A Rural Youth Consumer Perspective of Technology to Enhance Face-to-Face Mental Health Services
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The imbalance between need and available resources with respect to youth mental ill-health has encouraged a growing body of literature around technology to support existing face-to-face services. However, this literature has not adequately investigated the perspective of youth as consumers and no data exists on the views of rural youth. In response to this gap, in-depth qualitative study investigated the perspectives of rural youth who were currently seeking help at a mental health service. Semi-structured interviews were carried out with a clinical sample of 10 young people (5 female), aged 16–22 years. Participants were recruited from two different mental health services located in two rural South Australian regions. Data were analysed via inductive thematic analysis. Results highlighted a young person’s desire for self-determination around their health and help-seeking within a service current environment that systematically subverts it. Overall, participants had long and complex histories of help-seeking associated with a history of isolation, disadvantage and trauma. A strong need for personal connection in the context of help-seeking was evident. Preferences for, and actual use of, the internet for mental healthcare existed on a continuum from no current (or future desire) to use technologies through to active interest in, and current use of, technologies as an adjunct to face-to-face care. Limited financial and infrastructural resourcing made it more difficult to access help online. Understanding and actively seeking out these views in design and implementation of technologies is in line with the current shift toward more consumer-focused and inclusive service design and delivery.
KeywordsYouth Mental health Rural Technology Services
This research is part of a collaborative project supported by the Young and Well CRC and in partnership with Flinders University and Country Health SA. The Young and Well CRC is established under the Australian Government’s Cooperative Research Centres Program.
Compliance with Ethical Standards
Conflict of Interest
No conflict of interest declared.
Research Involving Human Participants and/or Animals
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Abbott, J.-A., Reynolds, J., Rogers, C., White, A., Sturk, H., Wilson, H., et al. (2015). Integrating ePsychology into practice and research: A guide for early career psychologists. InPsych: The Bulletin of the Australian Psychological Society Ltd, 37(6), 18–19.Google Scholar
- Abs. (2011). Australian social trends. Retrieved from http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features50Jun+2011.
- Aisbett, D., Boyd, C., Francis, K. J., Newnham, K., & Newnham, K. (2007). Understanding barriers to mental health service utilization for adolescents in rural Australia. Rural and Remote Health, 7, 1–10. Retrieved from http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=624.
- Australian Institute of Health and Welfare. (2005). Rural, Regional, and Remote Health: Indicators of Health (Rural health series no. 5.). Retrieved from Canberra, ACT: http://www.aihw.gov.au/publication-detail/?id=6442467718.
- Black, G., Roberts, R. M., & Li-Leng, T. (2012). Depression in rural adolescents: relationships with gender and availability of mental health services. Rural and Remote Health, 12(2092), 1–11. Retrieved from http://www.rrh.org.au.
- Blanchard, M., Herrman, H., Frere, M., & Burns, J. (2012). Attitudes informing the use of technologies by the youth health workforce to improve young people’s wellbeing: Understanding the nature of the digital disconnect. Youth Studies Australia, 31(Suppl 1), S14–24. Retrieved from http://acys.info/resources/ysa/ysa-journal-archive/.
- Boyd, C., Francis, K., Aisbett, D., Newnham, K., Sewell, J., Dawes, G., et al. (2007). Australian rural adolescents’ experiences of accessing psychological help for a mental health problem. Australian Journal of Rural Health, 15, 196–200. doi: 10.1111/j.1440-1584.2007.00884.x.CrossRefPubMedGoogle Scholar
- Boyd, C., Hayes, L., Nurse, S., Aisbett, D., Francis, K., Newnham, K., & Sewell, J. (2011). Preferences and intention of rural adolescents toward seeking help for mental health problems. Rural and Remote Health, 11, 1–13. Retrieved from http://www.rrh.org.au/Articles/subviewnew.asp?ArticleID=1582.
- Burns, J., Tracey, A. D., Helen, C., Georgina, M. L., John, A. M., Amanda, B., et al. (2013). Game on: Exploring the impact of technologies on young men’s mental health and wellbeing. Retrieved from http://www.youngandwellcrc.org.au/wp-content/uploads/2014/03/Young_and_Well_CRC_Game_On_Report.pdf.
