Identifying children’s mental health issues with mHealth technology

Identifying children’s mental health issues with mHealth technology

The World Innovation Summit for Health (WISH) released a Report on Mental Health and Well-being for children titled “Healthy Young Minds. Transforming the mental health of children.” The information included on this blog post is taken from the report. 

The report revealed that half of all mental health problems emerge before individuals reach 18 years old. However, even in developed countries, only 25% receive any specialised treatment. Mental health problems place massive costs on society, since the total cost of mental illness is 3.5 of GDP in Europe.  Besides causing direct health care costs, mental illness in youths also causes educational failure, adolescent crime, teenage pregnancy.

Early intervention is fundamental. Parents, doctors and teachers need to become more open and informed, since mental illness is a common part of life. Schools need to prioritise children’s well-being and “life skills” should be added to the teaching curricula alongside mathematics and literature.

It is estimated that 31% of the world’s population is aged under 18, and 10% of them (which is equivalent to 220 million children) suffer from mental illness as it is illustrated in Figure 1. 

The costs of mental illness in children are quite considerable. Children with conduct disorder are four times more likely to commit a crime, take drugs, become teenage parents, depend on welfare, and attempt suicide, as it is illustrated in Table 1.

Figure-11

The costs of mental illness in children are quite considerable. Children with conduct disorder are four times more likely to commit a crime, take drugs, become teenage parents, depend on welfare, and attempt suicide, as it is illustrated in Table 1.

Table-11

The report estimated that in the UK alone, these children may cost in criminal justice, an amount equal to three years’ average wages.

These figures are severe enough by themselves. However, on top of that, at least 50% of the children who experience mental illness during their early years, will suffer from mental illness as an adult. [7] Their lives are more likely to be impoverished and unhappy, and they are much more likely to commit suicide.

The report mentions that these statistics shouldn’t be so high. Nowadays, there are multiple and effective treatments available for children suffering from mental illness. Besides, there is also an enormous opportunity in schools and communities to make significant changes that can reduce the likelihood of the problem in the first place.

Additionally, technology, and mobile health solutions are a huge advantage! Smartphone applications can contribute to monitor and train youths about mental health.

The WISH report encourages local communities and countries to focus on 10 Action Plans to improve the mental health of children around the world.

  • Community action: Every local community should implement a child well-being strategy. This plan should include an assessment of the needs of children and families; and the role of healthcare organisations, schools, and non-government organisations.
  • Parity of esteem: Mental health care for children and their parents should be widely available.
  • Universality: Health professionals should be trained to identify mental health problems in children, perinatal depression in mothers, and they should also be trained to treat these issues.
  • Professionals: Countries should train more professionals in evidence-based treatments, especially psychological therapy.
  • Well-being in Schools: The well-being of students should be the priority of every school, including the implementation of a Well-being Code of Conduct to which all teachers, parents, and students must adhere to.
  • Measurement: Schools should evaluate all student’s well-being on a continuous basis.
  • Add life-skills to the teaching curriculum: Schools should use evidence-based methods to provide explicit instruction in life throughout school life, especially in the early years.
  • Teacher Training: All teachers should be trained to notice and promote well-being and mental health.
  • Use of smartphone technology: Implement a smartphone-based program to promote mental health and well-being of the children.
  • The Sustainable development goals: The sustainable development goals should include physical and mental health.


The Monsenso mHealth solution can help facilitate the achievement six of the ten points included in the WISH Action Plan.

  • Use of smartphone technology and well-being at schools – The Monsenso smartphone app can help adolescents express any negative feelings they may be experiencing. This information can help care givers identify problems such as depression, anxiety, eating disorders, ADHD or even more severe diagnosis such as bipolar disorder or borderline.
  • Measurement – With help from the Monsenso mHealth platform, school personnel can identify if some students present any Triggers or Early Warning signs. Once symptoms are identified in a group of students, care givers can monitor this group closely to ensure they are receiving the support and attention they need.
  • Teacher training – The Monsenso web portal is so easy to use that care givers do not require any special training to use the system. However, since they are not trained as mental healthcare specialists, they will need some training to help them interpret the information provided through the self-assessments.
  • Parity of esteem – In most countries, there is a lack of resources and the waiting time to schedule an appointment with a mental healthcare specialist can be up to a year. The Monsenso mHealth solution can help school personnel identify the students who are experiencing symptoms of mental illness. Once a student has been monitored for a determined period and the symptoms continue, school personnel can recommend the family to seek professional help.
  • Add life-skills to the teaching curriculum – Since all students would be required to fill out the daily self-assessments to evaluate and monitor their mental health well-being, the class dialogue can be facilitated by the information on the system. Teachers can provide students with real, anonymous examples of a person experiencing symptoms. Additionally, students could be encouraged to talk to a school counsellor if they experience any of the symptoms discussed in class. Students could also be taught how to act if they notice any symptoms on their peers.

If you are interested in running a pilot with the Monsenso mHealth solution at your school, please contact us.

Reference:

Healthy Young Minds. Transforming the mental health of children. Report of the WISH Mental Health and Well-being in Children Forum 2015

Borderline Personality Disorder in Adolescents

Borderline Personality Disorder in Adolescents

Borderline personality disorder (BPD) is a severe mental illness that causes unstable moods, behaviour, and relationships. It usually begins during adolescence or early adulthood [1].

