Towards the diversification of drivers and barriers for the adoption of eMental health by professionals: a conceptual model

Introduction: The Internet and mediated communication technologies offer major opportunities in supporting mental healthcare, and evidence for the effectiveness of eMental health is growing. However, their acceptance and use in clinical practice remains low. Material & methods: The current study deployed a qualitative descriptive approach to gain structured insight into the experienced drivers and barriers to adoption of eMental health from the perspective of clinical psychologists. Results: Multiple drivers and barriers emerged from the analysis of the data, several of which are new to the literature. Importantly, particular drivers and barriers are experienced differently by practitioners depending on the extent to which they have adopted online treatment. Based on these findings, we constructed the Levels of Adoption of eMental Health (LAMH) model, which distinguishes several categories of adoption of eMental health, and characterizes experienced drivers and barriers as a function of them. The LAMH model was then supported through a communicative validation. Conclusion: The LAMH model provides a more structured understanding of the process of adopting eMental health, thereby facilitating future research on this topic, and informs targeted recommendations with respect to technology, training and clinical practice that take into account the individual level of adoption

Enriching Everyday Lived Experiences in Dementia Care

Research in HCI is increasingly investigating the role of technology in supporting meaningful and social activities to enhance the lived experiences of people with dementia. However, to further enrich the daily experiences in care, more insight is needed into how technology can directly promote social participation and pleasurable experiences in everyday care situations. This paper discusses the deployment of VITA and SAM: two research products that address the social and emotional needs of residents in day-to-day dementia care. We report how both products offered aesthetic and sensory enrichment, created new experiences in the everyday, and were integrated into the care environment. Furthermore, we identify implications for design to provide: 1) aesthetics in care, 2) authentic experiences, 3) reinforcing everyday life, and 4) community-driven use in practice. We contribute to existing research by demonstrating how technology for dementia care can transcend instrumental use and culminate in warm-felt everyday experiences

The design of a game-based training environment to enhance health care professionals’ skills in using eMental health: study protocol for the user requirements analysis

Background: eMental health (EMH) offers various possibilities for mental healthcare delivery, with many studies demonstrating its clinical efficacy. However, the uptake of EMH technologies by mental healthcare professionals remains low. One of the reasons for this is the lack of knowledge and skills in using these technologies. Skill enhancement by means of serious gaming has shown to be effective in other areas already, but has not yet been applied to developing EMH skills of mental healthcare professionals. Objective: The objective of this paper is to describe the study protocol for the user requirements analysis for the design of a game-based training environment for mental healthcare professionals to enhance their skills in EMH. Methods: The user requirements will be formulated using three complementary outputs: personas (lively descriptions of potential users), scenarios (situations that require EMH skills), and prerequisites (required technical and organizational conditions). Data is collected by a questionnaire, co-design sessions, and interviews. The questionnaire is used to determine mental healthcare professionals’ characteristics, attitudes and skill levels regarding EMH and is distributed among mental healthcare professionals in the Netherlands. This leads to a number of recognizable (sub) user groups and forms the basis for the personas. Co-design sessions with mental healthcare professionals are used to further specify the personas and to identify different user scenarios for the game-based training environment. Interviews with mental healthcare professionals will help determine the preferences of mental healthcare professionals regarding training in EMH, as well as the technical and organizational conditions required for the prospective game-based training environment to be used in practice. This combination of requirements elicitation methods allows for a good representation of the target population in terms of both a broad view of user needs (through the large N questionnaire) as well as an in-depth understanding of specific design requirements (through interviews and co-design). Results: The questionnaire has been distributed and has been filled in by 432 respondents. Two co-design sessions with mental healthcare professionals and 17 interviews have also taken place. The data is currently being analyzed, which is expected to be finalized in the first half of 2020. Conclusions: To develop an environment that can effectively support professionals’ EMH skill development, it is important to offer training possibilities that address the specific needs of mental healthcare professionals. The approach as described in this protocol incorporates the elements that enable the design of a playful training environment that is user-driven and flexible, at the same time considering the technical and organizational prerequisites that influence its implementation in practice

Serious games for professional skills: an escape room for exploring the possibilities of eMental Health

