e-Mental health refers to services targeting mental health problems that are delivered through online and mobile interactive websites, apps, sensor-based monitoring devices, computers and phones. The Black Dog Institute aims to reform and improve the detection, treatment and delivery of e-mental health tools and programs.
Led by Professor Helen Christensen, researchers at Black Dog are utilising e-mental health to detect mental health symptoms, develop interventions for common mental health disorders, and deliver novel programs in a community setting.
Why e-mental health?
The Black Dog Institute is a leader in the area of e-mental health research developing interventions to lower depression, lower suicide risk and promote wellbeing. It is known that about two-thirds of people with a mental illness do not seek help. Despite increased investment and strong evidence showing that prevention and intervention saves lives, factors like geography, stigma and social circumstances make it hard for people to get help.
e-Mental health represents programs that target common mental health problems delivered through online and mobile interactive websites, apps and computers, as well as telephone and online crisis support lines. Mobile phones can also be used to collect individual data on risk factors, and thus offer for the first time the potential to collect individual data, detect mental health symptoms, and develop personalised, tailored programs delivered universally.
e-Mental health services are an effective and complementary sector to traditional face-to-face mental health services. By providing accessible and anonymous prevention the Internet can play an important role in overcoming obstacles for seeking help.
The e-mental health team is working on a range of projects in detection, treatment and delivery.
Socialise: mobile sensor technology to reduce social isolation
Social isolation is a known predictor of poor mental health and may also be a cause. More than 50% of Australians own an internet-enabled mobile device and research shows young people in particular are very comfortable using their mobile devices for their mental health needs. While a number of online solutions exist for young people, they do not provide immediate tracking and monitoring. This world-first project aims to use mobile sensor technology to reduce social isolation among young people. Using Bluetooth, this app will track social interactions, detect social withdrawal, facilitate connections and provide mental health advice as required. Social isolation is strongly associated with poor mental health and suicide.
Ground Truth Trial: social media and machine learning
In this study, the research team will profile users’ mental health by harnessing novel machine learning based analyses of social media conversations. Features that capture depression levels will be determined by correlating ‘ground truth’ depression measures with data-up indicators derived from machine learning using members of depression online communities. Outcomes of the study will include greater understanding of actual, real-time ‘descent’ into illness state – something unachievable using conventional survey methods – and the development of predictive systems capable of driving decisions concerning the provision of support for mental illness through social media, and the provision of alerts to individuals, carers and medical practitioners.
SpringboarD: A new approach to building wellbeing for people with type 2 diabetes
Diabetes can affect your mood and leave you feeling stressed and ‘burnt out’ from time-to-time. The SpringboarD project aims to learn whether an online self-help tool can help people with type 2 diabetes learn ways to care for their emotional wellbeing and live more active and healthier lives.
Healthy Thinking Trial: targeting suicidal thoughts
Suicide is the most common cause of death in Australians aged 15-44 and the tenth most common cause of death overall for Australian males. However, many people with suicidal thoughts are reluctant to seek help. The Healthy Thinking trial aims to test the effectiveness of a web-based self-help program for people with suicidal thoughts. The major aim of this study is to determine whether an evidence-based web-based self-help program reduces levels of suicidal thoughts.
A positive psychology app: SPARK is a mobile phone application which identifies people’s values, describes them, and then provides steps to improve one’s life to be consistent with those values. The SPARK positive psychology mobile application, currently in development, will provide easy access to evidence-based techniques and peer encouragement for people experiencing physical and/or psychological symptoms, which lead to psychological distress, social isolation and depression. The tool will help them build their resilience, increase wellbeing, deepen social connections and ultimately transform their lives.
RAFT (Reconnecting AFTer a Suicide Attempt)
The first few days following hospital release after a suicide attempt or deliberate self-harm are critical. However, one third of people presenting to hospital following a suicide attempt will receive no mental health follow up. Research has found that brief contact with patients discharged from hospital, through things like a postcard, letter or phone call, are effective in reducing suicidal behaviour including intentional self-harm or repeated attempts. Some research has seen brief interventions reduce the number of suicide re-attempts by around 50%. However, whether getting in contact with patients using digital communication has yet to be tested. RAFT (Reconnecting AFTer a Suicide Attempt), is assessing whether receiving text messages, is a feasible and effective method to reduce the rate of suicide and self-harm in individuals with a recent hospital-treated episode of deliberate self-harm.
iBobbly is a trial of the world’s first suicide prevention app designed especially for use by Indigenous people on mobile phones or tablet devices. Called iBobbly (a name derived from a Kimberley greeting), the app delivers treatment-based therapy in a culturally relevant way. Based on psychological therapies proven to reduce suicidal thoughts, it draws heavily on Indigenous metaphors, images and stories drawn from local Aboriginal artists and performers. The app format leaps two of the major hurdles to help seeking – perceived stigma and geographical isolation.
This trial assesses the potential for delivery of eMental Health programs in the general population.
In an Australian first, the StepCare clinic is being integrated into general medical practice through Primary Health Networks. Patients are given an iPad when they arrive at the practice as part of the regular welcome procedure and invited to complete a questionnaire on anxiety and depressive symptoms.
The results are sent to the GP, who can then raise them in the consultation and offer patients appropriate management options based on the severity of their symptoms.
Phase one of the trial is now complete, with a broader phase two trial currently underway. View the outcomes of the StepCare phase one trial.
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Adolescent stepped care trial clinic: Designed and delivered in partnership with schools, this online stepped-care service will match psychological care and support with students’ symptom levels. This program will be trialled in 25 schools across NSW and ACT, reaching approximately 12,500 students in total. Early intervention with at-risk youth within the target schools would result in approximately 2,500 young people receiving treatment they otherwise may not have received. It is estimated that the trial could prevent up to 700 of these students developing a more serious mental illness.
The Black Dog Institute offers a suite of e-mental health programs and apps now publicly available following on for research trials. The Institute has also produced a number of policy documents relating to the use and delivery of e-mental health:
1 in 10 Australians report problems with falling, or staying, asleep. Insomnia is both a cause and a symptom of common mental health conditions. The ‘Good Night Study’ was a world-first trial of an online insomnia treatment called ‘SHUTi’. The SHUTi online program provides a combination of sleep hygiene and CBT techniques to target unhelpful thoughts and behaviours, and is personalised so people can track their progress and see where they most need help. The study showed that the SHUTi treatment group experienced significantly reduced insomnia, anxiety and depression, with these improvements persisting for at least 6 months.This app is now publicly available
Black Dog Snapshot
The Black Dog Snapshot mobile phone app is designed to help you to keep track of your mental wellbeing. Designed by researchers at the Black Dog Institute for use among Australian adults, Snapshot is a confidential, password-protected tool that enables you to measure and monitor your mental health and wellbeing.
myCompass is a fully automated, interactive self-help program that is delivered via the Internet to people’s computers, mobile phones and tablet devices. The program provides people experiencing mild-to-moderate symptoms of stress, anxiety and/or depression, with 24/7 access to a private, personalised and evidence-based treatment program.
BITE BACK is the very first online positive psychology program aimed at improving the overall wellbeing and happiness of young Australians between the ages of 12 and 18 years. The key objectives of this program are to encourage young people to become more engaged in all aspects of their lives and, ultimately, to build resilience.
The Institute has also produced a number of policy documents relating to the use and delivery of e-mental health: