Giving up power to patients and communities to increase equity in mental health

eHealthNews.nz: Digital Patient

Giving up power to patients and communities to increase equity in mental health

Monday, 23 November 2020

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Pictures: Top - MyRivr chief executive Akerei Maresala Thomson; Below - Homecare Medical chief executive Andrew Slater (source: eMHIC)

eHealthNews.nz editor Rebecca McBeth

The need for the ‘system’ to give up power to the people and communities affected by mental health issues was a theme running through this year’s eMental Health International Congress.

Held at AUT on November 19, the 2020 Congress focused on Equity and eMental Health: Digital closing the gap.

MyRivr chief executive Akerei Maresala Thomson received a standing ovation for his presentation, saying that "solutions for issues in a community can be found in the community".

In an emotional presentation he spoke about his own mental health struggles after suffering abuse as a child and how the creation of MyRivr is to connect anyone experiencing difficulties with the many places they can go for help.

“Lack of services is not the issue, it’s about visibility of services," he said.

MyRivr allows users to search for and book appointments with more than 8000 health and social services across New Zealand and is also accessible via self-help kiosks in community libraries.

Thomson said it now has more than 10,000 users in South Auckland alone.

Tania Cargo, clinical psychologist Auckland University School of Medicine, laid down a challenge to give up power to Māori, saying the mental health system has been getting it wrong for Māori for 30 years and they should make their own decisions going forward.

Cargo presented on the development of the Aroha chatbot, to help young people manage stress and isolation due to Covid-19.

During lockdown almost 400 people accessed the chatbot, but the questions is how to get services like this to “stick” so that young people continue to use them, she explained.

Aroha is part of the HABITs (Health Advances through Behavioural Intervention Technologies) digital platform of e-health interventions which also encompasses SPARX, YouthCHAT and Quest - Te Whitianga

Karolina Stasiak, senior lecturer and senior research fellow at Auckland University, said there will be an implementation trial to assess barriers, enablers and implementation of the “digital wellbeing ecosystem” in a school setting.

This will involve going to schools to ask how they want to implement it and getting funding.

Homecare Medical chief executive Andrew Slater told Congress attendees that “what’s good for Māori is good for everyone”.

The organisation worked with Māori to rethink and rebrand its phone and counselling service called Puāwaitanga, significantly increasing Māori registrations and improving outcomes, as well as improving outcomes for other users.

He told attendees the organisation had also managed to double its Māori and Pasifika workforce by removing the need for people to provide a CV.

Analysis showed that many people who ticked these ethnic groups in their online application stopped the process when they got to the requirement to upload a CV. Now staff members contact prospective employees and interview them, creating a CV that can be signed off and kept on file.

Staying on Track clinical lead Anna Elders outlined her experience of developing an online cognitive behaviour therapy course in response to Covid-19 and barriers to adoption of eMental Health tools in general.

These include, the issue that clinicians might be recommending tools, but are not prescribing them and general risk aversion in the clinical workforce. Also, the sheer number of innovations in this space.

“We need to be making sure that eMentalHealth is taught to health professionals as a treatment so there’s an expectation it will be brought on,” she said.

“For trained health professionals, once they have their practice, it’s very hard to get them to do something different.”

Peggy Brown from Quality and Safety Standards Australia spoke about the country’s new National Safety Quality Digital Mental Health standards being launched in Australia at the end of this month.

Arran Culver, chief clinical advisor mental health and addiction at the Ministry of Health said New Zealand’s eMental Health Framework will be published in 2021 and identified equity as a key challenge in mental health space.

The framework is for the assessment of mental health apps and online programs and will consider; quality; safety, effectiveness, security, usability, cultural fit and relevance of products for New Zealand populations.