Digital Tools

As parents and professionals, we need to be able to understand the things our young people find and engage with: they can come to us and we can help. This toolkit aims to summarise the range of tools available and highlight examples. We invite readers to discuss these tools. Before presenting universal and digital tools available in ‘Digital Landscape’ toolkit section, here are some things to think about before using digital tools.

In this section, you’ll find:

1. What are digital tools?

We use this term to describe a piece of software that has a potential to support mental health. It might be a generic tool or designed for this purpose. The impact may be direct or indirect, positive or negative.

Software is a programme run by a computer (a desktop, laptop, a mobile, a car engine, or a wearable device like a fitness tracker). A software is also called an application – or ‘App’.

A website is a space on the Internet, usually found by a web address into a browser (an application like Internet Explorer, Safari, Chrome). You can view a website on different devices: computer, tablet, television, mobile phone, watch face. Many websites adapt their appearance to the type of device you’re using.

search engine is a tool for searching on the Internet for particular terms. Google is the best known search engine. It tailors the websites you see in searches according to what you type and the websites you tend to view.

Smartphones and tablets are devices that connect to the Internet and run software. For many young people, the telephone function is secondary. Mobile devices can be on set contract, with an allocation of free calls, text messages and data. They can also be on a pay-as-you-go where you can buy bundles of data, texts and calls. 4G connections are faster than much broadband services, and often, cheaper.

There are different operating systems for devices. The operation software is what controls the device. For example, Windows on a PC, iOS on Apple, Android used by Google

A wide range of businesses and individual develop Apps. Apps are either free or for sale through special shops like the App store for iOS and Google Play Store for Android. Apps sold through the App store have to meet tight criteria before they’re accepted.

Developers find the Android system more accessible so Apps may be less polished than iOS Apps. Users find that fewer Apps are available for Windows phones. There is a wide range of apps for health and mental health. NICE have reviewed some eMental Health services for clinical use.

Instant messaging (IM) is a popular way to exchange text or media – for free or at a low cost. It uses mobile data or WiFi. Messaging services such as WhatsApp are popular. Snapchat is another one where messages ‘disappear’ from the recipient’s device seconds after viewing. Privacy is still not guaranteed. The message can be ‘screenshot’ and shared – or hacked. Although young people can use IM for risky behaviours, these Apps are popular and well used.

Wearables are clothing and accessories that incorporate computer and electronic technologies, such as fitness or sleep trackers and pedometers.

2. Different purposes

It’s critically important to separate tools depending on their purpose:

  • For clinical clinical use: intended to use in a service context and should demonstrate the appropriate efficacy, and risk/benefit analysis. Clinical guidelines, such as SIGN and NICE, discuss some of these, and NHS Choices includes details of some NHS approved services, mainly targeted at adults.
  • For self-management or personal insight: for example, tools which use CBT principles or mindfulness are likely to use elements of tools which have an evidence base.
  • Further tools solve a particular problem identified by users of that tool in development process and may be so new as to not have been subject to trial or evaluation. In this case, it’s important to understand how the tool works and how a young person uses it before recommending it.
  • Finally, it’s important to understand ways in which young people use existing digital tools in both positive and negative ways in relation to their mental health. It’s unrealistic to expect young people not to use tools that could lead them into risky situations, or be a negative influence on their mental health; equally it’s very hard to decrease the risk of social media services without negating the positives which are indisputably there.

NIHR Mindtech developing a common set of criteria for evaluating digital mental health tools such as apps and mobile websites. The evidence base for digital health apps and tools is a growing area of research and commercial interest which is likely to develop rapidly in the coming years. It should be a central part of CPD to include the latest evidence developments in ongoing professional development.

Equally, young people are using digital tools now, and we need to be able to support and understand that as the evidence for both harms and benefits develops.

3. Keeping a critical mind

We have not conducted trials, nor assessed the effectiveness of all digital resources: we highlight resources that are available and seem credible. We invite young people, supporters and professionals to use the toolkit, and any professional guidelines they have, to help develop their own considered judgement. In each section, we draw on some of the challenges in evaluating tools.

There’re considerable challenges in evaluating health related digital tools, the main one being the fast pace of change. Digital moves faster than research: by the time research is completed and published, digital technology has moved.

Equally, innovation funded by start-up investors is not always evaluated beyond the user opinion. The ones funded by the public and charitable sectors don’t always include funding of rigorous evaluation.

That said, there are some digital interventions which have a strong evidence base, and others that are developed using evidence-based principles and so, can said to be evidence informed.

4. How to evaluate tools?

To help develop considered judgement, we have developed a ‘five things to think about’ approach to help you make a basic assessment of a tool or app which you come across. We hope this will enable you to consider a tool and the way a young person uses or seeks to use it.

ayemind_toolkit_think

The Open University uses the PROMPT model, inviting students to consider:

P-resentation
R-elevance
O-bjectivity
M-ethod
P-rovenance
T-imeliness

Read more and download the checklist.

5. Homework

Watch this video produced by Google and ask yourself, how do you determine whether to trust an online resource?

6. Want to read more?

The Young and Well Collaborative Research Centre in Australia has undertaken a large scale research study to develop a better practice guide for using digital tools safely with young people in a clinical and youth work environment.

Source: YAWCRC (2012) Young and Well CRC Better Practice Guide https://www.youngandwellcrc.org.au/research/user-driven-and/better-practice-guide/

Youth Net were the UK partner in a six country EU study funded by the DAPHNE programme on self-harm. One of the products was a transnational set of guidelines about using online peer support for young people who self-harm.

Source: YouthNet (2012) The Role of Online Peer Support for Young People Who Self-Harm: Good Practice Guide http://www.institut-utrip.si/doc/Good-Practice-Guide1.pdf

Victoria Betton, of MHabitat in Leeds published an eBook about the potential for using digital tools to support recovery in mental health.

Source: Betton (2014) Social Media in Mental Health Practice; Online Tools for Recovering and Living Well https://www.mentalhealth.org.nz/assets/ResourceFinder/social-media-in-mental-health-practice.pdf

7. Reminder

Remember, Aye Mind does not offer direct support for mental health issues and is not continuously monitored for messages. If you need an ambulance, call 999. If you or someone around you is in distress or need immediate help, click here to find a list of services you can talk to.

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