Co-developing a mobile application with young service users

Hertfordshire and Worcestershire Health and Care NHS Trust delivers a range of community physical health, community mental health, and learning disability services across Worcestershire and Hertfordshire. It also provides inpatient services for medical and adult mental health and older adult mental health patients, and some specialist services which extend beyond Worcestershire.

Feedback from young people involved in Children and Young People Mental Health Services (CYPMHS) at the Trust identified a need to support mental health needs through enhanced use of digital technology. This need has been observed nationally, as well as within Worcestershire.

Situation

CYPMHS service users and members of Youth Board have for some time highlighted that, while online resources for young people with mental health needs are increasing, many have been designed by adults on behalf of young people and as such, are not always engaging or user-focussed.

Moreover, where the NHS have used IT for patient care, young people feel that the technology is not comparable with technology they use in their daily lives, particularly in terms of gaming and social media. This presented an opportunity for the Trust to optimise the therapy journey through the use of technology.

Aspiration

The Trust sought to improve engagement of young people with mental health services by involving them in producing a safe digital space where they could find safe and evidence-based information about mental health, track their emotional wellbeing and interact with other users and mental health professionals. They anticipated that this would positively impact emotional wellbeing and mental health of young people while reducing exposure to more harmful social media platforms.

Solution and impact

The Youth Board was involved in an initial project to develop a proposed app, which involved using familiar computing and/or gaming technology to deliver information about mental health. This project became the development of the product ‘BESTIE’ (Balance, Energy, Support, Thrive, Interactive, Evolve).

Benefits and outcomes include:

• building emotional resilience in children and young people:
  • psychoeducation - improved awareness, reflection and understanding of own mental health needs and ways of managing these needs
  • sharing own recovery stories (including the positive impact on mental health)
• generalisation of skills:
  • being able to use skills learned in CYPMHS in real-world settings
• engagement and motivation:
  • engaging in the clinical therapy, including in between sessions
  • the ability to connect with clinicians and young people in safe, online group settings
• improved clinical outcomes recorded in CYPMHS
• improved self-reported self-esteem

Functionality

• Bestie is an application that can be accessed on mobile and web devices.

Capabilities

• Games - users can play when in need of distractions and engagement
• Information hubs - includes safe and evidence-based self-help information and information about local CYPMHS including virtual reality (VR) tours of the building so users can visualise what it it like to use services in-person
• Social and groups - clinicians can invite young people to engage in online clinical groups
• CYPMHS Extras - includes an urgent help function and suggestions of activities and games with which users can engage
• Tracking emotions, wellbeing and goals - users can note their moods and goals to see changes over time
• Diaries - online journal function for users, linked to their emotion tracking
• Personal space - users each have personal online environments they can adapt and change as desired, including saving their favourite self-help information
• Dress and wardrobe - users can dress and personalise their avatars

Scope

Mobile technology to be used in a home or school setting as well as in other real-life environments.

Key learning points

Governance

The Trust decided to involve their Trust information governance (IG) lead in every step of the development and testing so that any issues relating to security, patient confidentiality and IG were subject to early detection.

Regular reviews and discussion around IG compliance would be required in preparation for the second app rollout. Key factors are that the second app would involve the extraction, storage and sharing of clinical data.

Service user involvement in the design

Young people helped the groups to understand that the avatars would need to be tailored to a wider range of needs (including changeable body size, given some of the difficulties young people experience with body image, and also gender neutral avatars). Their suggestions were fed back to the developers, so that when creating an avatar the product would ensure inclusiveness for all users.

They decided to include recorded VR images in the app so that service users were able to familiarise themselves with the clinical sites and locations before they attended, to help reduce levels of stress which are often experienced.

The development of Bestie relied on a wide range of expert views (including those of the young people involved). While this required a clearer project plan with tighter co-ordination of those people, it allowed the participative nature of the project to be realised.

Find out more

Find out more about Bestie

Read more about the GDE blueprint here (requires login)

Key contact

Dr. Ben Rogers, consultant clinical psychologist, Trust lead for psychological interventions, clinical safety officer

benjaminrogers@nhs.net

Lesley Bennett, IT project manager

Lesley.bennett11@nhs.net

Steve Johnson, Wupwoo Ltd

steve@wupwoo.com