Acceptability and utility of an electronic psychosocial assessment (myAssessment) to increase self-disclosure in youth mental healthcare: a quasi-experimental study.

BACKGROUND: Technology is increasingly being used in youth mental healthcare to support service delivery and improve health outcomes. The current study trialed a new electronic psychosocial application (myAssessment) that aims to provide a holistic assessment of relevant risk and protective factors in youth mental healthcare. The study aimed to determine whether myAssessment was acceptable to all users, and whether it affected: reporting of certain behaviors and ratings of self-disclosure; youth ratings of control, fears of judgmental reactions or time-efficiency; clinician ratings of time-efficiency or their ability to formulate a treatment plan; and the therapeutic alliance. METHOD: The application was tested at a youth mental health service using a quasi-experimental two phase Treatment-as-Usual/Intervention design. Three hundred thirty nine youth and 13 clinicians participated across both phases. Reporting of behaviors, self-disclosure, youth control, judgmental reactions, time efficiency, ability to formulate treatment plans, and the therapeutic alliance were compared between groups. RESULTS: myAssessment was found to be widely accepted by both young people and clinicians. Use of myAssessment resulted in reporting of behaviors that were 2.78 through 10.38 times higher for a variety of substances (use of tobacco, alcohol, cannabis, sedatives, hallucinogens, and opioids), in identifying non-heterosexual sexual orientation, having had sex, an STI check, sex without a condom, having felt pressured to have sex in the past, having self-harmed, and in having put themselves in an unsafe situation. Participants who used the application also reported being less likely to lie on past experiences of being bullied, substance use, and self-harm. Use of the application resulted in improved youth ratings of time efficiency in session. The application was found to have no impact on youth control, judgmental reactions, formulation of treatment plans, or the therapeutic alliance. CONCLUSIONS: Electronic psychosocial assessments can increase rates of self-disclosure and, therefore, provide an earlier and more comprehensive picture of young people's risks without negatively impacting the therapeutic alliance. Additionally, this type of technology has been shown to be widely accepted by both young people and clinicians and can improve youth beliefs that there is enough time in session to speak about what is most important to them.

Young People's Views on Electronic Mental Health Assessment: Prefer to Type than Talk?

For mental health professionals to provide personalized early interventions, young people need to disclose sensitive information to a clinician they are unlikely to have yet formed a relationship with. We conducted in-depth qualitative interviews with 129 young people aged 12-25 years from several sites across Australia to gauge views on whether young people thought that an electronic psychosocial assessment tool could help them initially disclose personal information. Additionally, we were interested in whether young people from different demographic groups held similar views around using the e-tool. Results provided support for the use of an e-tool, with most young people stating that it could help in the disclosure of particularly embarrassing problems. The main advantages reported were that the e-tool would support disclosure without fear of judgment by health professionals, and would enable young people greater input in deciding what to focus on. Young people who held a preference to simply talk were most concerned about the clinician missing non-verbal cues. These findings highlight the value of incorporating electronic options within clinical practice, but also the need for health professionals to work within a flexible framework guided by the individual preferences of each of their clients.