Choosing the Best Digital Mental Health Tools for Patients

Written by Clinical Psychologist Tania McMahon

Digital Mental Health tools and resources are becoming an increasingly important part of our mental health system. They provide effective, evidence-based intervention for patients with mild-to-moderate mental health symptoms, and they can be a fantastic option for patients who experience barriers to accessing face-to-face psychological care (e.g. finances, location, stigma).

However, with a huge selection of digital mental health tools available (e.g. there are an estimated 1400+ mental health apps on the app store), health practitioners face the challenging task of finding and selecting suitable tools for patients on platforms that lack regulation or reliable quality assurance (e.g. the star-rating system on the app store is easily exploited).

A major concern of many practitioners is the quality of the interventions provided by these digital services, as well as concerns about privacy and data security of highly sensitive information. To help address this, the Australian Commission on Safety and Quality in Health Care is undertaking a project to develop national safety and quality standards and a certification framework for digital mental health services. The goal of certification of services is to increase user confidence, increase usage and increase consumer choice in digital mental health services.

With this certification framework still a little while off, the onus is currently on health practitioners and users to individually assess the quality of digital mental health services. While this can feel like an overwhelming task, it doesn’t have to be! Here are a few helpful options, including questions you can ask and steps you can take to help make the right decision:

For Apps – use the Mobile App Rating Scale (MARS)

Researchers at QUT have developed and validated the world’s first known mental health app quality rating tool (the MARS), to provide a multidimensional measure of the quality of each app. The indicators include engagement, functionality, aesthetics, information quality, and app subjective quality.

More information about the MARS (including a free download of the tool) is available here.

For all other services (e.g. websites, online programs)

Is it user-friendly and engaging?
- Is it easy to navigate and use? Is information easy to find?
- Is it engaging and pleasant to use?
- Is the information clearly communicated?
- Will users want to access it enough to get the full benefit?

Is the content clinically safe?
- There should be transparency about who owns the service and what the funding sources are (so that you can identify any conflicts of interest).
- There should be transparency about how the content was developed and by whom (e.g. through university research or a government grant, and what the expertise of the content developers is). Services developed by government-funded bodies and institutions are likely to be the most reliable in terms of content and efficacy. Check out Head to Health for a searchable index of Australian, government-funded digital mental health services.
- There should be some evidence as to the efficacy of the service - ideally a Randomised-Controlled Trial or other evaluative process. However, if not (as RCTs can be difficult to fund), digital adaptations of well-established efficacious treatment interventions (e.g. CBT) can generally be considered effective as long as the treatment is clearly communicated (i.e. something that claims to be online CBT clearly appears to be).
- Are there any treatment elements that could cause harm?
- There should be options for at-risk users to self-identify and seek further help (e.g. a ‘Get Help Now’ button that leads to Crisis Line information).
- If there are health professionals involved in the delivery of the service (e.g. conducting telephone assessments, moderating online forums), do they have appropriate qualifications?

Does it protect privacy and is it secure?
- Is the site secure?
- There should be clear information about how personal data is used and protected.
- The service should have a privacy policy stating that user information is not sold on to third parties.

To get started in your search for helpful digital mental health services, begin here:

Check out the Australian government’s ‘Head to Health’ digital mental health gateway - https://headtohealth.gov.au.
Search for some relevant services and try out one or two for yourself; evaluate them using the questions above (or the MARS, if it is an app).
See if they would be suitable for your clients – if so, great! If not, head back to Head to Health and search for another.

Choosing the Best Digital Mental Health Tools for Patientswebeditor2023-08-21T14:47:38+10:00

Why doesn’t mindfulness work for me?

by Tania McMahon

“Be in the moment.” “Clear your mind.” “Centre yourself.”

I remember feeling rather confused when I first learned about mindfulness as a provisional psychologist. It was so abstract and nebulous – an idea that I just couldn’t grasp as tangibly as behavioural strategies like pleasant […]

Why doesn’t mindfulness work for me?webeditor2023-08-21T14:50:54+10:00

Parent Self-Care: The Important Flow On Effect

by Dr Alison Bocquee

There is a lot written in social media and print about being a good parent, good enough parent, ‘the best you can be parent’. We hear of the importance of looking after ourselves as parents before or so we can best look after our little people. Anyone who has travelled by aeroplane will have heard the air hostesses instructing parents to put on their own oxygen masks first before attending to their child. It seems counterintuitive, but let’s look at the detail as to why this matters.

Self-care – who takes care of the parent? When the parent is constantly giving to others, do they ever think about how much they are giving of themselves? It’s probably not something that parents ask themselves or even consider often, until they are overwhelmed, feeling exhausted and irritable with their children. Then comes the guilt because they are not being the parent that they ideally want to be.

Let’s put it simply. We cannot give what we haven’t got. So if you, as a parent, are not looking after yourself, not showing yourself the love you show your loved ones, not treat yourself the way you want others to treat you (i.e., with respect), this not only affects you but potentially every member of your family.

Children can be viewed as the barometers of the parent’s functioning. Their behavioural outbursts or emotionality or sensitivity may reflect their parents’ imbalance of ‘all work and looking after the family’ but not themselves. When the parents are balanced (i.e., calm, consistent, non-reactive) there is a much better chance the children will be too. Hence the very important flow on effect of parent self-care.

