Neil Caton

Background People with mental health difficulties often experience social isolation. The importance of interventions to enhance social networks and reduce this isolation is increasingly being recognised. However, the literature has not yet been systematically reviewed with regards to how these are best used. This narrative synthesis aimed to investigate the role of social network interventions for people with mental health difficulties and identify barriers and facilitators to effective delivery. This was undertaken with a view to understanding how social network interventions might work best in the mental health field. Methods Systematic searches using combinations of synonyms for mental health difficulties and social network interventions were undertaken across 7 databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science) and 2 grey literature databases (EThoS and OpenGrey) from their inception to October 2021. We included studies reporting primary qualitative ...

Background Social integration, shared decision-making and personalised care are key elements of mental health and social care policy. Although these elements have been shown to improve service user and service-level outcomes, their translation into practice has been inconsistent and social isolation amongst service users persists. Aim To co-adapt, with service users, carers/supporters and health professionals, a web-based social network intervention, GENIE™, for use in secondary mental health services. The intervention is designed to support social activity and preference discussions between mental healthcare professionals and service users as a means of connecting individuals to local resources. Methods In Phase 1 (LEARN), we completed two systematic reviews to synthesise the existing evidence relating to the i) effectiveness and ii) the implementation of social network interventions for people with mental health difficulties. We undertook semi-structured interviews with a convenie...

Background Social connections have been linked to the genesis and amelioration of mental health problems and thus have potential therapeutic value. Purpose To identify the current evidence base, assess risk of bias and synthesise findings on the effectiveness of social network interventions for people with mental health problems. Methods Electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science, Scopus) and grey literature databases were systematically searched from inception to October 2021 using free text syntax combining synonyms for ‘mental health problems’ and ‘social network interventions’. Articles were eligible for inclusion if they reported data from randomised controlled trials on the effectiveness of interventions designed to improve social networks for adults (18+) with mental health problems. Papers were independently reviewed for inclusion with conflicts resolved through consensus. Included papers were quality assessed and data extracted...

Widespread use of mobile and wireless technologies has the potential to transform health care. Increasingly, digital technologies such as smart phones, the Internet and digital TV are becoming an important way to gain access to the social determinants of health including employment, education and social networks. The use of smart phones has rocketed, with over 11 million Smartphone users in Australia in 2013, up 29% compared to 2012 (Australian Communication and Media Authority, 2013). However, the quantity and quality of access to these technologies and the possible effects of this on people from socially disadvantaged groups especially for those experiencing mental health problems have rarely been considered. Perlgut (2011) has put it succinctly in the context of digital inclusion in Australia as ‘the concept of—digital divide has slipped from the public radar in recent years under the onslaught of smart phones, iPads, other—tablets and the bewildering and growing collection of digital devices ...’ The concepts of digital divide and digital inclusion are used interchangeably to describe the access or lack of access to the digital technology for the population. While the digital inclusion is hotly debated in social and information technology (IT) sectors, there is almost complete lack of debate about the digital inclusion in mental health. We will argue that digital inclusion will become the most important determinant of social inclusion and wellbeing, and will suggest measures to enhance digital inclusion for those suffering from mental illness. Digital inclusion is the ability of individuals and groups to access and use information and communication technologies (ICTs). This includes access to the Internet, suitable hardware and software and training for the digital literacy skills (Perlgut, 2011). Better access to these technologies results in wider choice and empowerment, with better integration in society. Much of social inclusion is now created and nurtured online. Lack of access to or the knowledge of how to use ICT results in digital exclusion which is considered as an important indicator of economic inequity (Norris, 2001). Socially disadvantaged people not only lack in access to digital technologies, they are also falling further behind the rest of society who use technology to their advantage. This increases both width and depth of the digital exclusion. Digitally excluded people are increasingly at risk of becoming ‘invisible’, as the key platforms for discussion and social participation (e.g. e-petitions) are also digitally driven. This leads to a vicious cycle in which those excluded from the digital advantage suffer from higher costs of living and often restriction to access from services. Disability groups and patients remain key groups who experience digital exclusion. In Australia, 28% of those suffering from a disability have broadband access compared to 48% of people who do not need assistance (Perlgut, 2011). As a result, those who lack digital access and are unable to use the technology effectively are likely to suffer from increasing health inequities. Most importantly, perhaps in future, large number of interventions will be based on digital platforms (see, for example, www.marketwired.com/pressrelease/wellframe-expands-partnershipwith-mclean-hospital-deliver-pioneering-support-model-1955815.htm). Therefore, digital exclusion may limit potential treatment options for patients with mental illness in the future. Although the effects of digital exclusion on mental health are not studied, the social exclusion and its relationship with poor mental health is well known. For example, a recent study based on a large dataset from 26 European countries found that both ‘economic/ employment’ and ‘social/welfare’ dimensions of social exclusion significantly influenced suicide mortality among male patients (Yur’yev et al., 2013). Existing literature on the use of Internet and mobile technologies in the assessment and treatment of psychiatric disorders is limited to cross-sectional surveys based on convenience samples from outpatient populations without comparison groups. A relatively larger Digital inclusion: The concept and strategies for people with mental health difficulties

Retrospective Assessment (RA) scores are often found to be higher than the mean of Ecological Momentary Assessment (EMA) scores about a concurrent period. This difference is generally interpreted as bias towards salient experiences in RA. During RA, participants are often asked to summarize their experiences in unspecific terms, which may indeed facilitate bias. At least in this unspecific form, the summary that participants apply to their remembered experiences can take many different forms. In this study, we reanalyzed an existing dataset (N = 92) using a repeated N = 1 approach. We reported on interindividual differences between EMA data and RA score, and assessed for each participant whether it was likely that their RA score was an approximation of the mean of their experiences as captured by their EMA data. We found considerable interpersonal differences in the difference between EMA scores and RA scores, as well as some extreme cases. Furthermore, for a considerable part of th...

Objectives: Technological advances in healthcare have shown promise when delivering interventions for mental health problems such as psychosis. The aim of this project is to develop a mobile phone intervention for people with psychosis and to conduct a feasibility study of the TechCare App. Methods: The TechCare App will assess participant’s symptoms and respond with a personalised guided self-help-based psychological intervention with the aim of exploring feasibility and acceptability. The project will recruit 16 service users and 8–10 health professionals from the Lancashire Care NHS Foundation Trust Early Intervention Service. Results: In strand 1 of the study, we will invite people to discuss their experience of psychosis and give their opinions on the existing evidence-based treatment (cognitive behavioural therapy) and how the mobile app can be developed. In strand 2, we will complete a test run with a small number of participants (n = 4) to refine the mobile intervention (Tec...

ObjectivesThe aim of the project was to examine the acceptability and feasibility of a mobile phone application-based intervention ‘TechCare’, for individuals with psychosis in the North West of England. The main objectives were to determine whether appropriate individuals could be identified and recruited to the study and whether the TechCare App would be an acceptable intervention for individuals with psychosis.MethodsThis was a mixed methods feasibility study, consisting of a test-run and feasibility evaluation of the TechCare App intervention.SettingEarly Intervention Services (EIS) for psychosis, within an NHS Trust in the North West of England.ParticipantsSixteen participants (test-run n=4, feasibility study n=12) aged between 18 and 65 years recruited from the East, Central and North Lancashire EIS.InterventionA 6-week intervention, with the TechCare App assessing participants’ symptoms and responses in real-time and providing a personalised-guided self-help-based psychologic...