Flip the Clinic: A Digital Health Approach to Youth Mental Health Service Delivery During the COVID-19 Pandemic and Beyond.

Tracey A Davenport,Amy Burton,Frank Iorfino,Elizabeth M Scott,Eva Castaldi,Vanessa Wan Sze Cheng,Ian B Hickie,Blake Hamilton

doi:10.2196/24578

Abstract

The demand for mental health services is projected to rapidly increase as a direct and indirect result of the COVID-19 pandemic. Given that young people are disproportionately disadvantaged by mental illness and will face further challenges related to the COVID-19 pandemic, it is crucial to deliver appropriate mental health care to young people as early as possible. Integrating digital health solutions into mental health service delivery pathways has the potential to greatly increase efficiencies, enabling the provision of “right care, first time.” We propose an innovative digital health solution for demand management intended for use by primary youth mental health services, comprised of (1) a youth mental health model of care (ie, the Brain and Mind Centre Youth Model) and (2) a health information technology specifically designed to deliver this model of care (eg, the InnoWell Platform). We also propose an operational protocol of how this solution could be applied to primary youth mental health service delivery processes. By “flipping” the conventional service delivery models of majority in-clinic and minority web-delivered care to a model where web-delivered care is the default, this digital health solution offers a scalable way of delivering quality youth mental health care both in response to public health crises (such as the COVID-19 pandemic) and on an ongoing basis in the future.

Highlights

The COVID-19 pandemic has created a major public health crisis that has led to multidisciplinary national coordination in which physical distancing and social isolation are being mandated to flatten predicted morbidity and mortality curves [1]
This has led to the emergence of a second public health crisis due to the onset or exacerbation of poor mental health symptoms caused by the social and economic impacts of the COVID-19 pandemic, leading to increased mental health service demand [2]
In March 2020, Medicare moved to support telehealth sessions through temporary Medicare Benefits Schedule (MBS) item numbers that include receiving care via information and communication technologies [3]. This has provided a mechanism for many Australian mental health services to continue to operate “business as usual” even though they have been required to close their front doors

Summary

Introduction

The COVID-19 pandemic has created a major public health crisis that has led to multidisciplinary national coordination in which physical distancing and social isolation are being mandated to flatten predicted morbidity and mortality curves [1]. Our proposed “flipped clinic” service delivery model was developed following many years of clinical and co-design research with participants in the Australian mental health system, including consumers and their supportive others, health professionals, and service providers, to address major problems faced by users of this system: a limited supply of mental health professionals who are burdened with administration and assessment [22]; a lack of communication between mental health providers [4,18]; and the “tyranny of distance” [18,21] This model proposes an innovative redesign of mental health service delivery that harnesses the capabilities of digital technologies (including, but not limited to, eHealth or mobile health [mHealth] interventions and other HITs) to enhance the provision of care for all participants in the system.

Conclusion

Conflicts of Interest

Findings

Empowering 8 Billion Minds