Last week at HTN Now: Digital Social Care and Mental Health, we were joined by Charlotte Stockton-Powdrell, Chief Operating Officer at the GM.Digital research unit. Her session covered the topic of digital navigation and current digital mental tools that have been introduced.
To begin the session, Charlotte spoke of the role of GM.Digital, explaining that it is a unit set up within the Greater Manchester Mental Health NHS Foundation Trust (GMMH), aimed at supporting the wellbeing and mental health of children and young people.
Since the COVID-19 pandemic, GM.Digital has worked closely with clinical teams at GMMH to improve the experience for its users. “We wanted to develop a digital and innovation pipeline so that the trust can make the most of the digital technologies to support their service users,” said Charlotte.
To set the scene for the digital developments, Charlotte noted that digital mental health can be defined as “anything along the mental health pathway that uses digital technology”, which could range from using a computer to access services online to the electronic patient record systems that the trust uses.
“These are ways in which we can look at using the routinely collected healthcare data to try and predict and prevent people from becoming more unwell,” she explained.
Charlotte then explained some of the challenges facing the mental health service in England currently, “About 25 percent of children or young people who are referred into child and adolescent mental health services don’t have a successful referral,” she said. “They don’t get seen.”
To address these challenges, Charlotte highlighted a few of the current digital projects set in place by the team, such as En-CAHMS, a project which aims to understand the current difficulties and to improve the overall process for those who need referring. The project has been co-designed with over 50 young people and children, along with other stakeholders such as parents. It exists to identify problems and also potential solutions.
Charlotte commented on another project developed by GM.Digital called Lumi Nova, which she described as “a really nice collaboration between BFB labs, The University of Manchester and GMMH.”
This project is an implementation study to identify and address the barriers and enablers in implementing Lumi Nova, a digital intervention tool aimed at seven to 12 year olds with childhood anxiety. The overall aim of this study, and of the Lumi Nova platform, is to improve outcomes for those with childhood anxiety so they do not require further interventions from the mental health service.
Charlotte explained: “We’re looking to see if Lumi Nova is usable and acceptable to users and their parents.” She detailed that the study is looking at whether people can engage effectively with the platform and produce clinically relevant outcomes.
Alongside these programmes, the service also offers a CAMHS digital young people’s group, which aims to enable the service users to drive forward the digital research agenda for children and young people. 50 children and young people are currently involved with the group. “We’ve been able to open this nationally and, in some cases, internationally,” said Charlotte, noting that this helps to shape the research agenda.
The group offers a range of training and mentoring for participants. They can receive training in digital mental health and wellbeing, and an opportunity is provided for industry partners involved with the service to be introduced to the group so that they can collectively give and receive feedback on current research ideas and focuses. “We’re very much led by the young people who decide on the focus of the groups,” commented Charlotte.
She acknowledged the importance of advisory groups such as this: “We know it’s really important to make sure the digital tools that are being used are well evaluated, well evidenced and robust, and that we are not just recommending tools that don’t have the evidence to support their safety or validity in their effectiveness.”
Charlotte then moved on to discuss GMMH’s “digital navigators”. Charlotte explained that the idea was initially conceived by John Torous from Harvard University and aims to “plug the gap that exists when we’re trying to increase the adoption of digital technologies within the health service.”
The purpose behind the digital navigators is to evaluate and recommend new technologies for the health services, which can help with focusing the recommended digital tools. “There are hundreds of thousands of health apps out there, and a lot of them don’t have evidence behind them,” Charlotte said. “It’s important for clinicians or patients to be able to choose technologies or apps that have the evidence that can help and benefit them.”
The digital navigators are also given training to troubleshoot technical or usability issues that may have prevented clinicians or patients from engaging with the tools previously. Explaining the benefits of this, Charlotte said, “This allows clinicians to focus on spending time with patients rather than needing to be concerned with finding out what specific difficulties people are struggling with.” She also highlighted the time it will save for clinicians and health care workers on needing to dedicate time and resources researching the various tools available.
The session then went on to detail how the navigators can engage with the services, with Charlotte discussing how they can collaborate with the clinical or research teams to provide feedback to policymakers through links with academics and clinicians.
One of the issues the digital navigators hope to address is digital exclusion. Charlotte said: “We know there is a big issue at the moment with digital health inequalities and people not having access, and sometimes that’s because people don’t have the knowledge or the skills.” Enabling the navigators to work with both clinicians and service users has been key, Charlotte noted; it is hoped that this will impact the digital inequality challenges that the trust currently faces.
Charlotte acknowledged the achievements the navigators had already completed, including reviews for GMMH for several mental health apps. They have also taken part in publication and conference submissions with regards to digital mental health.
The future goal for the digital navigator initiative, Charlotte said, is to roll it out across the UK. “After having conversations with other trusts in the UK who have liked the programme, we’d like the opportunity to really be able to share this with people throughout the UK to make the most of this initiative,” she said.
Many thanks to Charlotte for taking the time to join us; the full webinar is available to watch below.
