Adolescence, digital technology and mental health care: exploring opportunity and harm.

这项工作将为一项重要的研究方案铺平道路，该方案的重点是青少年使用数字技术与心理健康咨询的相关性。我们将探索数字技术使用带来的机遇和危害，以及在会诊中解决这些问题是否有助于临床医生管理患者风险。具体地说，我们将提出以下问题：是否可以利用年轻人的技术使用来丰富面对面咨询，并将其用作使这些咨询更好和更有效地工作的工具；以及临床医生是否可以在防范有害使用方面发挥作用。我们将有三个工作流程：1)我们将与年轻人、他们的照顾者、精神健康从业者、全科医生、社会护理工作者和技术提供者密切合作，让他们参与我们的计划。我们将询问他们认为这一领域最重要的问题和需求，并探讨他们关于可能的解决方案和可以接受的研究类型的想法。为此，我们会与这些团体举办一连串的讨论工作坊、征询从业员的意见，以了解他们目前如何处理与数码科技有关的问题，以及为年青人举办以艺术为本的活动计划，帮助他们表达自己和思考所讨论的问题。我们将创建一个在线中心，使我们成为一个工作社区。这将有助于我们共同为研究计划制定研究计划。2)我们将与其他研究人员合作，特别是普通医学和数据科学领域的研究人员，花时间考虑将这些重要领域纳入我们的研究方案的最佳方式。3)开展两个试点。第一项研究将着眼于一个新出现的例子，说明科技的使用可能提供了一个机会：在这个例子中，MeeTwo青少年心理健康应用程序向心理健康临床医生提供有关苦恼年轻人的信息，以帮助进行病史记录和分类。我们将对发生这种情况的地方进行案例研究，采访参与其中的年轻人和临床医生，以找出这是否有帮助，是否可以接受，以及它是否可能改善他们的关系和年轻人的护理。我们的第二个项目源于皇家精神病学学院最近发布的建议，即心理健康临床医生在评估风险时应该询问年轻人的在线活动。这是为了认识到一些内容的有害影响，例如，与身体形象和自我伤害有关的影响。我们从之前的研究中了解到，临床医生同意这一点很重要，但对如何安全地进行此类对话感到担忧。我们的项目将汇集一个由心理健康临床医生和有心理健康困难经历的年轻人组成的虚拟小组。每个小组将被要求对关于临床医生应该如何向年轻人询问技术使用情况的陈述(德尔福研究)进行评级，包括应该询问什么，何时和由谁询问。我们将寻求达成一致，保留获得高度认可的声明。我们将利用这些结果来设计一套由临床医生和年轻人达成一致的指导方针，指导精神健康临床医生与年轻人谈论技术使用的最佳方式。我们的试点项目将为全面研究提供基础。项目1引入了可行性工作，探索更广泛地使用丰富的历史记录和分类的机会。项目2引入了关于临床益处和干预的研究，这些研究可能会通过将有关技术使用的问题添加到精神健康评估中来进行。我们的活动将使我们能够设计一个全面的研究计划，了解对我们最重要的人的关键需求、问题和可能的解决方案；并与合作伙伴(临床、学术、数字技术提供商和年轻人)发展关系，以实现这一目标

This work will pave the way for a substantial programme of research focused on the relevance of adolescents' digital technology use to consultations about mental health. We will explore both opportunities and harms posed by digital technology use and if addressing these in consultations can help clinicians to manage patient risk. Specifically, we will pose questions around whether young people's technology use can be drawn upon to enrich face-to-face consultations, used as a tool to make these work better and more efficiently; and whether clinicians have a role to play in safeguarding against harmful use. There will be three workstreams of activity: 1) we will work closely with young people, their carers, mental health practitioners, general practitioners, social care workers, and technology providers to involve them in shaping our plans. We will ask what they consider to be the most important questions and needs in this area and explore their ideas about possible solutions and the type of research that would be acceptable to carry out. To do this, we will run a series of discussion workshops with these groups, consult practitioners to find out how they currently address issues relating to digital technology, and run a programme of arts-based activities with young people to help them express themselves and think about the issues under discussion. We will generate an online hub to make us a working community. This will help us jointly create research plans for a programme of research. 2) we will work with other researchers, especially those in general practice and data science, taking time to consider the best ways to include these important areas in our programme of research. 3) we will conduct two pilot projects. The first will look at a newly emerging example of where technology use may provide an opportunity: in this instance, for the MeeTwo teenage mental health app to provide information to mental health clinicians about a distressed young person, to help with history-taking and triage. We will build cases studies of where this happens, interviewing the young person and clinician involved to find out whether this was helpful, acceptable, and if it may have improved their relationship and the young person's care. Our second project stems from recent advice issued by the Royal College of Psychiatrists that mental health clinicians should ask young people about their online activities when assessing risk. This is in recognition of the harmful effects of some content, for instance, in relation to body image and self-harm. We know from our previous research that clinicians agree this is important but have concerns about how to engage in such conversations safely. Our project will gather together a virtual panel of mental health clinicians and of young people with experience of mental health difficulties. Each panel will be asked to rate statements (a Delphi study) about how clinicians should ask young people about technology use, including what should be asked, when and by whom. We will look for agreement, keeping the statements that receive a high level of endorsement. We will use the results to design a set of guidelines agreed by clinicians and young people about the best ways for mental health clinicians to talk to young people about technology use. Our pilot projects will provide the foundations for full-scale research. Project 1 leads into feasibility work exploring opportunities for technology enriched history taking and triage to be used more widely. Project 2 leads into research on clinical benefits and interventions that could follow from adding questions about technology use to mental health assessment. Our activities will allow us to design a comprehensive programme of research informed by the key needs, questions, and possible solutions of those to whom it matters most; and to develop relationships with partners (clinical, academic, digital technology providers, and young people) to bring this to fruition