P wegot99 overview

PROJECT 99: OVERVIEW THE CONTEXT, SCOPE AND INTENDED OUTCOMES OF PROJECT99

SNOOK

OUR APPROACH TO SHARING THE PROJECT 99 REPORT MATERIALS: Open Access, Some Rights Reserved The outputs of the Project 99 exploration of internet-based approaches to support youth mental health have emerged through a coproduction approach, involving Greater Glasgow and Clyde NHS (GGCNHS) as commissioning body, a three agency consortium (consisting of Mental Health Foundation, Snook and Young Scot) and young people, all supported by a multi-agency steering group. In turn, this project is an agreed action within the Board’s Strategic Framework for Child and Youth Mental Health Improvement, ratified by the Child and Maternal Health Strategy Group in June 2012.

embedded in the report documentation, which is a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, its main conditions being:

Note that the material presented in the Project 99 reports is the result of combined work from the commissioned partners and the participating young people and does not represent the views of GGCNHS.

· The work is not resold or used for any commercial purposes

GGCNHS is keen to make this work available to any interested party, while retaining the copyright. We have therefore applied an open access policy to this work which allows anyone to access the report material online without charge. Anyone can download, save or distribute this work in any format, including translation, without permission.

This is subject to the terms of the licence

· GGCNHS and the three commissioned partners – Mental Health Foundation, Snook and Young Scot are credited · This summary and the address www. wegot99.com are displayed · Creation and distribution of derivative works is permissible, but only under the same or a compatible licence

· A copy of the work or link to its use online is sent to GGCNHS via the contact form on wegot99.com

You are welcome to ask for permission to use this work for purposes other than those covered by the creative commons license.

GGCNHS gratefully acknowledges the work of Creative Commons in inspiring our approach to copyright for this report. To find out more go to www. creativecommons.org Potential for Future Development and Collaboration GGCNHS and its local community planning partners will now be actively considering all the material and recommendations contained in this work with a view to formulating a response and a forward development programme, as part of the wider body of work to improve child and youth mental health in Greater Glasgow and Clyde.

In recognising the emerging nature of this agenda, the Health Board would welcome dialogue with partners and potential partners who may be interested in collaborating in aspects of this work, and in discussion with agencies who may already be engaged in similar work, with a view to sharing good practice.

For further discussions please contact us via the wegot99.com contact form.

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1.1 PROJECT SUMMARY & CONTEXT

“COMMITMENT 6: DURING THE PERIOD OF THE MENTAL HEALTH STRATEGY WE WILL DEVELOP A SCOTLANDWIDE APPROACH TO IMPROVING MENTAL HEALTH THROUGH NEW TECHNOLOGY IN COLLABORATION WITH NHS 24.”

Mental health strategy for scotland, 2012-2015

Through this project, Greater Glasgow & Clyde NHS and its local partners are looking to explore the potential of the internet, social media and mobile technologies in promoting better mental health and wellbeing for young people. A collaborative approach is employed, working closely with local young people. Within the scope of this project, the age range of those we engaged with was between 15 and 21. It is recognised however, that much younger people need to be included in any further work.

The project intends to provide a basis for discussion with stakeholders in the board area.

Central to it is the hosting of codesign events with young people across the area, in order to explore and discuss their use and desired use of the internet in relation to mental health. The synthesised output from these events, presented in this report, will then give a direction for potential future work in the board area, and some practical suggestions for relevant workforce

groups for engaging with young people using the internet; social media in particular.

Improving the mental health and wellbeing of children and young people has been highlighted as a priority action area in a number of health strategies and policies.1 These policies come at a time in which a growing body of evidence suggests that the current economic climate is adding to level of distress and burden experienced by young people.

This project arose as an agreed action area in the approved strategic programme for Child and Youth Mental Health Improvement for Greater Glasgow and Clyde. It aligns with Commitment 6 of the Scottish Mental Health Strategy 20122, which stresses the intention to use new technologies in the improvement of mental health nationwide.

We have now entered the age of the ‘digital native’; young people have grown up with digital, mobile

technologies. Accordingly, new digital technologies and social media are being used across the globe to expand the range of support available for mental health and wellbeing. Many such initiatives have already been advanced in the UK, including the development of health related apps for mobile devices. Examples of such initiatives have been comprehensively (although by no means exhaustively) mapped in this report. They can be found in the appendices as a separate document.

The reliance of young people on digital technologies - the web and social media in particular - also presents new challenges in the mental health sphere. Whilst the web may be an extremely positive tool in supporting mental health improvement, it also allows for the rapid dissemination of potentially damaging material and affords new kinds of negative behaviours (such as cyber-bullying and obsessive use.)

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Examples include: ‘Towards a Mentally Flourishing Scotland – Strategy and Action Plan’, 2009-2011, Scottish Government; ‘No Health Without Mental Health’ strategic framework for mental health improvement for Greater Glasgow and Clyde - 2010; ‘Keeping Health in Mind’, Director of Public Health Report of 2011 for the Greater Glasgow and Clyde area.