Self-care includes aspects such as sufficient sleep, regular physical movement, nutrition, rest and relaxation, social connection, and engagement in pleasurable activities. Self-care is giving yourself a break, to recharge, taking time off. Self-care shows you matter. It models to your family the importance of your needs, that each member of the family is important. It reduces stress. Self-care is good for your well-being and that of your family.

Further engagement in each of these aspects of self-care demonstrates and models to your little people important life, coping and self-regulation skills. This is much more powerful than anything you could say or ‘lecture’ your child about. Demonstrating to your child that when you’re frustrated you engage in deep breathing, or when you’re anxious you run a bath, or at the end of the day if you’re tired you go to bed a bit earlier, and so on, are invaluable life lessons.

Self-care doesn’t have to be time intensive. Even engaging in breathing exercises for 2 minutes or watching the clouds, or listening to your preferred music is likely to shift your energy and provide you with a little joy. Getting up a little earlier than your little people to plan or consider your intentions for the day, perhaps whilst you sip a cup of tea, is also important self-care. You’ll likely be more calm, and therefore more intentional in your interactions with your loved ones and less reactive overall.

Our team of highly skilled and professional clinical psychologists are able to compassionately support your journey to being the parent you want to be, that makes your heart sing, a parent who prioritises their own self-care because they acknowledge their own importance and their own needs; and that ultimately flows on to a more contented family. Opening yourself to growth by learning and incorporating skills such as relaxation and mindfulness of thoughts and emotions techniques, means you are prioritising your own wellbeing and that of each member of your family.

Parent Self-Care: The Important Flow On EffectEllie Raymond2023-08-21T15:04:39+10:00

Freeing Ourselves From Avoidance

By Dr Jasmine Pang

As human beings, we are encoded to survive by avoiding things that are likely to cause us pain, which we have learnt in the past to induce pain or which is stressful or unpleasant: be it that giant spider sitting on the clothing line, that shoulder pain that has been ongoing for a while, or an article that you have promised to write for your upcoming practice newsletter.

In the initial phases, avoidance can work very well. By just using the part of the clothes line that the spider has not occupied, by not thinking about the article I need to write or by working around my sore shoulder, I can pretend that everything is ok and continue on my merry way. We work around it. The problem is that things very seldom remain the same. My resident clothesline spider decides to expand his territory and take up more and more of my clothesline, my shoulder pain worsens to a point that I cannot reach up beyond my shoulder and my practice manager starts sending me “reminder emails” that I cannot avoid anymore. Whilst some avoidance can be a very successful strategy to keep us safe from stressful situations, unpleasant experiences or threats, it can also become counter productive

So what have I learnt about avoidance?

1. Avoidance can be helpful when threats are real. If that spider on the clothesline turns out to really be that gastly dangerous “it’ll kill a grown man within an hour” species that Australia seems prone to having, avoiding it is probably a good idea. We can never totally avoid all the things that we want to avoid. It is seldom that avoidance makes things go away. The spider is still on the line, my shoulder still hurts and the looming newsletter article deadline is still there.

2. Avoidance feeds fear and is an all consuming voracious creature. The more we avoid the greater the problem often becomes. This is particularly so with anxiety. The more anxious I feel, the more I avoid. The more I avoid, the more anxiety I feel. As time goes by, our world becomes smaller and smaller and we feel more and more trapped.

3. Avoidance prevents us from learning that something different can happen or that what we were so fearful of is not as bad as we expected it to be. It prevents us from really experimenting and checking it out, to determine if something is really a threat or not.

What have I learnt to do about it?

1. Acknowledge the problem. We cannot do anything about a problem until we acknowledge it. For me, it was acknowledging that I had a problem in my shoulder (and in all likelihood had torn a ligament), that I was frightened of that spider and that the thought of having to sit down and write an article brought back traumatic memories of writing my thesis.

2. Start small. Be it writing notes on what you’d like to include in the article, finding out about physiotherapists or reading up about whether your resident spider is indeed as dangerous as you imagined it to be. Keep pushing yourself to be at the edge of your comfort zone. Don’t try to aim for the big wins. Small sustainable goals are more likely to get you there. Remember the tortoise and the hare.

3. Get support and help. Having someone to walk you through the journey can be invaluable. It helps give you perspective, keeps you accountable and gives you someone to whine to at the end of the day. This is particularly so if you have been avoiding a situation because of traumatic experiences. Until you stop avoiding, it will continue to intrude in your life and limit you. It might be uncomfortable but keep practicing and trying. Eventually it becomes the new normal.

To quote loosely from Vivian Greene, perhaps life is not about trying to avoid the storms but learning how to dance in the rain. Now excuse me whilst I get a broom to try to relocate my eight-legged friend for the fifth time before I head out for my physiotherapy appointment.

Freeing Ourselves From AvoidanceEllie Raymond2023-08-21T15:05:33+10:00

Rat Park – challenging pre-conceptions about addiction

Many of us remember the addiction story from our under-graduate Psychology 101 class. The story goes that drugs like heroin and cocaine are so addictive that when rats are exposed to them, they will continue to take the drug over food or water until they literally starve to death. So […]

Rat Park – challenging pre-conceptions about addictionbmadmin2023-08-21T15:49:41+10:00