Exploring design and implementation of technologies with rural mental health consumers and professionals

Author: Simone Orlowski

Orlowski, Simone, 2016 Exploring design and implementation of technologies with rural mental health consumers and professionals, Flinders University, School of Medicine

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Abstract

Young people (aged 16-24) are most at risk of developing mental illness; yet they under-utilise mental health services. Greater use of new and existing technologies is projected to play a significant role in the Australian mental health system into the future, with the aim of improving engagement in care and care systems. This research program has investigated the question: What are the scope and roles of technologies within rural, community-based youth mental health services? The research privileged end user perspectives and applied and investigated participatory design-based (PD) methods for their capacity to improve technology design and implementation to this context. Of principal interest were technologies used by mental health professionals and young people that assist with improving consumer engagement and support, along with navigation of the mental health system (ESN technologies). In the first instance, a systematic review was conducted to investigate ways in which participatory methodologies have been applied to develop technology-based youth mental health and well-being interventions. Results indicated that participatory methodologies are not well understood within this area of research, with impacts on intervention effectiveness unknown and lack of implementation following piloting. The review confirmed that consumer participation was predominantly consultative and consumerist in nature. Hence, the current research further explored the potential role of user-focussed, design-based methods in the design and implementation of technologies in mental health contexts. Building on the review, a detailed case study was conducted in one rural region in South Australia. Initially, a two-part scoping study was conducted to obtain in-depth end user perspectives (i.e. those of mental health professionals and consumers) around the role of ESN technologies in facilitating traditional mental health care. For a range of reasons, mental health professionals and youth consumers were ambivalent around use of technology to facilitate that care. End users, along with organisational and systematic factors were then investigated via an observational study. The results of that study positioned mental health work in rural community-based settings as contested, multifaceted and underpinned by an individualised and empowerment care focus. The participating services were conceptualised as operating within the larger, complex mental health system; this conceptualisation highlighted widespread and multilayered considerations and consequences for the design and implementation of any technology. Finally, a series of participatory workshops were conducted with mental health professionals and young people; they aimed to define domain criteria associated with mental health care. Through this research, self-directed and potentially narrative-redefining technologies were found to be philosophically aligned with community-based youth mental health service provision. Overall, this research outlined positive contributions that technology could make to the experience of current and future mental health help-seeking and service provision. It also outlined a range of consumer and workforce barriers that continue to influence the limited uptake of technologies to facilitate youth mental health care. This research has demonstrated application of PD to the investigation of the conditions and conflicts that characterise the context of technology use as opposed to the design of products within the context of youth mental health care.

Keywords: Youth mental health; Participatory Design; Technology, Rural
Subject: Medicine thesis

Thesis type: Doctor of Philosophy
Completed: 2016
School: School of Medicine
Supervisor: Professor Sharon Lawn