How Technology Can Help Student Wellbeing
Using technology to support youth mental healthDr Michael
Carr-GreggChild and Adolescent
Psychologistwww.michaelcarrgregg.com
Been an Apple computer user since 1984
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iPad 3iPadiPad MiniiPad 2
iPad Pro
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For Fathers Day
Around the world Governments are really trying to come to terms
with the idea of mental health being a much bigger community
problem than they previously have recognised. 5
. If we were only going to use traditional forms of therapy than
it would mean that we would all be having to work very, very long
hours. 6
So, governments are looking for ways they can deliver some form
mental health support, information and treatment to much larger
proportions of the population and this is where e-mental health
becomes so important as it can be used in mass delivery
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Can technology be a solution?
More people are using it3 billion people online43% of the worlds
population69% of people on earth will be covered by 3G
broadband
And its getting faster
Around the world31/08/201612
E-mental health is being used:in mass deliverycost effective
very effectivemore accessiblestay in controlprivateEngagingStigma
reducing
Around the world Governments are really trying to come to terms
with the idea of mental health being a much bigger community
problem than they previously have recognised. If we were only going
to use traditional forms of therapy than it would mean that we
would all be having to work very, very long hours. So, governments
are looking for ways they can deliver some form mental health
support, information and treatment to much larger proportions of
the population and this is where e-mental health becomes so
important as it can be used in mass delivery, it can be very cost
effective and very effective. Also helps people overcome some of
the barriers that make it harder for some people to seek help,
accessible, helps people stay in charge of their own work that they
do, it is private and also can be very engaging. Because the
internet is very consumer orientated it can also reduce feelings of
shame and stigma about having a mental health problem.12
Its transforming childhood
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A reconfiguring of Maslowfor young people
`
98% of students have a mobile
94.9% have a smart phone
91.89% of students have downloaded an app
ScreenagersBorn early 2000s
MillenialsBorn 1980-1990
Born early 1960s to early 80sPost WW2 born1946-1964
Why technology matters to young people?Their real world is both
off and onlineIt is how they communicateThey have never known a
world without computersIt provides them with flexibility and
confidentialityRemoves geographical, attitudinal & financial
barriers
The average 18-25 year old
Checks their phone 56 times a dayOnce every 15 minutes
What else do we know?
9 out of 10 teenagers tell us that they are using their phone
while spending quality time with their parents
What else do we know?
7 out of 10 teenagers tell us that they are using their phone
while hanging out with friends
What else do we know?5 out of 10 teenagers tell us that they are
using their phone while eating at restaurants
What else do we know?3 out of 10 teenagers tell us that they are
using their phone while crossing the road
What else do we know?1 out of 10 teenagers tell us that they are
using their phone while having sex
A device weighing 155 gms
Has infiltrated virtually every aspects of their lives
This gives us an unprecedented opportunity to provide real-time,
standardised health and wellbeing information and treatment
directly to young people in their natural environment using their
smartphones
So how might technology help the wellbeing of a young
person?
Meet Georgie
Georgies Hx16 years oldAttends local High SchoolPresents with a
long Hx of anxiety dating back to primary school when she was
bullied by a group of girlsNever really recoveredNow smoking
cannabis on weekends
Georgies developmental tasksIdentity FormationPeersEmancipation
from adult carersSchool/Vocation
Georgies AnxietyShe describes her worry as out of control and
has started to interfere with her life. She often feels fear or
worryShe often cant concentrate because of worry or fearShe often
feels on edge or nervousShe sometimes panics or get upset easily
when nervous
Her symptoms can be short lived, or stay for a long time. It can
cause her to:Become worried or constantly feel something bad is
going to happenOften ask unnecessary questions, or need constant
reassuranceGet upset when a mistake is made, or if there is a
change of routineBe a perfectionist, care too much about things
being just rightBecome irritable or constantly in a bad mood
Common ways anxiety affects herphysicallyHaving dry mouth or
difficulty swallowingExperiencing nightmares, difficulty
sleepingHaving difficulty concentratingExperiencing muscle aches
and pains (especially neck, shoulders, back)Feeling restless, or
trembling and shakingHaving a rapid heart and breathing rate,
sweating, dizziness, headacheFeeling sick nauseous, vomiting, or
having diarrhoea
Diagnosis
How Reach Out can help
CBCL and YSR (Achenbach)
The Centre of Excellence adapted the American HEEADSSS
assessment interview. This included: changing the language to suit
the Australian context extending the domains covered to allow the
detection of more serious mental disorders.
