A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service.

Alvarez-Jimenez, M; Rice, S; D'Alfonso, S; Leicester, S; Bendall, S; Pryor, I; Russon, P; McEnery, C; Santesteban-Echarri, O; Da Costa, G; Gilbertson, T; Valentine, L; Solves, L; Ratheesh, A; McGorry, PD; Gleeson, J

A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service.

Alvarez-Jimenez, M Rice, S D'Alfonso, S Leicester, S Bendall, S Pryor, I Russon, P

McEnery, C Santesteban-Echarri, O Da Costa, G Gilbertson, T Valentine, L Solves, L Ratheesh, A McGorry, PD Gleeson, J

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Publisher:: JMIR PUBLICATIONS, INC
Publication Type:: Journal Article
Citation:: J Med Internet Res, 2020, 22, (8), pp. e17155
Issue Date:: 2020-08-13

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Field	Value	Language
dc.contributor.author	Alvarez-Jimenez, M
dc.contributor.author	Rice, S
dc.contributor.author	D'Alfonso, S
dc.contributor.author	Leicester, S
dc.contributor.author	Bendall, S
dc.contributor.author	Pryor, I
dc.contributor.author	Russon, P https://orcid.org/0000-0001-7899-7451
dc.contributor.author	McEnery, C
dc.contributor.author	Santesteban-Echarri, O
dc.contributor.author	Da Costa, G
dc.contributor.author	Gilbertson, T
dc.contributor.author	Valentine, L
dc.contributor.author	Solves, L
dc.contributor.author	Ratheesh, A
dc.contributor.author	McGorry, PD
dc.contributor.author	Gleeson, J
dc.date.accessioned	2022-10-30T09:08:17Z
dc.date.available	2020-06-13
dc.date.available	2022-10-30T09:08:17Z
dc.date.issued	2020-08-13
dc.identifier.citation	J Med Internet Res, 2020, 22, (8), pp. e17155
dc.identifier.issn	1439-4456
dc.identifier.issn	1438-8871
dc.identifier.uri	http://hdl.handle.net/10453/162927
dc.description.abstract	BACKGROUND: Mental ill-health is the leading cause of disability worldwide. Moreover, 75% of mental health conditions emerge between the ages of 12 and 25 years. Unfortunately, due to lack of resources and limited engagement with services, a majority of young people affected by mental ill-health do not access evidence-based support. To address this gap, our team has developed a multimodal, scalable digital mental health service (Enhanced Moderated Online Social Therapy [MOST+]) merging real-time, clinician-delivered web chat counseling; interactive user-directed online therapy; expert and peer moderation; and peer-to-peer social networking. OBJECTIVE: The primary aim of this study is to ascertain the feasibility, acceptability, and safety of MOST+. The secondary aims are to assess pre-post changes in clinical, psychosocial, and well-being outcomes and to explore the correlations between system use, perceived helpfulness, and secondary outcome variables. METHODS: Overall, 157 young people seeking help from a national youth e-mental health service were recruited over 5 weeks. MOST+ was active for 9 weeks. All participants had access to interactive online therapy and integrated web chat counseling. Additional access to peer-to-peer social networking was granted to 73 participants (46.5%) for whom it was deemed safe. The intervention was evaluated via an uncontrolled single-group study. RESULTS: Overall, 93 participants completed the follow-up assessment. Most participants had moderate (52/157, 33%) to severe (96/157, 61%) mental health conditions. All a priori feasibility, acceptability, and safety criteria were met. Participants provided mean scores of ≥3.5 (out of 5) on ease of use (mean 3.7, SD 1.1), relevancy (mean 3.9, SD 1.0), helpfulness (mean 3.5, SD 0.9), and overall experience (mean 3.9, SD 0.8). Moreover, 98% (91/93) of participants reported a positive experience using MOST+, 82% (70/93) reported that using MOST+ helped them feel better, 86% (76/93) felt more socially connected using it, and 92% (86/93) said they would recommend it to others. No serious adverse events or inappropriate use were detected, and 97% (90/93) of participants reported feeling safe. There were statistically significant improvements in 8 of the 11 secondary outcomes assessed: psychological distress (d=-0.39; P<.001), perceived stress (d=-0.44; P<.001), psychological well-being (d=0.51; P<.001), depression (d=-0.29; P<.001), loneliness (d=-0.23; P=.04), social support (d=0.30; P<.001), autonomy (d=0.36; P=.001), and self-competence (d=0.30; P<.001). There were significant correlations between system use, perceived helpfulness, and a number of secondary outcome variables. CONCLUSIONS: MOST+ is a feasible, acceptable, and safe online clinical service for young people with mental ill-health. The high level of perceived helpfulness, the significant improvements in secondary outcomes, and the correlations between indicators of system use and secondary outcome variables provide initial support for the therapeutic potential of MOST+. MOST+ is a promising and scalable platform to deliver standalone e-mental health services as well as enhance the growing international network of face-to-face youth mental health services.
dc.format	Electronic
dc.language	eng
dc.publisher	JMIR PUBLICATIONS, INC
dc.relation.ispartof	J Med Internet Res
dc.relation.isbasedon	10.2196/17155
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	08 Information and Computing Sciences, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Medical Informatics
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Child
dc.subject.mesh	Counseling
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Mental Health Services
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Social Support
dc.subject.mesh	Telemedicine
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	Pilot Projects
dc.subject.mesh	Counseling
dc.subject.mesh	Mental Disorders
dc.subject.mesh	Mental Health Services
dc.subject.mesh	Telemedicine
dc.subject.mesh	Social Support
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Child
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Young Adult
dc.title	A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service.
dc.type	Journal Article
utslib.citation.volume	22
utslib.location.activity	Canada
utslib.for	08 Information and Computing Sciences
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Arts and Social Sciences
pubs.organisational-group	/University of Technology Sydney/Faculty of Arts and Social Sciences/School of Communication
utslib.copyright.status	open_access	*
dc.date.updated	2022-10-30T09:08:16Z
pubs.issue	8
pubs.publication-status	Published online
pubs.volume	22
utslib.citation.issue	8

