Teen mental health in an online world

Teen mental health in an online world

The media is replete with dystopian tales of the negative effects of social media on young people. In a recent speech, Simon Stevens (chief executive of the NHS) suggested that the Government should consider introducing a ‘mental health levy’ to fund NHS treatment of problems fuelled by sites such as Facebook and Instagram. But how accurate is this picture and what does the evidence tell us? Earlier in the year, my co-author James Woollard and I set about understanding the views and experiences of young people with mental health difficulties in our book Teen Mental Health in an Online World. We combined a review of the evidence with a series of qualitative interviews and focus groups with young people. Our mission was to give space to young people’s voices and provide a useful guide to mental health and other practitioners who work with them. Contrary to what one might believe from the media, we found a mixed picture with both positive and negative effects. Our qualitative findings are reflected in a recent representative survey of 1,141 American teens age 13-17  Social Media, Social Life: Teens Reveal Their Experiences (Common Sense Media 2018) which uncovered some interesting insights. Firstly, most teens say that social media has a positive effect in their lives, such as making them feel less lonely. Secondly, and more relevant to our book, whilst vulnerable teens are more likely to report negative effects of social media (such as feeling left out) they are nevertheless more likely to report the positive benefits of social media in their lives, such as helping them feel less lonely and depressed. Social...
Creating a digital citizen blueprint

Creating a digital citizen blueprint

One of the many challenges of using digital technology in health and care services is a lack of interoperability – we’re all using a slightly different lego set and the pieces don’t quite connect together. Every time we want to do a particular task we have to swap over to another lego set and start again. This is a well rehearsed and entrenched challenge in the NHS and my home city of Leeds and the wider region has a new initiative to help connect those lego pieces together through common standards and open source technologies. But what about citizens? In a way we have the opposite challenge. We are not standardised lego pieces and never will be. Each of us has differences in our use of digital technologies – these may be influenced by our attitudes, our aptitude, our access and particular barriers that we may experience. There are some commonalities but there are also particular factors that can be easily overlooked. If we don’t understand and pay attention to those differences then we risk designing and deploying digital technologies that entrench the inverse care law – that is, those who already have the most get more and those who have the least lose out further (you can read an excellent BMJ article from Margaret McCartney on this topic here). In Leeds we have a commitment in the Health and Wellbeing Strategy that people who are the poorest improve their health the fastest. This is easy to say but hard to do. This is where the blueprint comes in. At mHabitat we are helping the NHS and council in...
ABCD meets human-centred design – where’s the common ground?

ABCD meets human-centred design – where’s the common ground?

  Asset based community development (ABCD) – a methodology for the sustainable development of communities based on their strengths and potentials. It involves assessing the resources, skills, and experience available in a community; organizing the community around issues that move its members into action; and then determining and taking appropriate action. This method uses the community’s own assets and resources as the basis for development; it empowers the people of the community by encouraging them to utilise what they already possess.   Human-centred design – an approach to interactive systems development that aims to make systems usable and useful by focusing on the users, their needs and requirements, and by applying human factors/ergonomics, usability knowledge, and techniques. This approach enhances effectiveness and efficiency, improves human well-being, user satisfaction, accessibility and sustainability; and counteracts possible adverse effects of use on human health, safety and performance. ISO 9241-210:2010   The health and wellbeing theme of the 2018 Digital Festival was an opportunity to shine a light on the thriving digital health and care sector in Leeds. But whilst the digital sector is a key asset in our city, Leeds is also known for its thriving community sector and neighbourhood networks. The city’s Health and wellbeing strategy aims to build on both individual and community strengths in order to reduce health inequalities in Leeds. There is an opportunity (and a challenge) to align our digital ambitions with our asset based community aspirations to make Leeds a healthy and caring city for everyone. However…. if we don’t consciously and intentionally take steps to locate digital as an enabler to enhance the assets of...
What really counts – keeping humanity at the heart of digital innovation

What really counts – keeping humanity at the heart of digital innovation

Digital innovation is going to save the NHS. We use digital in every other aspect of our lives so why not the NHS? So the hyperbole and the mantra goes. But what if, in our fetishisation of digital, we get too focused on shiny products and forget what really counts? This moving blog post by health economist Dr Chris Gibbons about his family’s interactions with health services, when his dad was very ill, made me pause and reflect on how we keep values of humanity at the heart of efforts to innovate and improve health services. Here is a section of the blog post which emphasises that it was person-centred  and goal-orientated care that made the biggest difference to Chris’ dad: “Innovation has many guises. Innovative ways of thinking about the hospital system. From the point of admission to the successful discharge and rehabilitation of people in a place of their preference then linking up that system seamlessly with health and social care system. We need to emphasise the importance that people doing Neil’s [care worker] job have in linking that all together as a person centred, goal oriented approach to recovery and rehabilitation. That’s where the real value in innovation sits. It doesn’t fit neatly into a Markov model, or have fancy branding and the backing of a pharma company that’ll send you to Honolulu for a conference. But it is the kind of innovation that we should be judging against all the other “innovations” that do” How do we assess what really counts and what is going to make the biggest difference to patients when we have...
Frameworks, lyrics and non-adoption of technology

Frameworks, lyrics and non-adoption of technology

You know that feeling when a piece of music (or a book or film) resonates so strongly that it helps you understand something about your life? In my late teens it was The Smiths who did just that. I suspect that teenage hormones may have been a factor, but every lyric from Morrissey’s pen seemed to speak to me directly. Fast forward to 2018, and minus the heady mix of adolescent intensity and the tunes, I had a not altogether dissimilar sensation reading Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies by Trisha Greenhalgh et al (2017). This paper felt like reliving the first four years of my journey into the digital health technology sphere – every challenge, mistake, obstacle we have encountered is captured in this compelling paper on why technology doesn’t get adopted in the NHS. It felt a bit like the life story of mHabitat but minus the highs… NASSS is an evidence based and theory informed framework that endeavours to set out the interrelated factors that influence the non-adoption abandonment, scale-up, spread or sustainability of technology. It aims to be a tool that can easily be used in practice. The rich blend of research methods comprising case studies with qualitative interviews and ethnography, along with a review of the literature, elicited the seven framework themes (see the diagram above). Our tacit experience of non-adoption could have easily have been one of these case studies – everything from poor clarity of the problem the technology is meant to solve; poor...