BackgroundDespite a growing body of evidence in support of the benefits of eMental Health (EMH), its actual use among mental healthcare professionals remains relatively low. Reviews on this topic found that the adoption by professionals is negatively influenced by limitations in their skills, abilities, and experiences with EMH. To overcome these limitations, a possible approach is to apply gaming techniques in training skills and abilities. Gaming techniques are a powerful means to provide hands-on experiences in a safe and social environment, and increase engagement in skill enhancement. This supports professionals in exploring EMH in a meaningful setting which would be difficult and potentially problematic in genuine therapeutic settings.In our project we aim to design a game-based environment for mental health care professionals, anticipating required EMH skills in modern therapeutic settings. Extensive research into the context and needs of mental healthcare professionals informed the design of an escape room scenario. An escape room is a game in which participants find themselves in a story line and have to solve puzzles within a limited amount of time. An escape room scenario offers the possibility to design story lines that reflect the real therapeutic settings of mental healthcare professionals.GoalsIn the workshop we aim to present the developed escape room scenario by providing the attendants a hands-on opportunity to experience and evaluate elements of the escape room scenario. Having thispossibility to really ‘play’ parts of the escape room makes this workshop very interactive and increases participants’ awareness of the possibilities of EMH. In addition, it introduces them to using an escape room as a new concept for skill enhancement.Content and (interactive) activitiesIn the workshop we will first introduce our escape room scenario and underlying rationale for the design choices. Following this, we will have an interactive part where the attendants have the opportunity to work in small groups to work on a number of escape room puzzles.We will end the workshop with a short reflection on the experiences and a discussion on the applicability of an escape room for the purpose of exploring and experiencing EMH.Due to the content of the escape room puzzles, this will be a Dutch only session.Expertise of workshop leader(s)The workshop will be led by Joyce Bierbooms and Milou Feijt. Joyce Bierbooms is a senior researcher at Tilburg University, currently leading a postdoc research into the possibilities of serious games to enhance mental healthcare professionals’ skills in using EMH. Milou Feijt is a PhD student at TU/e and has done extensive research into the adoption of EMH among mental healthcare professionals. She is currently focusing on the development of a measurement instrument to assess professionals’ adoption of EMH, and the exploration of novel technologies to support empathic interactions in EM

Serious games for professional skills: an escape room for exploring the possibilities of eMental Health

Background Despite a growing body of evidence in support of the benefits of eMental Health (EMH), its actual use among mental healthcare professionals remains relatively low. Reviews on this topic found that the adoption by professionals is negatively influenced by limitations in their skills, abilities, and experiences with EMH. To overcome these limitations, a possible approach is to apply gaming techniques in training skills and abilities. Gaming techniques are a powerful means to provide hands-on experiences in a safe and social environment, and increase engagement in skill enhancement. This supports professionals in exploring EMH in a meaningful setting which would be difficult and potentially problematic in genuine therapeutic settings.In our project we aim to design a game-based environment for mental health care professionals, anticipating required EMH skills in modern therapeutic settings. Extensive research into the context and needs of mental healthcare professionals informed the design of an escape room scenario. An escape room is a game in which participants find themselves in a story line and have to solve puzzles within a limited amount of time. An escape room scenario offers the possibility to design story lines that reflect the real therapeutic settings of mental healthcare professionals. Goals In the workshop we aim to present the developed escape room scenario by providing the attendants a hands-on opportunity to experience and evaluate elements of the escape room scenario. Having thispossibility to really ‘play’ parts of the escape room makes this workshop very interactive and increases participants’ awareness of the possibilities of EMH. In addition, it introduces them to using an escape room as a new concept for skill enhancement. Content and (interactive) activities In the workshop we will first introduce our escape room scenario and underlying rationale for the design choices. Following this, we will have an interactive part where the attendants have the opportunity to work in small groups to work on a number of escape room puzzles.We will end the workshop with a short reflection on the experiences and a discussion on the applicability of an escape room for the purpose of exploring and experiencing EMH.Due to the content of the escape room puzzles, this will be a Dutch only session. Expertise of workshop leader(s) The workshop will be led by Joyce Bierbooms and Milou Feijt. Joyce Bierbooms is a senior researcher at Tilburg University, currently leading a postdoc research into the possibilities of serious games to enhance mental healthcare professionals’ skills in using EMH. Milou Feijt is a PhD student at TU/e and has done extensive research into the adoption of EMH among mental healthcare professionals. She is currently focusing on the development of a measurement instrument to assess professionals’ adoption of EMH, and the exploration of novel technologies to support empathic interactions in EM

Integrating technology in mental healthcare practice: a repeated cross-sectional survey study on professionals' adoption of Digital Mental Health before and during COVID-19

As a consequence of the outbreak of the COVID-19 global pandemic in the Spring of 2020, large-scale social distancing measures were implemented, resulting in the forced adoption of online or digital forms of psychological treatment. This sudden transition to digital care offered a unique opportunity to investigate if and how this experience impacted mental healthcare professionals' perceptions and use of Digital Mental Health tools. The current paper presents findings of a repeated cross-sectional study consisting of three iterations of a national online survey in [COUNTRY]. This survey contained open and closed questions on professionals' adoption readiness, frequency of use, perceived competency, and perceived value of Digital Mental Health collected in 2019 (before the pandemic), in 2020 (after the first wave), and in 2021 (after the second wave). The inclusion of data gathered prior to the COVID-19 pandemic offers a unique window to assess how professionals' adoption has developed through this transition from voluntary to mandatory use of Digital Mental Health tools. Our study also re-assesses the drivers, barriers, and needs of mental healthcare professionals after having gained experience with Digital Mental Health. In total, 1039 practitioners completed the surveys (Survey 1: n=432, Survey 2: n=363, Survey 3: n=244). Results indicate that compared to the period before the pandemic, there was a particularly large increase in use, competency, and perceived value regarding videoconferencing. Small differences were also found for some other basic tools that were crucial to ensure the continuation of care, such as e-mail, text messaging, and online screening, but not for more innovative technologies, such as Virtual Reality and biofeedback. Many practitioners reported to have gained skills regarding Digital Mental Health and experienced several benefits of it. They expressed the intention to continue with a blended approach, using Digital Mental Health tools in combination with face-to-face care, focused on situations in which they found it to have specific added value, such as when clients are unable to travel. Others were less satisfied with the technology-mediated interactions and remain more reluctant to future use of DMH. Implications for broader implementation of Digital Mental Health and future research are discussed