Like 98% ofher friends, Georgie has a smartphone
What are Georgies current issues?
Problem 1. Sleep
SleepThe single most important behavioural experience that we
have is sleepAverage person spends 36% of their life sleeping
Psychoeducation in Sleep
Inform and educate
She gets guidelines
EXPLAINS THE PSYCHOLOGY OF SLEEP VIA A FACT SHEET FROM
ORYGEN57http://oyh.org.au/sites/oyh.org.au/files/factsheets/oyh_sleep_factsheet.pdf
Psychologists can provide some beducation by providing Richard
with:57
Offers Georgie a Prof Russell Foster Ted Talk
App Intervention - Recharge (free)
https://itunes.apple.com/au/app/recharge-move-well-sleep-well/id878026126?mt=8
This is a personalised six-week program that might help Georgie
improve hergeneral health and wellbeing by focusing on four key
areas: Helping her establish a regular wake and sleep time each
day, achieved gradually over six weeks;An alarm clock that triggers
fun activities designed to get Georgie up and out of bed;Increasing
her exposure to daylight early in the day, to help reset his body
clock; and,Encouraging her to increase herphysical activity,
especially within two hours of waking up.
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// RESEARCH program three: user driven and empoweredrecharge
practical tips to improve her sleep/wake routine and
wellbeingGet daily reports to track her mood, energy, exercise and
sleepView graphs to help monitor her progress which can be reviewed
in each session
Recharge starts by asking Richard a few simple questions to set
his personalised program goals, which can be done together with the
psychologist, once Richard consents to trial it. By simply
answering a few questions about his mood, energy, exercise and
sleep, he will receive a daily report that will show him which
goals youve met each day. His progress tracker will help him see
the relationship between his mood, energy, exercise and sleep over
the six-week program.
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Wearable Device/App intervention for her Insomnia: JawboneUP 24
(A$149.95)
https://jawbone.com/up
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SLEEP TRACKING
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Given herinterest in technology, as an adjunct to the beducation
strategy, a good psychological ploy may be to introduce him to a
wearable device, such as Jawbone UP, a slim computer wristband
launched in November 2011 by Jawbone, a privately held audio
technology company headquartered in San Francisco, California. A
Psychologist might start by sending him:A youtube clip that
describes the jawbone UPA blog on how the Jawbone might be used in
therapyThe Jawbone UP is a flexible rubber-coated wristband that
can be purchased at major electrical retailers for A$149.95 (at
time of writing) and requires Richard to download the free
accompanying iPhone or Android app, that allows him to track his
sleep, eating habits, and daily activity including steps taken and
calories burnedRichard can set the device to wake at a particular
time and he will be, woken by a soft vibration on his wrist, timed
to start buzzing at the lightest point in his sleep cycle. He
presses a button on the bracelet to tell it that he is awake, and
immediately plugs it into his iPod, iPhone, or iPad to find out how
well he has slept. After a few seconds, a graph pops up to tell him
how much deep sleep he has had. He logs how he feels by touching a
happy or sad face on his screen. The wristband is water-resistant
and designed to be worn 24/7, with a rechargeable battery that
lasts for up to 10 days at a time. It features a vibration motor
that can be programmed as an alarm to wake users in the best phase
of their natural sleep cycle, or act as a reminder when users have
been sedentary too long. Clients report that there is something
about seeing their stats written down that prompts them to move
more and eat less. The app allows Richard to add teammates much
like a Facebook friend stream, and seems to awaken a competitive
element within them. He can adjust his settings to Tweet his
psychologist, automatically when he reaches a certain goal. There
are some organisations outside of private practice that prohibits
the use of social media and such behavior would be considered a
breach of protocol. This is discussed in greater detail in Module
3.Logging food using the app is easy they can scan the barcode and
the app works out calories, sodium and saturated fat levels. UP is
compatible with other health and fitness apps, including
MyFitnessPal, which has a vast database of existing foods and
allows people to input ingredients from a recipe to get accurate
calories. It also provides a word cloud of their most-eaten meals.
