Online options for youth mental health

12 August 2019
Connecting the dots
The statistic is distressing but it suggests an effective place to start treatment: 75 percent of mental health problems begin before age 25, and 50 percent before age 15. Now a common point of contact has suggested a radical approach to service delivery.

Dr Frank Iorfino

It’s 3 o’clock in the morning and a young person is having a mental health crisis. What can he or she do? Currently, the only option is the emergency department of a local hospital. If that young person lives in rural Australia, even that option might not be available.

This is one of the scenarios that mental health professionals at the University’s Brain and Mind Centre (BMC), have wrestled with, looking for solutions, and the signs are good that they’ve found one. It’s called the Innowell Platform and it harnesses the online environment to provide a 24-hour option for people seeking to improve their mental health.

“People can get online and do something immediately,” says postdoctoral research fellow Dr Frank Iorfino (PhD ’18 MBMSc ’14). With an obvious enthusiasm for his work, Iorfino believes there’s real value in online engagement. “People can fill out questionnaires about their current mental health, which in itself can be quite therapeutic. They can also find out what they can do right now – maybe using an app or fact sheet, or even having a ‘video visit’ with a counsellor.”

A worldwide consensus is emerging among mental health researchers that online interactions can be positive and can even be used to provide clinical care. An online portal is also less confronting for someone who has avoided seeing their GP or psychologist because of the stigma around mental illness.

Professor Ian Hickie

As the co-director of health and policy at the BMC, Professor Ian Hickie is a tireless advocate for improving access for people with mental illness. As he points out, fewer than one in three girls and one in six boys with a major mental health problem ever gets an assessment or intervention.

“There’s a total disconnect between the need for health care in that period of adolescent and early adulthood and what our health system currently does,” he says.

The Innowell Platform is designed to fill that gap. Developed by a multidisciplinary design team including psychiatrists, software engineers and people who will actually use it, the platform so impressed the federal government that it agreed to contribute $30 million dollars to a related program called Project Synergy that could revolutionise mental health service provision.

After four trials were completed with promising results, the Innowell Platform is now being trialled with headspace, a youth mental health service; Open Arms, a military veterans’ counselling service; and the Butterfly Foundation for Eating Disorders. But creating and refining the technology is not the only hurdle.

“Getting people to change their behaviour and understand how this platform can help is a major barrier,” says Iorfino. “There’s a big need to run education and training, not just for those using it but the clinicians as well.”

Perfecting the Innowell Platform is just one facet of what happens at the BMC, a multi-faculty initiative encompassing research, social policies, engineering, IT and economics. BMC was established in 2015 to build on a decade of work carried out by the Brain and Mind Research Institute (BMRI). Hickie was appointed the BMRI Executive Director in 2003 – he stayed on at BMC because he believes the centre’s investment in mental health research has put it at the cutting edge.

“In childhood, there are things like autism and anxiety. For teenagers, there is depression, substance abuse and the onset of disorders like schizophrenia,” he says. “Then in ageing, it’s about dementia, Alzheimer’s and Parkinson’s disease. The social costs of mental health are seen as the big health and medical research challenges of the 21st century.”

With the Project Synergy trials set to finish next year, Hickie is looking to a future where similar innovations are an integral part of Australia’s mental health system.

“In five years, any teenager will be able to connect immediately with effective and highly personalised health care,” says Hickie. “And the services will put the person and their family at the centre of that care.”

For all the current inadequacies in service provision, Hickie estimates that Australia is still a decade ahead of most other countries. “What we haven’t had is the confidence that, if you invest in this area, we’ll see breakthroughs.”

Hickie uses a favourite quote to illustrate the point, “President Obama said that we have ventured much further into outer space than we have inside our own heads. The thing now is to turn the awareness into investment.”

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