Abstract
Objective: Youth with mental illnesses often engage in unhealthy behaviors associated with early mortality from physical diseases in adulthood, but interventions to support positive health behaviors are rarely offered as part of routine mental health care for this group. Digital health technology that is desirable, accessible, and affordable has the potential to address health behaviors in public mental health settings where many adolescents with severe mental health problems receive care. The aims of this study were to examine how adolescents receiving public mental health services use digital technology and social media and to explore their preferences using technology to support health and wellness.Methods: Using a convergent parallel mixed methods design, we surveyed adolescents ages 13–18 from four community mental health centers in one state and conducted focus group interviews to explore their perspectives on using digital technology and social media to receive health coaching and connect with peers to support healthy behaviors. The survey and focus group data were merged to inform the future development of a digital health intervention for adolescents receiving public mental health services.Results: Of 121 survey respondents (mean age 15.2, SD = 1.5), 92% had a cell phone, 79% had a smartphone, 90% used text messaging, and 98% used social media. Focus group interviews revealed that adolescents were interested in receiving strengths-based mobile health coaching, and they preferred structured online peer-to-peer interactions in which a professional moderator promotes positive connections and adherence to privacy guidelines.Conclusions: Adolescents receiving public mental health services in this study had access to smartphones and were frequent social media users. These data suggest that digital health interventions to promote health and wellness among adolescents may be scalable in community mental health settings. Adolescent participants suggested that digital health interventions for this group should focus on strengths and online peer support for health promotion should include a professional moderator to foster and manage peer-to-peer interactions.
Highlights
Improving the health and mental health of adolescents with serious psychiatric disorders, such as anxiety disorders, bipolar disorders, and psychotic disorders is a public health priority
The unique contribution of this study to the existing literature is the focus on adolescents who receive public mental health services where the majority of poor and low-income families turn for mental health care
With respect to preferences for using digital technology to promote health and wellness, focus group interviews revealed that adolescents were interested in receiving support from a mobile health coach who focused on their strengths, and they preferred a professionally moderated social media intervention with opportunities for structured online peer-to-peer interactions in which the moderator promotes positive connections and adherence to privacy guidelines
Summary
Improving the health and mental health of adolescents with serious psychiatric disorders, such as anxiety disorders, bipolar disorders, and psychotic disorders is a public health priority. Adults who have a serious mental illness (SMI) die 10 to 30 years earlier than the general population. These premature deaths are largely due to preventable and modifiable physical health conditions such as diabetes and heart disease. 50% of adults with SMI smoke [1], nearly two-thirds of individuals with schizophrenia are obese [2], and adults with SMI are significantly more likely to have low physical activity and cardiorespiratory fitness than people without mental illness regardless of socioeconomic status [3]. Intervention may be the key to preventing these dangerous health-risk behaviors before they cause long-term damage for individuals with mental illness. Approximately 50% of all lifetime cases of mental illness begin to develop by the mid-teens and 75% by the mid-20s [4], few evidence-based strategies exist that target health promotion in youth mental health service users, among those who receive care in the public mental health sector that serve many poor and low income households
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