Prevention of mental health disorders in young people
Adolescence can be a difficult time for many young people. It is seen as a crucial period for intervention as 75% of mental health problems emerge before the age of 25 years. Led by Scientia Professor Helen Christensen, the Black Dog Institute is focused on developing ways to prevent the onset of mental illness in young people. Prevention targeted at the right time can help to stop young people from experiencing episodes of both depression and bipolar disorder. To engage adolescents, our prevention work often utilises web-based technology and mobile apps.
Why focus on prevention and treatment in youth?
Depression and anxiety affects the lives of many young Australians; annually one in six experiences an anxiety disorder and one in 16 experiences depression. These illnesses lower the quality of life of young people and their families, increase the risk of suicide and worsen the outcomes of other physical or mental health problems. Adolescence can be a difficult time for many young people. Amongst the many pressures experienced by teens, final exams are considered to be among the most stressful. We know that stress can trigger underlying vulnerabilities that can result in mental illness such as depression. Indeed, more than 40% of Year 12 students report symptoms of depression, anxiety and stress that fall outside what is considered the normal range for this age group.
This program aims to deliver prevention programs through games, apps and websites, and to bring together information from social media, self report and pervasive devices to develop a rich data set for the future. The school is an ideal environment to deliver prevention programs at appropriate transitions and for that reason, many of our programs are delivered in the school setting.
Targeting young people’s sleep to prevent depression
Dr Aliza Werner-Seidler is developing an app aimed at preventing depression in adolescents through targeting sleep. Adequate sleep is critical for adolescent health and development, yet teenagers seldom get enough of it. In 2015, researchers at Black Dog Institute concluded that delivering an online program to adults with insomnia prevented the onset of a major depressive episode. This was the first study to show that targeting sleep difficulties could prevent depressive episodes.
The research team are now using this idea to develop a novel mobile phone app for at-risk adolescents, delivered in the school setting. With approximately 90% of Australian teenagers now owning a mobile phone, a sleep program delivered via a mobile app is likely to engage and appeal to young people.
The research team has been working with young people to find out what features they would like to see in an app designed to improve their sleep. This feedback will be integrated together with core strategies that are known to work to improve sleep to develop and test this innovative approach.
Smooth Sailing: Stepped care online adolescent clinic
Dr Bridianne O’Dea is currently trialling an online stepped care clinic for adolescents, delivered in the school setting. The Smooth Sailing project is a novel approach that will enable detection of anxiety and depression symptoms, whilst delivering treatment in a stepped care fashion. This approach will allow treatment to be tailored to meet the adolescent’s symptom severity and provide ongoing monitoring should more intensive treatment be needed or likewise, less intensive treatment be needed when symptoms have improved.
Sources of Strength project: help-seeking for suicidality in adolescents
This trial led by Dr Alison Calear is investigating the effect of the Sources of Strength program on help-seeking for suicidality in adolescents. The universal Sources of Strength peer leadership program takes a social connectedness approach to improving help-seeking for suicide and general psychological distress. The program will be run in ACT and NSW high schools.
Staying Connected trial
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. Following a 3-5 year development and trial period to ensure clinical efficacy, this app could improve, and potentially save, the lives of up to 400,000 Australians per year. Bluetooth will enable young people, and possibly their clinicians or carers, to detect the quality and quantity of social interactions in the real world and monitor when these may change in real time. This information enables users to recognise social isolation as it occurs. It also enables the delivery of a stepped care system where friends and family are encouraged and empowered to make contact and users are directed to seek clinical help as required.
The TriPoD project
This Trial for the Prevention of Depression (TriPoD) investigated the effectiveness of a universal prevention intervention for Major Depression Disorder (MDD) in adolescence prior to a major stressor, in this case prior to the Higher School Certificate (HSC). The trial was conducted with students in 30 schools across New South Wales (NSW). The schools were randomly allocated to receive an online, automated, preventative Cognitive Behavioural Therapy (CBT) program or an online control program focused on health and wellbeing. The results of this trial are now being analysed to see how effective this project was.
Following on from research trials, the Black Dog Institute a suite of youth specific e-mental health programs and apps are now publicly available:
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.
HeadStrong is an evidence-based online resource, linked to the Health and Physical Education curriculum, and designed for teachers to teach their students about depression, mental health and resilience.