Monthly Archives: November 2018

Elvira Perez Vallejos: Digital technology will transform the role of NHS clinical staff

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A blog by Elvira Perez Vallejos, Associate Professor of Digital Mental Health, Mental Health and Technology theme.

I recently attended a workshop at the Royal College of Psychiatrists to discuss and reflect on the impact of digital technology on the future of mental healthcare. This workshop was part of the Topol review which is aiming at preparing the NHS healthcare workforce to embrace current and future digital developments for mental healthcare.

This review is being led by Dr Eric Topol, an American cardiologist, geneticist, and digital medicine researcher, author of ‘The patient will see you now’ and ‘The creative destruction of medicine’ among other more clinical textbooks.

During the workshop, attendees were distributed into heterogeneous groups. My table included several mental health practitioners (three psychiatrists and a mental health nurse), a policy maker and a machine learning expert. We were asked to reflect on these questions:

1. How will digital technologies change roles and functions of clinical staff?
2. What are the implications for the skills required?
3. What will this mean for the selection, education and training of staff?

To my surprise, I did not have to defend or argue about the need to promote a basic understanding of how the digital economy works and its implications for users’ data privacy and security, the dangers of secondary data being sold in data markets, harm related to self-diagnosis and self-treatment. Nor did we discuss the use of unreliable smartphone apps (see Bauer 2017 for more details), the risks of persuasive design, or the need for human-centred design and co-production of new tech for mental health engaging and involving clinicians, service users and developers.

We all agreed about the need for a cultural shift in which data ethics and responsible research innovation (RRI) drives tech advances. One of the barriers that kept appearing during our discussions on the effective adoption of digital tech was the software licence issue.

I was not aware that NHS Trusts have to pay a substantial amount of money in order to be able to offer specific treatments to service users or analyse health data. If software were instead developed in-house or with taxpayer money, this should be open access and freely available within the NHS.

We also discussed the lack of research evidence to help us understand current and future relationships developed towards machines (i.e. avatars, robots, virtual human therapists and chatbots) designed to support or monitor peoples’ mental health. These new attitudes and human-machine relationships have a generational effect and younger people may place more or less trust on tech outcomes than older people.

This is an aspect that needs more research, specifically understanding the implications of these new attitudes on mental healthcare.

It was agreed that technology advances are moving fast; too fast for health services to cope with. And tech innovation cannot be slowed down and NHS services cannot speed up. This is a problem that will influence how training is delivered and medical curricula is updated.

Digital technology will force a rapid transformation of the roles and functions of clinical staff who will be expected to adapt quickly and cope with a constant flow of new solutions.

Bringing the digital into the NHS will require the training of staff on digital literacy, basic maths and statistics (e.g. to understand mental health algorithm-mediated outputs), and to become more multidisciplinary than ever before. The data analyst or natural language processing developer working alongside clinicians may become the expected norm.

I really enjoyed the whole discussion but what struck me the most was the realisation that ‘the digital’ can actually revolutionise psychiatric diagnosis. It was argued that mental health distress and difference is more fluid and dynamic than the DSM (Diagnostic and Statistical Manual of Mental Disorders) codes, a product influenced by the pharmaceutical industry.

Digital tech for mental health seems to highlight the issues embedded within the current diagnostic system and may offer an alternative perspective that can influence the future of psychiatry.

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This post was originally hosted on the Nottingham Biomedical Research Center pages.

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Why celebrate World Mental Health Day?

Interview and commentary from Mercè Santos Mir.

Every year #MentalHealthAwareness day steps into the limelight for its annual day of recognition, but has  it ever truly left? Mental health awareness is increasingly becoming a daily conversation between friends, family, colleagues and health service providers across the country and abroad – breaking down a little piece of the taboo topic each and every time we discuss anxiety, depression, schizophrenia and all the other conditions that fall under the mental health umbrella.

We caught up with our Exhibitions Curator at the Institute of Mental Health , Mercè Santos Mir, who has worked closely with artists who deal with issues of mental health within their practice, who put theirs and others’ inner-experiences on canvas for all to see, to raise awareness and break down the barriers we face in the introverted dark of battling against a mental health condition.

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Not many people know that I’ve been working in collaboration with the Institute of Mental Health (IMH) curating temporary exhibitions since 2014. My first contact with the IMH was after they invited artist Rachel Oxley to show a retrospective of her work. At the time Rachel was finishing her MFA at Nottingham Trent University and I was also finishing my MA in Curation at the same university. I had grown very close to Rachel during our studies while supporting each other through the rollercoaster of emotions that a postgrad can become. We were there for each other, at our best and at our worst. Rachel is a Nottingham based artist who deals with mental health subjects in her work, drawing most of her inspiration from her own experience living with dissociative identity disorder (DID). DID is a complex psychological condition caused by many factors, including severe trauma during early childhood. Due to the nature of my studies and our friendship, Rachel approached me for support while putting on her exhibition at the IMH.

Since then I have worked with artists that use all sorts of media; photography, painting, sculpture, ceramics and many other, in artistic ways to share and explore their experiences with mental health. From conditions as common as depression or anxiety to more complex medical conditions like DID or schizoaffective disorder, I have learned that each of us have our own way to overcome and move forward. I have learned that artistic practices help us channel emotions and thoughts, and that helps a great deal in the process of recovery.

This year’s World Mental Health Day fell on the 10th October. To commemorate this we celebrated the launch of the exhibition The Twisted Rose and Other Lives by artist Andy Farr, which will run until the 1st March 2019. I worked with Andy to curate a thought-provoking exhibition focused on post-traumatic stress disorder (PTSD). Post-traumatic stress is more common than we think. Andy claims that his own traumatic experiences were much less severe than those who have suffered abuse or been involved in war conflicts, nevertheless they had a profound impact on his life, leaving his career in marketing research and advertising to become a full-time artist. With help from the IMH Andy has been meeting with other people who have experience post-traumatic stress to create a series of paintings that brings their experiences to life.

Andy says: “My hope with this exhibition is to show what it is like to suffer and recover from mental health problems, to raise awareness and consciousness of the issues surrounding trauma, and to provide positive therapeutic outcomes for those directly involved.”

It’s important to give visibility to artists like Rachel or Andy, and to support the work that organisations like the IMH and many others do in the city, to appreciate the space they provide, because it’s priceless.

While World Mental Health Day is a great opportunity for global mental health education, awareness and advocacy,  we should be listening to those voices every day, in order to break down the social stigma around mental health. Let’s make every day World Mental Health Day.

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If you or someone you know is struggling with mental health, please call the NHS on 111 or visit NHS Every Mind Matters.

 This piece has been reposted with consent after first appearing here

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