Abstract:

BACKGROUND: Mental ill-health is the leading cause of disability worldwide. Moreover, 75% of mental health conditions emerge between the ages of 12 and 25 years. Unfortunately, due to lack of resources and limited engagement with services, a majority of young people affected by mental ill-health do not access evidence-based support. To address this gap, our team has developed a multimodal, scalable digital mental health service (Enhanced Moderated Online Social Therapy [MOST+]) merging real-time, clinician-delivered web chat counseling; interactive user-directed online therapy; expert and peer moderation; and peer-to-peer social networking. OBJECTIVE: The primary aim of this study is to ascertain the feasibility, acceptability, and safety of MOST+. The secondary aims are to assess pre-post changes in clinical, psychosocial, and well-being outcomes and to explore the correlations between system use, perceived helpfulness, and secondary outcome variables. METHODS: Overall, 157 young people seeking help from a national youth e-mental health service were recruited over 5 weeks. MOST+ was active for 9 weeks. All participants had access to interactive online therapy and integrated web chat counseling. Additional access to peer-to-peer social networking was granted to 73 participants (46.5%) for whom it was deemed safe. The intervention was evaluated via an uncontrolled single-group study. RESULTS: Overall, 93 participants completed the follow-up assessment. Most participants had moderate (52/157, 33%) to severe (96/157, 61%) mental health conditions. All a priori feasibility, acceptability, and safety criteria were met. Participants provided mean scores of ≥3.5 (out of 5) on ease of use (mean 3.7, SD 1.1), relevancy (mean 3.9, SD 1.0), helpfulness (mean 3.5, SD 0.9), and overall experience (mean 3.9, SD 0.8). Moreover, 98% (91/93) of participants reported a positive experience using MOST+, 82% (70/93) reported that using MOST+ helped them feel better, 86% (76/93) felt more socially connected using it, and 92% (86/93) said they would recommend it to others. No serious adverse events or inappropriate use were detected, and 97% (90/93) of participants reported feeling safe. There were statistically significant improvements in 8 of the 11 secondary outcomes assessed: psychological distress (d=-0.39; P<.001), perceived stress (d=-0.44; P<.001), psychological well-being (d=0.51; P<.001), depression (d=-0.29; P<.001), loneliness (d=-0.23; P=.04), social support (d=0.30; P<.001), autonomy (d=0.36; P=.001), and self-competence (d=0.30; P<.001). There were significant correlations between system use, perceived helpfulness, and a number of secondary outcome variables. CONCLUSIONS: MOST+ is a feasible, acceptable, and safe online clinical service for young people with mental ill-health. The high level of perceived helpfulness, the significant improvements in secondary outcomes, and the correlations between indicators of system use and secondary outcome variables provide initial support for the therapeutic potential of MOST+. MOST+ is a promising and scalable platform to deliver standalone e-mental health services as well as enhance the growing international network of face-to-face youth mental health services.

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http://hdl.handle.net/10453/162927