In a few weeks time I am speaking at the 2nd Summit New Technologies and Mental Health: Future Possibilities in Barcelona. In my presentation I will share opportunities, challenges and unexpected benefits arising from the first year and a half of our mHabitat programme – supporting digital innovation in the sphere of mental health and beyond.
People first – technology second
The first insight I will share is a simple one – the fundamental importance of putting people first and technology second. It seems obvious that people should be at the heart of any innovation in mental health, but we have learnt that it is often missed. It is too easy for the allure of new technology to outshine more mundane but crucial considerations of understanding what people actually want and need.
Why is it so important to put people first? Creating or licensing a digital technology will only add real value if we deeply understand the preferences, motivations and capabilities of the people they are intended for. Fortunately there are established methodologies, such as user centred design and service design for co-designing digital technologies that add value to a user’s journey through a service. In the health service there is the added dimension that digital technologies need to be underpinned by sound theories of behaviour change and/or clinical guidance as well as meeting regulatory requirements. Generating evidence so we know what works and what doesn’t is also an important consideration.
Putting people at the centre is the first step to developing digital technologies that will really make a difference to people’s lives. Putting people first means recognising that some people face digital exclusion and taking steps to help people get online. Lastly, putting people first means supporting staff to understand and make the most of digital technologies in their day to day work.
Workforce and organisational challenges
At mHabitat we have been struck by three challenges to digital innovation when it comes to mental health organisations and their workforce:
- One group of staff are are unconfident and fearful about using digital technologies in their day-to-day practice
- Another group of staff recognise the value of digital technologies and are using them despite their employer and often with their own devices and data packages
- Managerial and organisational attitudes to digital technologies are highly variable and often based on assumptions and prejudices – worries about boundaries, risk, what’s good and bad, right or wrong, arise again and again.
An absence of organisational infrastructure such as free public wifi and protocols to help people stay safe can all be barriers to digital innovation. Many mental health care organisations are failing to keep pace with the way people accessing and working in mental health services are using digital technologies in their day to day lives. This is a systemic issue that needs addressing at an organisational level and includes infrastructure issues such as free public wifi, devices for the workforce and a considered and permissive approach to use of online social networking. If mental health organisations pay attention to these constraints they have the best chance of leveraging the potential and mitigate the perils of digital technologies.
Sometimes the benefits we believe people will derive from digital technologies are different to what happens in practice. Just as technologies shape how people live their lives, so do people shape technologies and take them in unexpected directions.
The mHabitat team recently supported a trial of teleconsultation appointments in a regional specialist service. The purpose of of the trail was to see if we could increase access and convenience for people accessing the service. A survey told us that teleconsultations would reduce travel time for people coming long distances to attend appointments. We hypothesised that this would increase satisfaction and efficiency. There were some worries about possible negative impacts on the therapeutic relationship and and an assumption that teleconsultations would be a second-best option.
However, through an evaluation it became apparent that the opposite happened – staff reported that the therapeutic relationship was strengthened because they could ‘meet’ with people in their own environments and get a stronger sense of their circumstances. For people accessing the service there was not only reduced travel time but also pleasure taken from showing the practitioner round their home virtually via their smart phone. Teleconsultations by no means worked for everyone but for some they were actually better than in-person contact. A surprising and gratifying unexpected benefit and just one example of many we have found.
To finish up…
These are a few of the themes I’ll be sharing at the Summit and I’ll be fascinated to hear whether the opportunities, challenges and unexpected benefits we are experiencing in the North of England are similar or different to those in other parts of Europe. If you’re interested in the conference, you can follow the organisers on Twitter at @mhealthglobal.