On December 1, 2017, Dr. Dorien Nieman and collaborators of the AMC Dept. of Psychiatry starts with a ZON-MW funded project (of k€ 460) entitled ‘ENgage YOung people earlY (ENYOY): Headspace in the Netherlands ‘
Since 75 percent of mental disorders start before the age of 25, early detection and intervention in young people is critical to prevent mild symptoms from becoming chronic. Unfortunately, professional help-seeking and access to care are low in this group. Australia is world leading in reforming youth mental health with over 100 youth-friendly, low-stigma community Headspace centres in which youngsters, their family and friends can seek help for general health and education problems, drug use and (emerging) psychiatric symptoms. These centres aim at early detection and treatment of psychiatric symptoms as well as personalized health care for young people aged 12-25 years and have also been implemented in Denmark and Ireland. Inspired by this example, a consortium consisting of three Dutch mental health care institutions (de Bascule in Amsterdam and Mondriaan and Virenze in Maastricht) together with the academic centres AMC, VUmc and Maastricht University recently started with the development of Headspace teams funded by Innovatiefonds Zorgverzekeraars. The Headspace centres operated by the above-mentioned consortium are organized according to the Danish Headspace model and provide personalized health care for young people aged 12-25 years.
The project presented here will be implemented by this consortium in collaboration with the Australian group led by professor McGorry, Trimbos Institute, Buurtzorg Nederland and with young experts by experience in emerging psychiatric problems from Ixta Noa, ExpEx and Jeugdplatform Amsterdam who are involved in the design, evaluation and implementation. The aim of this project is the adaptation and translation of the Australian website eHeadspace Generation Next (GN) for the Netherlands and to assess its effectiveness in supporting young people 12-25 years with mental health problems. eHeadspace GN has been developed in Australia over the past 10 years by the group of profs Alvarez-Jimenez and Gleeson. It integrates the one-to-one service of first generation eHeadspace with the Moderated Online Social Therapy (MOST) platform (the combination of eHeadspace and MOST is abbreviated in this grant-application to eHeadspace GN).
Within eHeadspace GN young people are able to request immediate contact with a clinician. However, they are also able to connect with others, team-up to achieve goals, obtain peer support, take positive interpersonal risks, practice therapeutic techniques, or quietly do their own thing, browsing content and reading the social feed. The therapeutic content combines low-literacy, high concept comics that gently explain and enact therapy skills, in an engaging, interactive way. The therapeutic content is tailored to the needs of help-seeking young people, including support for depression and anxiety, relationships, drug use and vocational assistance. eHeadspace GN protects young people’s anonymity. Accounts are deactivated and content removed when young people do not use the eHealth service for longer than 10 days.
eHeadspace GN incorporates state of the art tools to ensure safety and promote a supportive and positive network. Sophisticated technologies including sentiment analysis prioritise content and enable the moderation of high volume activity ensuring the rapid removal of harmful content. Automation and peer support will relieve pressure on the system by reducing the burden on the live chat resources, and more young people can be helped. The site is characterized by social connectivity, i.e. users can share personal experiences with peers, follow therapeutic modules and contact clinicians if required. The system resembles regular social networking programs i.e. asynchronous, ongoing communication, but provides a private and enclosed social network. In addition, expert moderators guide, but not censor, the interaction to ensure a safe and supportive environment. Young people who visit the Headspace and centres in Amsterdam and Maastricht and have emerging mental health problems will be referred to the eHeadspace GN website and will receive login information as this website is protected.
In addition to the effectiveness of eHeadspace GN, the relationship between stress biomarkers, symptoms and outcome measures that are relevant for clients who use the eHeadspace GN website is also object of this study. To enhance sustainability of the project, the project group has already established working relations with the municipalities of Amsterdam and Maastricht and has invited members of health insurance companies to conferences and workshops to inform them about Headspace and eHeadspace GN.