By Mark Brown - Digital technology, most often pictured in the form of the ubiquitous smartphone, is being spoken of both as the destroyer of young people’s mental health and its potential saviour. We’ve noticed young people are always on their phones; we’ve noticed that more of them are becoming unhappy and unwell and we’ve put the two together.
As far as people writing letters to broadsheet newspapers are concerned, these devices are have brought about a calamity for young people and their mental health, a view exemplified by Gary Turk’s 2014 ultra-twee viral hit video ‘Look Up’. But what if we stopped saying ‘get off your phones youngsters and you’ll be better’ and asked how they could be used to improve young people’s mental health, too?
Was it better before the internet?
The argument that things were better in pre internet days for young people is one that has a lot of popular support. On 12th June, Children's Commissioner for England Anne Longfield told The Telegraph newspaper "The internet is set up to be addictive. All of the algorithms on it are silently working there to keep us addicted... It’s smartly set up to keep us dependent and part of what I hope to see in the next phase is to break that dependency so that children have the chance to make positive, informed choices about what they do when they are on it." Her sentiments were echoes By Sir Simon Stevens, Chief Executive of NHS England, later the same week.
There is a lot of support for the argument that things were better before the internet
Digital is attractive
If you're a young person looking for help around your mental health, or someone who cares about a young person who is going through hard times, the gap between realising you might have a problem and actually getting access to something that might help via the NHS can be long and difficult. This is where digital services step in. There are a number of advantages to digital services for young people’s mental health. They can be accessed quickly. They provide privacy. They are something that can be used in ways and at times that are convenient for the young person in question. They can provide choice where choice might not otherwise be available.
Digital services are attractive for young people to close the help gap
Secretary of State for Health Jeremy Hunt is a digital enthusiast and believes technology will make the next decade of the NHS the “patient power” decade. Young people’s mental health apps were some of the first apps approved by the relaunched NHS apps library, with 13 approved mental health-related apps out of a total of 49. It is fairly certain the newly agreed NHS spending increase will include some form of digital service for young people’s mental health.
The three things apps can do for young people's mental health
Despite a huge range of available apps and websites focusing on supporting young people's mental health at present there are very few that offer novel and evidence supported therapeutic or medical interventions based on a specific function that has been proven to be effective. Most cluster around changing behaviour rather than tackling symptoms.
There are really only three things that apps to support young people's mental health can do. The first is that an app can help a young person to track how their mental health affects them. This might in the form of a mood diary, or an app that tracks other things such a physical activity and relates it to their mental health. Sometimes apps like this can also be linked with encouragement to carried out specified actions or to avoid others through the introduction of reward mechanisms.
The second common from of young person's mental health is intended to help a young person learn new things. At the most basic, an app might deliver information about a particular condition or situation in a more interactive way than printed materials. Given how much we love them, it's far less likely that we'll lose or forget our phone than it is a leaflet or a book. An app, for example, might introduce different forms of breathing exercise and then guide the user through trying them out.
The third thing that an app can help a young person do is to mitigate the effect their mental health difficulty has upon them by providing real time interventions or activities that alter the moment. Examples of this might be applications specifically designed for use when a young person feels their anxiety rising or applications that are intended to be used as distractions when particular feelings or desires become overwhelming.
Know what you want to change
If you are a young person, or someone who cares about one, the single most important factor in choosing an application is knowing what it is you want to happen. The technology won’t work if it’s trying to get you to do something you really don't want or isn’t providing you with sufficient incentive or is as irritating as a stone in your shoe or a fly in your bedroom. Persuasive design works with you, but it can’t completely change your behaviour. Key for any process of finding something that might work is doing your homework and being prepared to try a number of different apps until you find the right one. Mental health change is hard and apps can’t do all of the difficult work for someone. They’re helpers, not saviours. And the current generation of apps, with a few exceptions, aren’t quite as good as they could be. Embracing the potential while being critical of what is already here will help close this gap.
Technology won't work if you don't want it to. Apps are helpers, not saviours.
Any mental health app on your phone or tablet or online is in competition with everything else you could be doing looking at your screen. The best ones work when they understand that and make themselves fit around this reality. They don’t try to be there all the time, or to take up huge amounts of screentime, or becoming an all-singing, all-dancing replacement for other online or digital activity. They are useful, do something a young person wants them to do at times and they do it in ways that feel comfortable.
Supping with the devil
To get apps and online experiences that really make young people’s mental health better will take embracing the best of what social media platforms can teach us in terms of design and persuasion and putting it to a purpose that builds better mental health rather than erodes it. For those who identify the coming of smartphones as the beginning of the mental health crisis for young people this will seem like supping with the devil.
Telling young people to get offline for the sake of their mental health is ignoring the promise of digital apps to improve mental health
Being ‘online’ is an increasingly meaningless concept as smartphones make accessing apps and services that use the internet an ‘always on’ experience. Smartphones specifically bring online and offline together, mixing the two. To an outsider, a young person on the phone will just look like a young person on their phone. Telling them to ‘turn it off and go do something less boring instead’ might be ignoring the potential for this tiny powerful computer to actually make a positive difference to their mental health. Even if they’re on social media, too.
Mark Brown is a guest-blogger for Minddistrict, blogs at thenewmentalhealth.org and was the editor of mental health magazine One in Four.