- Cave, L., Fildes, J., Luckett, G., & Wearing, A. (2015). Mission Australia’s 2015 Youth Survey Report. Retrieved from http://www.file:///C:/Users/orlo0008/AppData/Local/Downloads/Mission%20Australia%20Youth%20Survey%202015-NAT%20(full%20version).pdf.
- Christensen, H., & Hickie, I. B. (2010). E-mental health: a new era in delivery of mental health services. Medical journal of Australia, 192, S2–S3. Retrieved from https://www.mja.com.au/.
- Clever, S. L., Ford, D. E., Rubenstein, L. V., Rost, K. M., Meredith, L. S., Sherbourne, C. D., et al. (2006). Primary care patients’ involvement in decision-making is associated with improvement in depression. Medical Care, 44, 398–405. doi: 10.1097/01.mlr.0000208117.15531.da.CrossRefPubMedGoogle Scholar
- Eckert, K. A., Taylor, A. W., Wilkinson, D. D., & Tucker, G. R. (2004). How does mental health status relate to accessibility and remoteness? Medical journal of Australia, 181, 540–543. Retrieved from https://www.mja.com.au/.
- Gillis, G. (2015). Improving mental health care for young adults in Badakshan Province of Afghanistan using eHealth. Global Telehealth 2015: Integrating Technology and Information for Better Healthcare, 209, 46.Google Scholar
- Green, A. C., Hunt, C., & Stain, H. J. (2012). The delay between symptom onset and seeking professional treatment for anxiety and depressive disorders in a rural Australian sample. Social Psychiatry and Psychiatric Epidemiology, 47, 1475–1487. doi: 10.1007/s00127-011-0453-x.CrossRefPubMedGoogle Scholar
- Hardy, C., Kelly, K., & Voaklander, D. (2011). Does rural residence limit access to mental health services. Rural and Remote Health, 11, 1–8. Retrieved from http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=1766.
- Judd, F. K., Jackson, H., Davis, J., Cockram, A., Komiti, A., Allen, N., et al. (2001). Improving access for rural Australians to treatment for anxiety and depression: The University of Melbourne Depression and Anxiety research and treatment group—Bendigo Health Care Group initiative. Australian Journal of Rural Health, 9, 91–96.PubMedGoogle Scholar
- Klein, B., Meyer, D., Austin, D. W., & Kyrios, M. (2011). Anxiety online—A virtual clinic: preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms. Journal of Medical Internet Research, 13, e89. doi: 10.2196/jmir.1918.CrossRefPubMedPubMedCentralGoogle Scholar
- Matthews, M., & Doherty, G. (2011, 7–12 May 2011). In the mood: engaging teenagers in psychotherapy using mobile phones. Paper presented at the SIGCHI conference on human factors in computing systems Vancuver, Canada.Google Scholar
- Montague, A. E., Varcin, K. J., & Parker, A. G. (2014). Putting Technology into Practice: Evidence and opinions on integrating technology with youth health services. Retrieved from Melbourne: http://www.youngandwellcrc.org.au/wp-content/uploads/2014/10/Putting-Technology-into-Practice_FINAL.pdf.
- National Mental Health, C. (2014). The National Review of Mental Health Programmes and Services. Retrieved from Sydney: NMHC: http://www.mentalhealthcommission.gov.au/our-reports/review-of-mental-health-programmes-and-services.aspx.
- Newman, L., Biedrzycki, K., & Baum, F. (2012). Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services. Australian Health Review, 36, 125–129. doi: 10.1071/AH11042.CrossRefPubMedGoogle Scholar
- Newton, A. S., Ali, S., Johnson, D. W., Haines, C., Rosychuk, R. J., Keaschuk, R. A., et al. (2010). Who comes back? Characteristics and predictors of return to emergency department services for pediatric mental health care. Academic Emergency Medicine, 17, 177–186. doi: 10.1111/j.1553-2712.2009.00633.x.CrossRefPubMedGoogle Scholar
- NVivo Qualitative Data Analysis Software (Version 10). (2012). QSR International Pty Ltd.Google Scholar
- Orlowski, S. K., Lawn, S., Matthews, B., Venning, A., Winsall, M., Jones, G., et al. (2016). Technology to better engage youth with mental health services: How far have we come? Unpublished data.Google Scholar
- Perkins, D., Fuller, J., Kelly, B. J., Lewin, T. J., Fitzgerald, M., Coleman, C., et al. (2013). Factors associated with reported service use for mental health problems by residents of rural and remote communities: cross-sectional findings from a baseline survey. BMC Health Services Research, 13(1), 1–13. doi: 10.1186/1472-6963-13-157.CrossRefGoogle Scholar
- Ranney, M. L., Thorsen, M., Patena, J. V., Cunningham, R. M., Boyer, E. W., Walton, M. A., et al. (2015). ‘You need to get them where they feel it’: Conflicting Perspectives on How to Maximize the Structure of Text-Message Psychological Interventions for Adolescents. Proceedings of the Annual Hawaii International Conference on System Sciences, 2015, 3247–3255. doi: 10.1109/HICSS.2015.391.