2 Mental Health Strategy for Scotland, 2012-2015: http://www.scotland.gov.uk/ Publications/ 2012/ 08/9714/downloads

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As such, this project aims to explore the excellent potential of digital technologies as a means for supporting mental health improvement, and the positive aspects of young people’s participation in online activities; such as the development of creativity, sharing self-generated content and engagement with civil society. However, means to safeguard young people from negative patterns of use will also form a crucial simulataneous consideration.

It also takes the view that digital and online behaviour should not be seen in isolation. Young people’s digital lives should be considered in interrelation with their work, home, school and leisure time, as opposed to emphasising an artificial distinction between online and offline worlds. Such a holistic approach aligns with recommendations made by Collin (2011)3 in a key review that will be discussed further in our literature summary (see Chapter 5).

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Collin, P , Rahilly K, Richarson I, Third A(2011) The Benefits of Social Networking Services: A Literature Review. Young and Well CRC, Melbourne http://www. yawcrc.org.au/knowledge-hub/publications (accessed July 2013)

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1.2 SUMMARY OF RECOMMENDATIONS

The main body of recommendations drawn from the findings of this report can be read in Chapter 7.

However, here we provide a concise summary of the key points.

PROCESS 1. A co-design approach,

with a framework for on-going engagement with young people is the default for any projects seeking to develop digital assets for youth mental health.

2. GGC NHS should develop

a youth engagement framework to support this on-going engagement, with potential internships for young people.

DIGITAL ASSETS A digital springboard (or gateway) consisting iterative, user-centred content focused on supporting mental wellbeing (not solely focused on mental health issues) should be developed. This would ideally contain the following elements:

Within this digital springboard specific areas should focus on supporting individual young people, including:

Emergency 24 hour Instant Messaging tools

1. Service directory 2. Advice directory 3. Tool kit for wellbeing 4. Links to and connections

Empathy tools

Access to forums for group support

Access to tools which help maintain good mental health

Practical day to day tips on managing common mental health problems

with wider services

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WIDER IMPACT 1. GGC NHS should develop an emotional literacy programme as part of educational curriculum.

2. A ‘first responder for mental health’ training scheme should be developed to allow support within schools.

3. A campaign should be

developed through which young people are encouraged and incentivised to find ‘a third space’.

NHS USE OF SOCIAL MEDIA NGS GGC should appoint young people as social media managers for peer related content.

NHS GGC social media strategy should include:

1. Creation of interesting,

relevant, engaging content which young people would want to share

2. Find appropriate health related and user-generated content to share

3. Monitor and respond

to trends (both positive and negative) with appropriate content

4. Blog developments in digital asset strategy

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1.3 PROJECT PARTNERS and young people programme,

Project Partners Mental Health Foundation, Snook and Young Scot have been commissioned to carry out this time-limited project in partnership, concluding in November 2013.

Mental Health Foundation is a leading UK mental health charity, connecting policy, practice and research agendas to support change and campaign for better mental health for everybody. Across two Scottish offices, the organisation

focuses on mental health and inequalities, leading the Scottish Mental Health Arts and Film Festival.

From November 2013, the Foundation will be working in partnership with SAMH to deliver the renewed ‘see me’ anti-stigma programme, which will include increased capacity to support social movements and co-designed campaign approaches with stakeholders. Across the UK the Foundation has a major children

which includes Right Here, and the Innovation Labs programme.

Snook have developed a range of creative tools and methods which help people reflect on and articulate their service experiences, uncover insights into barriers to - and opportunities for - service improvement, and re-imagine new design solutions for improved service experience.

Young Scot is the national youth information and citizenship charity for Scotland, specialising in youth engagement. They provide young people with a mixture of information (which includes mental health related issues), ideas and opportunities to help them become confident, informed, active citizens.

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1.4 SUMMARY OF APPROACH Approach The project’s approach is two-fold.

Firstly, it involves a desk research segment to create an illustrative snapshot of the digital media-mental health territory. The snapshot highlights key examples of services and innovations, and identifies existing literature reviews, practice guides and research of note.

case study interviews, engagement activity sessions and surveys form the initial insight gathering stage, with the aim of understanding young people’s digital and social media use, their experiences of mental health related issues and the kinds of support they have had in this respect.

Secondly, the project takes a participatory approach, working with local young people. A series of

This is followed up by co-design sessions with a core group of young people identified during the

engagement sessions.

The outcomes of these sessions is a series of co-produced ideas and recommendations.

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1.5 CASE FOR A CO-DESIGN / CO-PRODUCTION BASED APPROACH The health service rationale The Scottish Government recently outlined a serious commitment to engaging a wider range of people in the co-design and co-production of public services in the Christie Commission Report (2011). This was followed in 2007 by the Scottish Government’s Better Health, Better Care Action Plan which made a commitment to “a mutual NHS where patients and the public are confirmed as partners rather than recipients of care.” Nationally and internationally, co-design and coproduction of health and wellbeing services, where people take more responsibility for self-care, are recognised as the only solution for sustaining an already overloaded healthcare system (Wanless, 2004).