After a month of wearing the UP, Richard may realise that he isnt
sleeping enough no where near the 8.25 to 9.25 hours a night, that
research recommends. The app also delivers daily insights based on
Richards data. At first they are quite generic, but the longer he
wears it the more targeted the suggestions, such as eating pumpkin
seeds before bed to improve his quality of sleep and supplying a
link to a study that explains why.One of the greatest features is
the trends function. It gives two parallel timelines: how much
sleep Richard has had, with how many steps he has taken underneath.
The day he took 25,000 steps he slept the best, with more hours of
deep sleep; when he took only 7,000 steps one day, his sleep was
reduced. Not everyone needs to track how much they move, eat and
sleep indeed for some clients, for instance, those with eating
disorders, this device would be contraindicated. But for the young
people that have high prevalence disorders, such as anxiety and
depression for whom exercise and sleep is part of the recommended
treatment the UP it is a useful adjunct to their treatment. One of
the most useful aspects of the device is that my clients are helped
to realise that they need to invest in their sleep, rather than
just accept feeling tired all the time. This is what UP does best
it forces them to see the things that they already knew werent
quite right.
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Georgie has a jawbone tracker
Light sleepREM sleep
Fitbit dashboard
Georgies Mum is worried about her snoring
Problem 2. Georgies Mum is worried about her not eating
breakfast
Georgie gets directed to a website on breakfast
Problem 3. Eating too much junk food
diets high in processed foods, soft drinks and sweets to an
increased risk of behaviour and emotional problems
What is aMediterranean diet?Eating primarily plant-based foods,
such as fruits and vegetables, whole grains, legumes and nuts.
Replacing butter with healthy fats, such as olive oilUsing herbs
and spices instead of salt to flavour foods.
Problem 4. How do we address her Anxiety?
Georgie is offered a fact sheet
Offered a free, evidence based online treatment program to do on
her own time
What about psychoeducation for Georgies parents?
Georgie is offered a link to a pamphlet from beyondblue for her
parents
How do we deal with Georgies panic attacks?
Georgie is offered an app to help her deal with her panic
attacks
Georgie is invited to do someevidence based online treatment
Georgie is offered an app that uses ACT to help deal with her
anxiety
Solution: Mindfulness
88Georgie is offered an app that helps with stress
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New website
Georgie can download the app
A study at UCLA showed that students who participated in an
8-week mindfulness course showed significantly lower levels of
stress in comparison to a control group. This same research group
also found that participating in a mindfulness course enhances
concentration, cognitive flexibility, attention, empathy and
self-awarenessIt boosts levels of happiness and lowers the impact
of stress It increases your ability to focus your attention and
improves your memory It makes you less sensitive to pain and boosts
your immune system, making you less prone to getting ill. It makes
it easier for you to fall asleep peacefully.