Integration of Online Treatment Into the "New Normal" in Mental Health Care in Post-COVID-19 Times: Exploratory Qualitative Study

Background: The COVID-19 pandemic has necessitated an immediate and largescale uptake of online treatment in mental healthcare, and we are still unsure about the new normal in mental healthcare in post COVID-19 times. A relevant question we can begin to ask is to what extent the experiences gained during the pandemic will influence a sustainable adoption and implementation of online treatment in mental healthcare in the future. Objective: In this paper we aim to formulate expectations with regard to the sustainability of online treatment in mental healthcare after COVID-19. Methods: In an interview study 11 mental healthcare professionals were asked about their experiences and expectations for the future. Participants were recruited in a mental healthcare organization in the Netherlands. The interviews took place between 7 April and 30 April 2020, at the peak of the COVID-19 crisis in the Netherlands. The data were analyzed using a thematic coding method. Results: From the interviews we learn that the new normal in mental healthcare will most likely consist of more blended treatments. Due to skill enhancement and (unexpected) positive experiences with the possibilities of online treatment, an increase in adoption is likely to take place. However, not all experiences promise a successful and sustainable upscaling of online treatment in the future. Mental healthcare professionals are learning that not all clients are able to benefit from the possibilities it offers. Conclusions: Sustainable upscaling of online mental healthcare requires customized solutions, investments in technology, and flexibility by mental healthcare providers. Online treatment could work for those open to it, but many factors influence whether it will work in specific situations. There is work to be done yet before online treatment is inherently part of the new normal in mental healthcare

Mental Health Care Goes Online: Practitioners' Experiences of Providing Mental Health Care During the COVID-19 Pandemic

The outbreak of the COVID-19 pandemic has necessitated sudden and radical changes in mental health care delivery, as strict social distancing and lockdown measures were imposed in the early phases of the pandemic. Almost overnight, practitioners were forced to transfer their face-to-face care practice to online means. To understand the implications of this drastic change for mental health care, and to improve the online care offerings, an online qualitative survey was held among mental health care professionals in Netherlands (n = 51). Our findings indicate that technological and usability problems pose a significant challenge, as do difficulties to establish rapport with clients. Moreover, not all mental health issues and treatment forms are equally amenable to online interaction. In contrast, in many instances, practitioners were positive about the effectiveness of treatment, and reported flexibility, a lower threshold for contact, and lack of travel time as advantages. Their most prominent needs concern better technological, organizational, and logistical support. It is critical that these needs are acted upon by institutions and governments. In addition, current results inform future research on the improvement of e-mental health technologies

Supporting the adoption of eHealth: addressing needs of mental healthcare professionals

Background:Online and mobile technologies offer major opportunities in supporting mental healthcare. Online treatment carries several distinct advantages and convincing evidence is available for its clinical efficacy. However, adoption rates of online tools in clinical practice remain low. Our work is aimed to support mental healthcare professionals in exploring eHealth options, and to address some of the inherent limitations of eHealth technology – specifically in mediated interpersonal communication. Methods:Knowledge and experience of mental healthcare professionals regarding eHealth tools were probed using in-depth interviews (N=12). Insights drawn from these interviews were structured by developing a levels-of-adoption model, and will be used to inform ways to enhance online treatment tools. Findings: From the data, several drivers and barriers to the adoption of online treatment emerged. Main barriers consist of lack of skills, knowledge and experience regarding eHealth tools, as well as technological issues and lack of organizational support. Perceived drivers include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities. All participants emphasized that a minimum amount of face-to-face contact is vital to the quality of their treatment, indicating that current technological solutions do not entirely address their needs. Moreover, it was found that the particular drivers and barriers that are experienced differ between psychologists, depending on the extent to which they have adopted online treatment. Discussion: Based on the current findings we can already identify several potential design improvements to current eHealth technologies to ameliorate experienced barriers. In addition, our results also provide inspiration for novel ways to enhance online treatment tools, including the use of social biofeedback and virtual reality. In the end, our project will develop a game-based environment that challenges and supports therapists to playfully explore a variety of online tools, allowing them to improve their skills in online psychological treatment