakeholders

Dimitropoulos,

Bassi,

Bright

et al. 2024

JMIR Ment Health

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Background Youth, aged 15 to 24 years, are more likely to experience mental health (MH) or substance use issues than other age groups. This is a critical period for intervention because MH disorders, if left unattended, may become chronic and serious and negatively affect many aspects of a young person’s life. Even among those who are treated, poor outcomes will still occur for a percentage of youth. Electronic MH (eMH) tools have been implemented in traditional MH settings to reach youth requiring assistance with MH and substance use issues. However, the utility of eMH tools in school settings has yet to be investigated. Objective The objective of this study was to gain an understanding of the perspectives of key school staff stakeholders regarding barriers and facilitators to the implementation of the Innowell eMH platform in secondary schools across the province of Alberta, Canada. Methods Guided by a qualitative descriptive approach, focus groups were conducted to elicit stakeholder perspectives on the perceived implementation challenges and opportunities of embedding the Innowell eMH platform in secondary school MH services. In total, 8 focus groups were conducted with 52 key school staff stakeholders. Results Themes related to barriers and facilitators to youth and school MH care professional (MHCP) capacity in implementing and using eMH tools were identified. With respect to youth capacity barriers, the following themes were inductively generated: (1) concerns about some students not being suitable for eMH services, (2) minors requiring consent from parents or caregivers to use eMH services as well as confidentiality and privacy concerns, and (3) limited access to technology and internet service among youth. A second theme related to school MHCP barriers to implementation, which included (1) feeling stretched with high caseloads and change fatigue, (2) concerns with risk and liability, and (3) unmasking MH issues in the face of limited resources. In contrast to the barriers to youth and MHCP capacity, many facilitators to implementation were discussed. Youth capacity facilitators included (1) the potential for youth to be empowered using eMH tools, (2) the platform fostering therapeutic relationships with school personnel, and (3) enhancing access to needed services and resources. MHCP capacity facilitators to implementation were (1) system transformation through flexibility and problem-solving, (2) opportunities for collaboration with youth and MHCPs and across different systems, and (3) an opportunity for the continuity of services. Conclusions Our findings highlight nuanced school MHCP perspectives that demonstrate critical youth and MHCP capacity concerns, with consideration for organizational factors that may impede or enhance the implementation processes for embedding eMH in a school context. The barriers and facilitators to implementation provide future researchers and decision makers with challenges and opportunities that could be addressed in the preimplementation phase.

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Section: Discussionmentioning

confidence: 99%

Implementation of an Electronic Mental Health Platform for Youth and Young Adults in a School Context Across Alberta, Canada: Thematic Analysis of the Perspectives of Stakeholders

Dimitropoulos,

Bassi,

Bright

et al. 2024

JMIR Ment Health

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“…Further to this are the potential effects of functional impairment on PLEs which were also observed in these networks. This is critical given the increased rate of PLEs in those presenting to youth mental health services and the future risks they confer (Capon et al, 2023;Yung et al, 2008). Previous research has shown the importance of the direct impacts of improving social and occupational functioning through individual placement support (Heffernan & Pilkington, 2011;Killackey et al, 2008;Michon et al, 2014); however, indirect effects of these interventions could be expected on suicide ideation and self-harm (McGorry et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…This is critical given the increased rate of PLEs in those presenting to youth mental health services and the future risks they confer (Capon et al. , 2023 ; Yung et al. , 2008 ).…”

Section: Discussionmentioning

confidence: 99%

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The temporal dependencies between social, emotional and physical health factors in young people receiving mental healthcare: a dynamic Bayesian network analysis

Iorfino,

Varidel,

Marchant

et al. 2023

Epidemiol Psychiatr Sci

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Aims The needs of young people attending mental healthcare can be complex and often span multiple domains (e.g., social, emotional and physical health factors). These factors often complicate treatment approaches and contribute to poorer outcomes in youth mental health. We aimed to identify how these factors interact over time by modelling the temporal dependencies between these transdiagnostic social, emotional and physical health factors among young people presenting for youth mental healthcare. Methods Dynamic Bayesian networks were used to examine the relationship between mental health factors across multiple domains (social and occupational function, self-harm and suicidality, alcohol and substance use, physical health and psychiatric syndromes) in a longitudinal cohort of 2663 young people accessing youth mental health services. Two networks were developed: (1) ‘initial network’, that shows the conditional dependencies between factors at first presentation, and a (2) ‘transition network’, how factors are dependent longitudinally. Results The ‘initial network’ identified that childhood disorders tend to precede adolescent depression which itself was associated with three distinct pathways or illness trajectories; (1) anxiety disorder; (2) bipolar disorder, manic-like experiences, circadian disturbances and psychosis-like experiences; (3) self-harm and suicidality to alcohol and substance use or functioning. The ‘transition network’ identified that over time social and occupational function had the largest effect on self-harm and suicidality, with direct effects on ideation (relative risk [RR], 1.79; CI, 1.59–1.99) and self-harm (RR, 1.32; CI, 1.22–1.41), and an indirect effect on attempts (RR, 2.10; CI, 1.69–2.50). Suicide ideation had a direct effect on future suicide attempts (RR, 4.37; CI, 3.28–5.43) and self-harm (RR, 2.78; CI, 2.55–3.01). Alcohol and substance use, physical health and psychiatric syndromes (e.g., depression and anxiety, at-risk mental states) were independent domains whereby all direct effects remained within each domain over time. Conclusions This study identified probable temporal dependencies between domains, which has causal interpretations, and therefore can provide insight into their differential role over the course of illness. This work identified social, emotional and physical health factors that may be important early intervention and prevention targets. Improving social and occupational function may be a critical target due to its impacts longitudinally on self-harm and suicidality. The conditional independence of alcohol and substance use supports the need for specific interventions to target these comorbidities.

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“…The Innowell Platform is an online platform that aims to assist the assessment, management, and monitoring of mental ill health and maintenance of well-being 3,52 . It is a Web-based platform that can be accessed via traditional computing and mobile devices.…”

Section: The Innowell Platformmentioning

confidence: 99%

Dynamic learning of individual-level suicidal ideation trajectories to enhance mental health care

Varidel,

Hickie,

Prodan

et al. 2023

Preprint

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There has recently been an increase in ongoing patient-report routine outcome monitoring for individuals within clinical care, which has corresponded to increased longitudinal information about an individual. However, many models that are aimed at clinical practice often have difficulty fully incorporating this information. This is in part due to the difficulty in dealing with the irregularly time-spaced observations that are common in clinical data. Consequently, we built individual-level continuous-time trajectory models of suicidal ideation for a clinical population (N=585) with data provided by a digital platform. We demonstrate how such models predict an individual’s level and variability of future suicide ideation, with implications as to how often that individual may need to be observed. These individual-level predictions provide a more personalised understanding than other predictive methods and have implications for enhanced measurement-based care.

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Characterising variability in youth mental health service populations: A detailed and scalable approach using digital technology

Cited by 9 publications

References 16 publications

Implementation of an Electronic Mental Health Platform for Youth and Young Adults in a School Context Across Alberta, Canada: Thematic Analysis of the Perspectives of Stakeholders

Implementation of an Electronic Mental Health Platform for Youth and Young Adults in a School Context Across Alberta, Canada: Thematic Analysis of the Perspectives of Stakeholders

The temporal dependencies between social, emotional and physical health factors in young people receiving mental healthcare: a dynamic Bayesian network analysis

Dynamic learning of individual-level suicidal ideation trajectories to enhance mental health care

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