Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health Professionals
BackgroundHospitals are insufficiently resourced to appropriately support young people who present with suicidal crises. Digital mental health innovations have the potential to provide cost-effective models of care to address this service gap and improve care experiences for...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-11-01
|
| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2023/1/e51398 |
| _version_ | 1827761338587283456 |
|---|---|
| author | Demee Rheinberger Rachel Baffsky Lauren McGillivray Isabel Zbukvic Ann Dadich Mark Erik Larsen Ping-I Lin Daniel Z Q Gan Catherine Kaplun Holly C Wilcox Valsamma Eapen Paul M Middleton Michelle Torok |
| author_facet | Demee Rheinberger Rachel Baffsky Lauren McGillivray Isabel Zbukvic Ann Dadich Mark Erik Larsen Ping-I Lin Daniel Z Q Gan Catherine Kaplun Holly C Wilcox Valsamma Eapen Paul M Middleton Michelle Torok |
| author_sort | Demee Rheinberger |
| collection | DOAJ |
| description |
BackgroundHospitals are insufficiently resourced to appropriately support young people who present with suicidal crises. Digital mental health innovations have the potential to provide cost-effective models of care to address this service gap and improve care experiences for young people. However, little is currently known about whether digital innovations are feasible to integrate into complex hospital settings or how they should be introduced for sustainability.
ObjectiveThis qualitative study explored the potential benefits, barriers, and collective action required for integrating digital therapeutics for the management of suicidal distress in youth into routine hospital practice. Addressing these knowledge gaps is a critical first step in designing digital innovations and implementation strategies that enable uptake and integration.
MethodsWe conducted a series of semistructured interviews with young people who had presented to an Australian hospital for a suicide crisis in the previous 12 months and hospital staff who interacted with these young people. Participants were recruited from the community nationally via social media advertisements on the web. Interviews were conducted individually, and participants were reimbursed for their time. Using the Normalization Process Theory framework, we developed an interview guide to clarify the processes and conditions that influence whether and how an innovation becomes part of routine practice in complex health systems.
ResultsAnalysis of 29 interviews (n=17, 59% young people and n=12, 41% hospital staff) yielded 4 themes that were mapped onto 3 Normalization Process Theory constructs related to coherence building, cognitive participation, and collective action. Overall, digital innovations were seen as a beneficial complement to but not a substitute for in-person clinical services. The timing of delivery was important, with the agreement that digital therapeutics could be provided to patients while they were waiting to be assessed or shortly before discharge. Staff training to increase digital literacy was considered key to implementation, but there were mixed views on the level of staff assistance needed to support young people in engaging with digital innovations. Improving access to technological devices and internet connectivity, increasing staff motivation to facilitate the use of the digital therapeutic, and allowing patients autonomy over the use of the digital therapeutic were identified as other factors critical to integration.
ConclusionsIntegrating digital innovations into current models of patient care for young people presenting to hospital in acute suicide crises is challenging because of several existing resource, logistical, and technical barriers. Scoping the appropriateness of new innovations with relevant key stakeholders as early as possible in the development process should be prioritized as the best opportunity to preemptively identify and address barriers to implementation. |
| first_indexed | 2024-03-11T10:10:32Z |
| format | Article |
| id | doaj.art-13cc0063f01841c5a66ed5816811ccf3 |
| institution | Directory Open Access Journal |
| issn | 2561-326X |
| language | English |
| last_indexed | 2024-03-11T10:10:32Z |
| publishDate | 2023-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj.art-13cc0063f01841c5a66ed5816811ccf32023-11-16T14:31:35ZengJMIR PublicationsJMIR Formative Research2561-326X2023-11-017e5139810.2196/51398Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health ProfessionalsDemee Rheinbergerhttps://orcid.org/0000-0002-4493-8565Rachel Baffskyhttps://orcid.org/0000-0001-7679-0617Lauren McGillivrayhttps://orcid.org/0000-0001-9022-0274Isabel Zbukvichttps://orcid.org/0000-0002-6816-1199Ann Dadichhttps://orcid.org/0000-0001-5767-1794Mark Erik Larsenhttps://orcid.org/0000-0002-0272-2053Ping-I Linhttps://orcid.org/0000-0002-9739-7184Daniel Z Q Ganhttps://orcid.org/0000-0002-3788-5848Catherine Kaplunhttps://orcid.org/0000-0002-8601-3587Holly C Wilcoxhttps://orcid.org/0000-0003-2624-0654Valsamma Eapenhttps://orcid.org/0000-0001-6296-8306Paul M Middletonhttps://orcid.org/0000-0003-0760-1098Michelle Torokhttps://orcid.org/0000-0003-3741-8075 BackgroundHospitals