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Lovely ambassadors
8 week mindfulness course - 27 minutes per dayMassachusetts
General HospitalMRI scans documented how meditation produced
massive changes inside the brains gray matterA major increase in
gray matter density in the hippocampusDecreased gray-matter density
in the amygdala
Gets info on mindfulness
The Pip is a biosensor. Its breakthrough technology measures
stress reactions at the skin level electrodermal activity and sends
data to your smart device. That data feeds into thePip Apps, which,
using biofeedback, helps your mind learn how to manage
stress.94
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eSense Skin Response is a small sensor to measure Lucys skin
conductance using the microphone input of her smartphone or tablet
(Android or Apple iOS.) The Psychologist explains to Lucy that skin
conductance depends directly on her state of relaxation or stress,
making it a commonly used and very precise stress indicator. With
the eSense Skin Response, Lucy can precisely identify her stress
level and reduce it with biofeedback training.
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measurement curves, video display
The eSense app provides Lucy with feedback about her momentary
stress levels, e.g. with measurement curves, video display and
audio feedback features. For the audio biofeedback, the eSense has
a headphone jack, so she can listen to meditation music or a guided
mindfulness exercise while training her stress level down! The app
for eSense is free, and allows exporting the measured data via
e-mail. With the aid of a computer, physiological processes which
are otherwise difficult or impossible to perceive, are registered
and thus made manifest and visible.
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http://www.thinkmelon.com100
An activity monitor for your brain that teaches you about
cognitive performance.Turn the invisible activity of your mind
visible! Melon's brainwave monitoring (EEG) headband listens to the
electrical activity naturally given off by your brain. Using
Bluetooth 4.0LE, Melon wirelessly connects to your phone to help
you track and train themental state of focus. The headband is
adjustable in the back to fit most people(ages 10+).100
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Solution Increase Exercise not getting 10,000 steps
Georgie gets a fact sheet on exercise
104Georgie is offered an app that helps with exercise
Couch to 5K Running App ($1.99), is a program that's been
designed to help Richard progress from minimal exercise to running
5 kilometers or 30 minutes in just 9 weeks. Given Richards interest
in technology and a stated desire to get fit, this app may be very
useful for him. It is a gentle introduction to getting his body
moving, starting off alternating between walking and running small
distances, and slowly building up until after 8 weeks, when Richard
will be ready to run 5 kilometers or 30 minutes non stop. Once fit
he can set himself goals and track progress on walking, running,
swimming, cycling. The key to success is to encourage Richard to
ease into his 5K training plan gradually. In fact, the beginners'
program is less of a running regimen than a walking and jogging
program.
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Each session should take Richard about 20 or 30 minutes, three
times a week. That just happens to be the same amount of moderate
exercise recommended by numerous studies for optimum fitness.
Richard needs to space out these three days throughout the week to
give him a chance to rest and recover between efforts. Richard
needs to precede each training session with a five-minute warm up
walk or jog. Being sure to stretch both before and after the
sessions. The apps designers provide a fact sheet on stretching
called "Stay Loose"
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Georgie gets an encouraging message when she has completed a
session or week of 3 sessions
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an ultra-immersive running game and audio adventureEvery run
becomes a mission where youre the hero, with our immersive audio
drama putting you at the centre of your very own zombie adventure
story. While you run to the perfect mix of heart-pumping audio
drama and pulse-pounding songs from your own playlist, youll
collect supplies to grow your base back home.
Problem 7. Georgie is worried about a friend
Georgie is offered an app to help her approach her friend
Problem 8. Georgie wants to cut down her cannabis use
Problem 9. Georgies relationship breaks up
Georgie is offered an app that helps her cope
Problem 10. Georgies mate is self harming
119been developed by mental health nursesoffers alternatives to
deliberate self harm. Practical easy steps to distract, displace
and seek help, all at the touch of a button and with you at all
times
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Georgie decides to get some counseling
She is offered a smorgasbord of choices
She is offered a smorgasbord of choices
She is offered a smorgasbord of choices
She is offered a smorgasbord of choices
Visit local General Practitioner
She is offered a smorgasbord of choicesVisit a local headspace
centre
School Counseling Service
Georgie has suicidal thoughts
Gets a digital safety plan
Georgie gets some medication
An app to help her remember her medication
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http://www.pillboxie.com
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Questions and Thanks