Most psychiatric disorders cause a permanent abnormal social behaviour, whereas borderline personality disorder only causes brief psychotic episodes. As a result, experts believe this is an atypical mental illness that can be misleading [2].

According to a 2015 study undertaken by French psychiatrist Lionel Cailhol, BPD is equally common in both genders. Nonetheless, in clinical populations, females represent 75% of all patients. Some experts believe this is due to men having difficulty seeking help, especially in psychotherapy [3].

BPD usually appears during late adolescence. However, clinicians recommend that a diagnosis should not be made before the age of 18 years. Patients should be treated later on when the symptoms are clear and persistent.

The most common causes of BPD are believed to be early maternal separation and childhood trauma [3]. However, identifying symptoms at an early stage or educating a child in a manner that could prevent BPD would spare the patient a lot of pain, time and money. As life-coach Tami Green explains in one of her talks, a good way of avoiding BPD is to accept people and their flaws without trying to change them. She gives an example of a very sensitive child that is pressured by their parents to become tougher and bearable, however the pressure violates this child to the core of who they are. It can be very difficult to handle this sort of conversation without criticizing them. [4]

It is particularly hard for families of adolescents, because they need to help their children cope with their behaviour, provide them with help, and teach them to manage their risk-taking behaviour. Besides the many challenges that young people face, adolescents suffering from BPD can be very vulnerable and difficult to handle [3].

BPD symptoms evolve over time, however, here is a list of a few common symptoms that teenagers face:

  • Para-psychotic manifestations
  • Risky sexual behaviour
  • Regression linked to treatment
  • Counter-transference problems, “special” treatment relations
  • Abuse, dependence on psychoactive substances
  • Self-harm
  • Repeated suicide attempts
  • Demandingness
  • Severe identity disorder [3]

One of the best therapies that helps patients to cope with BPD is Dialectical Behavioural Therapy (DBT). This method consists of a cognitive-behavioural approach that emphasises the psycho-social aspects of treatment. DBT is conceived for people that are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships [5].

The Monsenso mHealth solution can help clinicians monitor and treat young patients suffering from BPD. In fact, the Mental Health Services in the Region of Southern Denmark (MHS) will soon begin clinical trials of a mobile coach app that supports DBT of BPD patients. To learn more about this project, click here!

References:

[1] About Borderline Personality Disorder (BPD). National Education Alliance Borderline Personality Disorder
http://www.borderlinepersonalitydisorder.com/what-is-bpd/bpd-overview/

[2] Borderline Personality Disorder. National Institute of Mental Health.
http://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

[3] Borderline Personality Disorder in Adolescentes. L. Cailhol, L. Gicquel and J.P. Raynaud (2015)
http://iacapap.org/wp-content/uploads/H.4-BORDERLINE-2015-UPDATE.pdf

[4] How BPD Forms in a Child. Video. T. Green (2009)
https://www.youtube.com/watch?v=Ct1ZmMCRP18

[5] An Overview of Dialectical Behavior Therapy. Psych Central Staff
http://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/

[6] Borderline Personality Disorders: Signs, Symptoms and Treatment
https://www.choosingtherapy.com/borderline-personality-disorder/ 

An increasing demand for mental health services by university students

An increasing demand for mental health services by university students

In 2015, the increasing demand for mental health services by university students raised a huge concern amongst teachers, parents and society in general.

In fact, the Centre for Collegiate Mental Health (CCMH) released a report that included the participation of 139 college and university counselling centres, and more than 100,000 students seeking mental health care during the academic year 2014/2015.

It is necessary to mention that according to clinicians, anxiety has surpassed depression as the leading mental health issue being faced by college students.

However, students have become more self-aware and have started seeking help at counselling centres. In fact, students have taken over more than 50% of the centres’ total capacity, increasing the average demand for this type of service to at least five times more than the average institutional enrolment.

Why is this happening? During recent years, different theories that try to explain the growth of mental health issues have surfaced, and they range from different parenting styles to lack of resilience. While there are many reasons why a student could suffer from anxiety or depression, most of them are very personal and can be identified and treated with counselling.

Therefore, it is fundamental that institutions of higher education can accommodate the increasing demand for mental health services to help at-risk students. Another option could be monitoring students’ mental health on a regular basis and identifying early warning signs and triggers before they reach a critical point. This can easily be done with the help of mobile health (mHealth) technology such as the solution offered by Monsenso. In fact, the Monsenso platform will begin clinical trials to support the treatment of anxiety disorders.

The Monsenso mHealth platform is being used to collect patients’ self-rated status and sensor-based behavioural data (e.g., physical activity, phone usage, social activity) on a daily basis. It consists of a smartphone application for patients and a web portal for clinicians. The advantage of using this method is that at-risk students that develop critical mental health conditions can be treated before the condition has a negative impact on their daily lives.

Reference:
Annual Report on Mental Health. The Centre for Collegiate Mental Health. 2015.
https://assets.documentcloud.org/documents/2686415/Penn-State-CCMH-Annual-Report-on-Student.pdf