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Technology Can Play A Role In Keeping Young Minds Appy

An e-mental health system can deliver seamless support across online and offline services which empowers the individual, focuses on wellbeing and can provide world-class treatment that is user-friendly, accessible and cost-effective.

A friend of mine, let's call him Ted*, last year had a stroke. An ambulance was called and within 30 minutes they were receiving 21st century medical care in a state-of-the-art stroke ward in a public hospital. After a few days in a high-dependency unit, he was transferred to a stroke ward and then to a rehabilitation hospital and eventually returned home with a superb discharge plan and great in-home community support.

On the other hand, another young person of my acquaintance, Jason*, was last year diagnosed with a mental illness. It took him months to get to see a psychologist, eight weeks to see a psychiatrist, and a critical incident saw him involved with an emergency involuntary hospitalisation causing huge trauma and distress to his family. He was discharged without a plan and it was only because his family were well-educated and sourced their own support that Jason is now functioning reasonably well. In different circumstances, it could easily have gone the other way for him.

The reality is that in Australia a form of 'health apartheid' exists. On the one hand, there is a physical health system that gobbles up resources like there is no tomorrow and, on the other, the poor cousin in the form of the mental health care system that lives on scraps and is perpetually under-resourced and under massive pressure.

This situation can no longer be tolerated. Australia cannot afford it.

Research from Mission Australia in 2015 shows that young people are highly concerned with coping with stress, school or study problems, body image and depression. The largest study ever conducted in Australia by the Telethon Kids Institute, in collaboration with the University of Western Australia, last year found that 1 in 4 secondary students and 1 in 7 primary school students have a diagnosable mental illness.

Alarmingly, 1 in 10 teenagers has engaged in self-harm, 1 in 13 have contemplated suicide, 1 in 40 have attempted suicide and 2 in 5 young people have tried illicit substances. In short the mental health of young Australians is worse than it was for their parents and is costing the country a fortune.

A major new report by accounting and consultancy firm Ernst and Young found the health care of young people with a mental illness is costing nearly $1.3 billion a year, and that better mental health services and early intervention could produce big savings for taxpayers as well as improve the lives of people with a mental illness.

Fiscal costs include lost productivity at work, benefit payments and health-care expenditure. Social costs include poor quality of life, unnecessary burden and significant suffering when a life is lost to suicide, which happens seven times every day in Australia. Our failure to help young people with a mental illness is costing the country a staggering $6.2 billion a year in health, welfare, business and prison costs. Half the young people with a mental illness are unemployed and many are stuck in the prison system because 70 percent of them don't get help from mental health services.

The Australian government is constantly under pressure from consumer groups, the mental health sector and the media, and are actively looking for new ways to deal effectively with the growing burden of youth mental health, but also new ways to improve wellbeing. A series of major reports over the past few years suggests that improving mental health services for young people would dramatically lift national productivity as well as reduce the proportion of young people requiring treatment.

The question is how might this be achieved?

A revolutionary idea is to use new and emerging technologies to improve and promote wellbeing in young people. The National Mental Health Commission report published last year made a strong argument that the Government could rapidly expand access to mental health care if it used online services and better integrated them into the traditional health system supports.

The idea would be to first offer people a way to manage their wellbeing through evidence-based online self-care, using a combination of web-based programs, smartphone apps and biometric devices. If this support was not enough, people with more severe mental illness could access online counseling and progressively advance through to more intense levels of care if needed. A small group of researchers and clinicians at the Young and Well Cooperative Research Centre have come up with a unique solution that argues that new and emerging technologies could indeed be a mental health game changer -- not just in Australian but worldwide.

This research shows that an e-mental health system can deliver seamless support across online and offline services which empowers the individual, focuses on wellbeing and can provide world-class treatment that is user-friendly, accessible and cost-effective.

This revolutionary idea is based on four incontrovertible facts. First, that 75 percent of mental health problems in adults occur under the age of 25, and 50 percent under the age of 15. Second, that there are now more mobile phones than people in the world. Third, that young people are the heaviest users of both smartphones and download apps more than any other age group. And, lastly, that there is good evidence that e-mental health interventions work and are effective as an adjunct to conventional treatment.

The proposal is for a digital ecosystem of online support, which includes certified apps and web-based interventions, running on an underpinning common set of technological, medico-legal and ethical standards. The ecosystem is based on the principle of self-management and is all on a young person's mobile phone.

First, young people download an app from their school, university or workplace which prompts them to complete a specialised wellbeing questionnaire and then creates a tailored digital wellbeing plan on the basis of their responses. Second, through the use of smart algorithms that analyse their individual data, the system recommends a customised set of apps and web-based programs that address their specific needs and affords young people a choice as to how they respond to, control and share their data. Finally, the system can automatically determine if the young person requires clinical care and can facilitate engagement with clinical services, both online and offline.

The system eliminates the need to repeat information unnecessarily and, using smart algorithms, ensures young people receive the right care at the right time. The system has a commitment to user-centred information security, strongly encrypted data storage and the establishment of guidelines to ensure all services are compliant with medical, legal and ethical standards to ensure the privacy of young people's information.

The bottom line is that such a system may have alerted Jason's carers to the nature and extent of his distress, helped him get the right help at the right time and, ultimately, prevent him from becoming so unwell and ensure that he didn't have to wait for so long to get treatment, let alone have a traumatic involuntary admission.

Albert Einstein said the definition of insanity is doing something over and over again and expecting a different result. It is time we change the way we do things so that Jason gets the sort of treatment that Ted did.

*Names have been changed.


Young Minds Matter is a new series meant to lead the conversation with children about mental and emotional health, so youngsters feel loved, valued and understood. Launched with Her Royal Highness, The Duchess of Cambridge, as guest editor, we will discuss problems, causes and most importantly solutions to the stigma surrounding the UK's mental health crisis among children. To blog on the site as part of Young Minds Matter email

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