Mobile applications or ‘apps’ have significant potential for use in mental health interventions with adolescents. However, there is a lack of research exploring end users’ needs from such technolog...

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Developing mental health mobile apps: Exploring adolescents' perspectives.

Many adolescents have poor mental health literacy, stigmatising attitudes towards people with mental illness, and lack skills in providing optimal Mental Health First Aid to peers. These could be improved with training to facilitate better social support and increase appropriate help-seeking among adolescents with emerging mental health problems. teen Mental Health First Aid (teen MHFA), a new initiative of Mental Health First Aid International, is a 3 × 75 min classroom based training program for students aged 15–18 years. An uncontrolled pilot of the teen MHFA course was undertaken to examine the feasibility of providing the program in Australian secondary schools, to test relevant measures of student knowledge, attitudes and behaviours, and to provide initial evidence of program effects. Across four schools, 988 students received the teen MHFA program. 520 students with a mean age of 16 years completed the baseline questionnaire, 345 completed the post-test and 241 completed the three-month follow-up. Statistically significant improvements were found in mental health literacy, confidence in providing Mental Health First Aid to a peer, help-seeking intentions and student mental health, while stigmatising attitudes significantly reduced. teen MHFA appears to be an effective and feasible program for training high school students in Mental Health First Aid techniques. Further research is required with a randomized controlled design to elucidate the causal role of the program in the changes observed.

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‘teen Mental Health First Aid’: a description of the program and an initial evaluation

In everyday decision-making, individuals make trade-offs between short-term and long-term benefits or costs. Depending on many factors, individuals may choose to wait for larger delayed reward, yet in other situations they may prefer the smaller, immediate reward. In addition to within-subject variation in the short-term versus long-term reward trade-off, there are also interindividual differences in delay discounting (DD), which have been shown to be quite stable. The extent to which individuals discount the value of delayed rewards turns out to be associated with important health and disorder-related outcomes: the more discounting, the more unhealthy or problematic choices. This has led to the hypothesis that DD can be conceptualized as trans-disease process. The current systematic review presents an overview of behavioral trainings and manipulations that have been developed to reduce DD in human participants aged 12 years or older. Manipulation studies mostly contain one session and measure DD directly after the manipulation. Training studies add a multiple session training component that is not per se related to DD, in between two DD task measurements. Ninety-eight studies (151 experiments) were identified that tested behavioral trainings and manipulations to decrease DD. Overall, results indicated that DD can be decreased, showing that DD is profoundly context dependent and changeable. Most promising avenues to pursue in future research seem to be acceptance-based/mindfulness-based trainings, and even more so manipulations involving a future orientation. Limitations and recommendations are discussed to identify the mechanistic processes that allow for changes in discount rate and behavior accordingly.

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Behavioral trainings and manipulations to reduce delay discounting: A systematic review.

Introduction This chapter outlines a developmental orientation to understanding the mental health of children and young people. It examines the implications for mental health in children and young people in relation to the environment, nature and nurture, and brain development in the context of vulnerability or risk, and resilience or protection. The chapter explores mental health promotion for young people, drawing from two real stories about bullying and altered eating patterns, including anorexia nervosa and bulimia, which include experiences of depression, anxiety and psychosis. Emphasis is given to prevention, promotion and early intervention for mental illness, including social media and e-mental health interventions for young people in relation to non-suicidal self-injury or suicide crisis, and popular public health initiatives to reduce suicide, such as R U OK? Day, headspace and other online services. Respect for young people Health professionals providing mental health care to children and young people should do so in a way that conveys respect and genuine concern. For children and young people, the first occurrence of a mental illness is likely to be a very confusing and perhaps a frightening experience. An important priority is for health care professionals to develop a strong initial therapeutic rapport with the young people they are helping. Young people are unsure of what to anticipate in mental health care, especially if it is their first appointment, or their first experience of a mental illness (Watson, Rickwood & Vanags, 2013; Wilson, Cruickshank & Lea, 2012). Health professionals can do a great deal to allay the confusion, anxiety and apprehension that may accompany a first experience of gaining mental health care, simply by creating a respectful and trusting relationship from the outset (Coughlan et al., 2011; Wilson et al., 2012). Most mental health conditions are first encountered during the ages of 12–25 years, and approximately 20 per cent of the world's young people are affected (Wei et al., 2013). It is very important to promote mental health, provide accessible, youth-focused early intervention when it is needed, and to support the recovery care of young people, because we know that the earlier mental health care is initiated, the more likely will be the success of recovery (Boyd et al., 2011; Coughlan et al., 2011; McAllister & Handley, 2008; Wilson, 2007; Wilson et al., 2012).

Mental health of children and young people

Background: Early intervention is important in order to improve mental health outcomes for young people. Given the recent rise in mobile phone ownership among adolescents, an innovative means of delivering such intervention is through the use of mobile phone applications (apps). Objective: The aim of this study was to evaluate the feasibility of “CopeSmart”, a telemental health app developed to foster positive mental health in adolescents through emotional self-monitoring and the promotion of positive coping strategies. Methods: Forty-three adolescents (88% female) aged 15-17 years downloaded the app and used it over a one-week period. They then completed self-report questionnaires containing both open-ended and closed-ended questions about their experiences of using the app. The app itself captured data related to user engagement. Results: On average participants engaged with the app on 4 of the 7 days within the intervention period. Feedback from users was reasonably positive, with 70% of participants reporting that they would use the app again and 70% reporting that they would recommend it to a friend. Thematic analysis of qualitative data identified themes pertaining to users’ experiences of the app, which were both positive (eg, easy to use, attractive layout, emotional self-monitoring, helpful information, notifications, unique) and negative (eg, content issues, did not make user feel better, mood rating issues, password entry, interface issues, engagement issues, technical fixes). Conclusions: Overall findings suggest that telemental health apps have potential as a feasible medium for promoting positive mental health, with the majority of young people identifying such technologies as at least somewhat useful and displaying a moderate level of engagement with them. Future research should aim to evaluate the efficacy of such technologies as tools for improving mental health outcomes in young people. [JMIR Ment Health 2015;2(3):e22]

Feasibility of "CopeSmart": A Telemental Health App for Adolescents.

A recent and growing body of evidence on youngpeople’s mental health has pointed to the need foran international response to the increasing and con-cerning rates of mental ill-health among youngpeople.1,2The periods of adolescence and emergingadulthood3are considered the peak periods for theonset of mental ill-health4with 75% of all adult diag-noses of mental ill-health having had an onsetbefore the age of 25 years.5In an era when the physi-cal health of young people has never been better,6their psychological and mental health has neverbeen worse.7This leaves young people vulnerable todeveloping potentially intractable and enduringmental health difficulties with the inevitable per-sonal, familial, social and vocational consequencesthat accompany the experience of mentalill-health

Michael Maher

Papers

Towards a new paradigm of care: the International Declaration on Youth Mental Health