are insufficiently resourced to appropriately support young people who present with suicidal crises. Digital mental health innovations have the potential to provide cost-effective models of care to address this service gap and improve care experiences for young people. However, little is currently known about whether digital innovations are feasible to integrate into complex hospital settings or how they should be introduced for sustainability. ObjectiveThis qualitative study explored the potential benefits, barriers, and collective action required for integrating digital therapeutics for the management of suicidal distress in youth into routine hospital practice. Addressing these knowledge gaps is a critical first step in designing digital innovations and implementation strategies that enable uptake and integration. MethodsWe conducted a series of semistructured interviews with young people who had presented to an Australian hospital for a suicide crisis in the previous 12 months and hospital staff who interacted with these young people. Participants were recruited from the community nationally via social media advertisements on the web. Interviews were conducted individually, and participants were reimbursed for their time. Using the Normalization Process Theory framework, we developed an interview guide to clarify the processes and conditions that influence whether and how an innovation becomes part of routine practice in complex health systems. ResultsAnalysis of 29 interviews (n=17, 59% young people and n=12, 41% hospital staff) yielded 4 themes that were mapped onto 3 Normalization Process Theory constructs related to coherence building, cognitive participation, and collective action. Overall, digital innovations were seen as a beneficial complement to but not a substitute for in-person clinical services. The timing of delivery was important, with the agreement that digital therapeutics could be provided to patients while they were waiting to be assessed or shortly before discharge. Staff training to increase digital literacy was considered key to implementation, but there were mixed views on the level of staff assistance needed to support young people in engaging with digital innovations. Improving access to technological devices and internet connectivity, increasing staff motivation to facilitate the use of the digital therapeutic, and allowing patients autonomy over the use of the digital therapeutic were identified as other factors critical to integration. ConclusionsIntegrating digital innovations into current models of patient care for young people presenting to hospital in acute suicide crises is challenging because of several existing resource, logistical, and technical barriers. Scoping the appropriateness of new innovations with relevant key stakeholders as early as possible in the development process should be prioritized as the best opportunity to preemptively identify and address barriers to implementation.https://formative.jmir.org/2023/1/e51398 |
| spellingShingle | Demee Rheinberger Rachel Baffsky Lauren McGillivray Isabel Zbukvic Ann Dadich Mark Erik Larsen Ping-I Lin Daniel Z Q Gan Catherine Kaplun Holly C Wilcox Valsamma Eapen Paul M Middleton Michelle Torok Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health Professionals JMIR Formative Research |
| title | Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health Professionals |
| title_full | Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health Professionals |
| title_fullStr | Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health Professionals |
| title_full_unstemmed | Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health Professionals |
| title_short | Examining the Feasibility of Implementing Digital Mental Health Innovations Into Hospitals to Support Youth in Suicide Crisis: Interview Study With Young People and Health Professionals |
| title_sort | examining the feasibility of implementing digital mental health innovations into hospitals to support youth in suicide crisis interview study with young people and health professionals |
| url | https://formative.jmir.org/2023/1/e51398 |
| work_keys_str_mv | AT demeerheinberger examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT rachelbaffsky examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT laurenmcgillivray examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT isabelzbukvic examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT anndadich examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT markeriklarsen examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT pingilin examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT danielzqgan examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT catherinekaplun examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT hollycwilcox examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT valsammaeapen examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT paulmmiddleton examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals AT michelletorok examiningthefeasibilityofimplementingdigitalmentalhealthinnovationsintohospitalstosupportyouthinsuicidecrisisinterviewstudywithyoungpeopleandhealthprofessionals |