Most recently Nesta (2013) make the case for a People Powered Health programme that offers the opportunity for “a redefined relationship, a partnership of equals between people and health care professionals. These relationships are trusting, purposeful and oriented to the needs of the individual and not the system.”

Marmot suggests that to reduce

health inequalities we must ‘Enable all children young people and adults to maximise their capabilities and have control over their lives.’

(Marmot 2010). An increase in participation can lead to more appropriate and accessible services, while increasing social capital and people’s self confidence and health-enhancing attitudes (Popay, 2006). Bate and Robert (2007) have championed the use of a design approach to healthcare service improvement under the theme of ‘experienced based design’.

Precedent for such an approach specifically relating to the health of young people and digital technology has been set in Australia. The Australian Cooperative Research Centre for Young People, Technology and Wellbeing (YAW-CRC) was founded in 2010 to bring together academic, voluntary sector and commercial partners to collaborate on research and innovation in young people, digital and mental health research. The organisation has added substantially to the evidence base through developing, piloting and evaluating methods of engaging young people and other

stakeholders in the field. It has recently produced a guide for applying participatory design principles to the development of digital tools for young people in relation to mental health and wellbeing.1 Co-design and co-production: the design approach Co-design as an approach in the design tradition has evolved from Scandinavian models of participatory design developed to enable employees and employers to work together to co-design better working environments. (Ehn, 1993). The methodology’s roots are grounded theory by virtue of the iterative approach, where insights gained and themes identified in each cycle of engagement then inform and are explored in the proceeding stages (Glaser and Strauss, 1967, Sanders and Stappers 2008). The Design Council defines co-design practised by designers as: • Tools used by designers to engage non-designers by asking, listening, learning, communicating and

creating solutions collaboratively.

• A community centred methodology that designers use to enable people who will be served by a designed outcome to participate in designing solutions to their problems.

• A way to design a solution for a community, with that community.

Emphasis is on delivering improvements and innovation through a ‘do-with’ not ‘do-to’ approach. The co-design process explores and values differences in opinion and places particular emphasis on understanding the everyday lived experience of ordinary people. The designer facilitates of other’s creativity, using design tools and methods to stimulate a dynamic, creative environment, within which others are able to generate ideas.

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Participatory Design of evidence-based online youth mental health promotion, prevention, early intervention and treatment (Young and Well CRC) http://www.yawcrc.org.au/knowledge-hub/ publications

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References Bate, S.P. and Robert, G. (2007).

Bringing user experience to health care improvement: the concepts, methods and practices of experience-based design. Oxford: Radcliffe Cottam, H and Leadbeater C. (2004).

HEALTH: Co-creating Services, RED paper 01. London: Design Council.

Ehn, P. (1993) Scandinavian Design: On Participation and Skill in Participatory Design: Principles and Practices. Routledge

Marmot, M. (2010) Fair Society, Health Lives: The Marmot Review.

Strategic Review of Health Inequalities in England post-2010.

Sanders, E. B. N. and Stappers, P.J. (2008) ‘Co-creation and the new landscapes of design’, CoDesign, 4: 1, 5 — 18

Glaser, Barney G. and Strauss, Anselm L. (1967) The discovery of grounded theory: strategies for qualitative research. Chicago, Aldine.

Popay, J. (2006) Community engagement, community development and health improvement: a background paper for NICE (available on request by emailing lorraine.taylor@nice.org.uk)

Scottish Government (2011) Commission on the future delivery of Public Services

Horne, M. and Shirley, T. (2009). Coproduction in public services: a new partnership with citizens. London Cabinet Office Strategic Unit.

Wanless, D. (2004). Securing Good Health for the Whole Population.

HMSO. London.

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1.6 OUTCOMES AND DELIVERABLES DELIVERABLE 1:

DELIVERABLE 2:

DELIVERABLE 3:

This includes:

Working through co-design sessions, we have produced advice for young people, in part by young people, that will help them to utilise digital and social media in order to aid positive mental wellbeing. These guidelines will be presented in an imaginative and attractive way, through a short series of illustrated ‘postcards’. These may be printed, but will be flexibly designed for optimum digital dissemination through a variety of channels, critically including the social media networks utilised most frequently by young people. The digital ‘postcards’ will include links to related content and websites.

Taking place on 14th November 2013, the project and its findings were presented in a lively interactive format to interested parties.

Selected young people and key external speakers were invited to speak.

PROJECT REPORT

• The project process in full detail.

• Insights from the case studies, engagement activities and co- design workshops in full detail.

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Ideas from the co-design sessions with our team of young people. It is important to stress that these ideas are not finalised, polished solutions but their feasibility and sustainability have been assessed and inform the final report recommendations.

• A body of recommendations, falling into three categories:

1. Recommendations for development of digital assets

2. Wider recommendations

YOUTH GUIDE

PROJECT PRESENTATION

3. Recommendations for use of existing social media sites by the NHS

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