- Reynolds, J., Griffiths, K. M., Cunningham, J. A., Bennett, K., & Bennett, A. (2015). Clinical practice models for the use of e-mental health resources in primary health care by health professionals and peer workers: a conceptual framework. JMIR Mental Health, 2, e6. doi: 10.2196/mental.4200.CrossRefPubMedPubMedCentralGoogle Scholar
- Rickwood, D. J., Deane, F. P., & Wilson, C. J. (2007). When and how do young people seek professional help for mental health problems? Medical journal of Australia, 187, S35–S39. Retrieved from https://www.mja.com.au/.
- Salamone-Violi, G. M. L., Chur-Hansen, A., & Winefield, H. R. (2015). ‘I don’t want to be here but I feel safe’: Referral and admission to a child and adolescent psychiatric inpatient unit: The young person’s perspective. International Journal of Mental Health Nursing, 24, 569–576. doi: 10.1111/inm.12163.CrossRefPubMedGoogle Scholar
- Sawyer, M. G., Arney, F. M., Baghurst, P. A., Clark, J. J., Graetz, B. W., Kosky, R. J., et al. (2001). The mental health of young people in Australia: key findings from the child and adolescent component of the national survey of mental health and well-being. Australian and New Zealand Journal of Psychiatry, 35, 806–814. doi: 10.1046/j.1440-1614.2001.00964.x.CrossRefPubMedGoogle Scholar
- Slade, J., Johnston, A., Teesson, M., Whiteford, H., Burgess, P., Pirkis, J., & Saw, S. (2009). The Mental health of Australians 2: report on the 2007 national survey of mental health and wellbeing. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-m-mhaust2.
- Smith, C. L. (2012). Mental health and help-seeking in adolescence. Australasian Epidemiologist, 19(1), 5–8. Retrieved from http://search.informit.com.au/documentSummary;dn=851777256865445;res=IELHEA.
- Swanson, K. A., Bastani, R., Rubenstein, L. V., Meredith, L. S., & Ford, D. E. (2007). Effect of mental health care and shared decision making on patient satisfaction in a community sample of patients with depression. Medical Care Research and Review, 64, 416–430. doi: 10.1177/1077558707299479.CrossRefPubMedGoogle Scholar
- Titov, N., Dear, B. F., Staples, L. G., Bennett-Levy, J., Klein, B., Rapee, R. M., et al. (2015). MindSpot clinic: an accessible, efficient, and effective online treatment service for anxiety and depression. Psychiatric Services, 66, 1043–1050. doi: 10.1176/appi.ps.201400477.CrossRefPubMedGoogle Scholar
- Wadley, G., Lederman, R., Gleeson, J., & Alvarez-Jimenez, M. (2013). Participatory design of an online therapy for youth mental health. Paper presented at the Proceedings of the 25th Australian Computer-Human Interaction Conference: Augmentation, Application, Innovation, Collaboration, OzCHI 2013.Google Scholar
- Webster, S., & Harrison, L. (2008). Finding a way: A grounded theory of young people’s experience of the pathway to mental health care. The Australian Journal of Advanced Nursing, 26(2), 85.Google Scholar
- Wetterlin, F. M., Mar, M. Y., Neilson, E. K., Werker, G. R., & Krausz, M. (2014). eMental health experiences and expectations: A survey of youths’ web-based resource preferences in Canada. Journal of Medical Internet Research, 16, e293. doi: 10.2196/jmir.3526.CrossRefPubMedPubMedCentralGoogle Scholar
- ReachOut.com. Support worker webinars. ReachOut.com Professionals. Retrieved from http://au.professionals.reachout.com/professional-development/support-workers/support-worker-webinars.