Integrating digital interventions with clinical practice in youth mental health services

Cross, S. P., Nicholas, J., Bell, I. H., Mangelsdorf, S., Valentine, L., Thompson, A., Gleeson, J. F., & Alvarez-Jimenez, M. (2023). Integrating digital interventions with clinical practice in youth mental health services. Australasian Psychiatry, 31(3), 302–305. 

https://doi.org/10.1177/10398562231169365

Summarized by Ariel Ervin

Notes of Interest:

• There is a mental health crisis in Australia. Because of the high demand for mental health services and low service capacity, it takes people a long time to receive professional help.
• Given the current state of providing mental health services, it’s evident that traditional approaches to delivering mental health services aren’t enough to address this systemic problem.
• Incorporating digital technologies into face-to-face clinical care (“blended care”) can reduce wait time & drop rates and improve the overall quality of service.
• This paper discusses the growing research on blended care for youth, provides examples of implementations, and describes associated challenges & how to overcome them.
• Examples of potential platforms for blended care: Moderated online social therapy (MOST), virtual reality (VR), and smartphone apps
• Moderated Online Social Therapy (MOST)
  • Incorporates peer & vocational support with interactive, guided, evidence-based therapy content with a social network of virtual clinicians & peers.
  • It allows clinicians to personalize treatments according to their patient’s needs and administer therapeutic tasks to complete before, between, and after sessions.
  • Evidence shows that it improves an individual’s well-being, social functioning, & vocational recovery and reduces psychological distress, anxiety, depression, & usage of emergency services.
• Virtual Reality (VR)
  • Given VR’s ability to provide simulations of real-world environments, it has the potential to offer supervised clinical assessments & learning opportunities.
• Smartphone Apps
  • They provide customized, real-time treatments that can provide helpful information that traditional methods can’t offer.
• Although there’s mounting evidence for blended strategies and digital interventions in trials, there’s still a lack of successful examples of blended care integrated into mainstream mental health services for youth.
• However, preliminary findings on utilizing digital tools in youth clinical care are still promising.
  • It can alleviate some of the challenges youths face while seeking mental health services and improve the overall quality of care they receive.
  • Evidence also indicates that including online assessment tools to service pathways can notably bolster multidisciplinary team treatment planning, the depth and range of the assessment, and responsiveness to suicide risk.
• Researchers need to keep evaluating how people can decipher and carry out evidence-based practices in regular service delivery and clinical care.
• Developing a structured implementation plan is essential in developing effective integrated digital interventions.
• While this study takes place in Australia, these findings still have implications for other countries, such as America, where access to mental health services is also limited.
• Similarly, these findings can be helpful for the mentoring field. Because of the lack of access to mental health services, there is a growing interest in assessing the feasibility of paraprofessional mentorships, where mentors engage in professionally supervised therapeutic activities with their mentees.

Introduction (Reprinted from the Abstract)

Objective: Integrating digital technologies with clinical practice promises to improve access and enhance care in the context of high service demand and constrained capacity.

Method: We outline the emerging research in the integration of digital tools in clinical care, known as blended care, and provide case examples of mental health technology platforms currently in use, summarise findings regarding novel technologies such as virtual reality, and outline real-world implementation challenges and potential solutions.

Results: Recent evidence shows that blended care approaches are clinically effective and improve service efficiency. Youth-specific technologies such as moderated online social therapy (MOST) are achieving a range of positive clinical and functional outcomes, while emerging technologies like virtual reality have strong evidence in anxiety disorder, and accumulating evidence in psychotic conditions. Implementation science frameworks show promise in helping overcome the common challenges faced in real-world adoption and ongoing use.

Conclusion: The integrated, blended use of digital mental health technologies with face-to-face clinical care has the potential to improve care quality for young people while helping overcome the growing challenges faced by youth mental health service providers.

Implications (Reprinted from the Conclusion)

The emerging evidence suggests that the integrated blended use of digital mental health technologies with face-to-face clinical care has the potential to improve care quality for young people while helping overcome the growing challenges faced by youth mental health service providers. Translating and implementing these evidence informed practices into routine clinical care and service delivery remains an ongoing area of focus.

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