using technology to improve the mental health literacy · pdf file“medically ready force...

“Medically Ready Force . . . . Ready Medical Force” 1

Kelly A. Blasko, Ph.D.

20 January 2016 13:15 – 14:45

Counseling Psychologist

Mobile Web Program Lead

National Center for Telehealth & Technology (T2)

Joint Base Lewis-McChord, WA

Session 3: Using Technology to Improve the Mental Health Literacy of Military Youth


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“Medically Ready Force . . . . Ready Medical Force”

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8

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Questions and Chat



Webinar Overview

Research on the psychological health of military youth suggests that frequent transitions, parental separations, and the cumulative effects of multiple deployment can negatively impact their well-being.

Although military youth are generally resilient, many are coping with increased levels of anxiety, stress, depressive symptoms, suicidal ideation and behavioral problems. Age-appropriate mental health literacy is important to instill an understanding of psychological distress and to improve self-care.

In general, youth are entrenched in the use of mobile technology on a day-to-day basis. As a result, Web- and mobile-based technologies are vehicles for delivering psycho-education to military youth to teach coping strategies.

Webinar participants will learn to:

Define mental health literacy and how it relates to military youth.

Understand the latest research on mental health literacy and technology.

Integrate the use of Web- and mobile-based applications resources into outreach and clinical settings.

10


Dr. Kelly Blasko is a counseling

psychologist leading the mobile Web

program for the National Center for

Telehealth & Technology (T2).

She earned her M.A. in Marriage and

Family Therapy at Appalachian State

University and her Ph.D. in counseling

psychology from the Pennsylvania State

University.

She is internationally recognized for her

work in using technology to improve the

well-being of military children and their

parents. Currently, she is managing projects

to improve the adoption of behavioral health

technology applications in primary care

within the military health system.




Counseling Psychologist

Mobile Web Program Lead

National Center for Telehealth & Technology

(T2)

Joint Base Lewis-McChord, WA

Using Technology to Improve the Mental

Health Literacy of Military Youth

12


Disclosures

The views expressed in this presentation are those of

the presenter, Dr. Blasko, and do not reflect the official

policy of the Department of the U.S. Army or U.S.

Department of Defense.

Dr. Blasko has no relevant financial relationships to

disclose.

Dr. Blasko does not intend to discuss the off-

label/investigative (unapproved) use of commercial

products or devices.

13


Stock photo

Over 700,000 (38.5 percent) of military children

are between the ages of 9 and 18.8 I want to provide

military children

with every

opportunity to

flourish as they

face the unique

challenges of

military life.

Impetus for My Work


Stock photos

Military Children Support

System


Overview

Psychological health of military children

Mental health literacy

Technology as tools

Application: Military Kids Connect

16


Military Children’s Lives

Will my parent be safe and return unharmed?

Transitions: Moving, Deployment(s), Homecomings,

Reintegration, Military to Civilian

Adopt Military Values: Resilience, Trust, Service, Duty24

17


Hierarchy of Risk

Peacetime

Wartime

Deployment

Trauma

Wounds and injuries

Bereavement

Levels of stress: “positive, tolerable, toxic”10

18


Military Youth:

Psychological Health Concerns

Rates of behavioral and stress disorders among youth

increased by about 18 percent during times of parental

deployment.14

Reported concerns of military adolescents: loss of

interest in activities, social withdrawal, changes in

sleeping and eating, sadness, irritability, worry about

their parent’s safety, and disrespectful behavior.12

19


Suicidality and

Military-Connected Youth

Compared to not military-connected youth, military youth

are reporting a higher prevalence of suicidal ideation and

suicidal behavior (i.e., made a plan, attempts, attempt

requiring medical treatment).11

20


Barriers Military Teens (n=13)

Military Parents (n=12)

Internal - Lack of perceived relevance

5 6

Internal - Ethic of self-reliance

4 3

Internal –Confidentiality concerns

3 7

Internal - Stigma concerns 1 6

External - Time and effort concerns

6 10

External - Logistical concerns 4 8

External - Financial concerns 1 4

Based on a

qualitative study of

military adolescents

(ages 12 to 17)³

Barriers to Help-Seeking


Mental Health Literacy

What:

“…knowledge and beliefs about mental disorders which

aid their recognition, management or prevention.” 17

Why:

Recognition of early signs of mental health disorders

facilitate early help-seeking.

Mental disorders often have first onset during

adolescence or early adulthood.16

22


What We Need To Know

How to prevent mental disorders

Recognize symptoms as they emerge

Available help-seeking options and treatments

Effective self-help strategies for milder problems

Skills to give mental health first aid and support to others

23


Source of Help

Adolescents often say they will turn to friends as a

source of help if they have a mental health problem.6

Peers may not have the experience or maturity to take

on this role or to facilitate professional help-seeking.18

24


Improving Mental Health Literacy

Whole-of-community campaigns

Interventions based in educational settings

Mental health first aid training

Web-based interventions16

25


Stock photo

“‘Native speakers’ of the

digital language of

computers, video games

and the Internet”26

Anybody born after 1980

New cohorts of digital

natives15

Increased usage of mobile

technologies and social

networking

Military Children Are

Digital Natives


Technology

Internet

Search engines: Find information across many different websites

Websites: Enable browsing through mental health information

provided by a trusted source

Crisis and helplines

Mobile apps

Prevention through skill-building and education (per app)

Social media

Create a community of interested users

Sharing of community-relevant information

Commenting on topics

27


Behavioral Health and Technology

Internet-based programs have been found effective in

improving the behavioral health of children at-large.7,28

Web-based peer support utilizing online forums and chat

rooms has been found to help children cope with

parental cancer12 and with asthma.29

28


Behavioral Health and Social Media

Youth use Facebook to maintain and build relationships

with their geographically dispersed peers and is a useful

tool for receiving social support.22

29


Environmental Scan

Found

Many military parent-facing technology resources

available

Use of technology to improve parent-child

communication

Missing

Limited child-facing, military-specific Web resources

No military youth online community

30


Improve the quality of life for military youth

(ages 6-17) as they face the psychological

challenges unique to military life.5

Mission


Military Kids Connect Program

Education

Age-appropriate quality

content and website

design

Designed for military

children (ages 6 to 17)

Inclusion of information

for parents and educators

Peer support

Outreach

Marketing strategies for

target audience

Alliance and partnership

building

Conference activities

Outreach activities

Live in-person events

Live social media events

32


Military Kids Connect and

Mental Health Literacy

Web-based interventions MKC is a military youth-facing website

Whole-of-community campaigns Engage military teens through social media

Outreach to military parents and educators

Interventions based in educational settings Training educators on military culture

Mental health first aid training Resources for military youth support network

33


Underlying Principles

Emphasis on stress reduction Recognizing and managing stress

Normalizing experiences

Setting expectations

Self-expression

Use of peer-to-peer support Sense of connectedness with military peers23

Online community, role models

Social learning1/social comparison19

34


Key Requirements

Provide prevention services for military children

Create engaging psycho-educational activities or tools

Facilitate peer-to-peer support between military youth

Develop and design content to be age-appropriate

Represent materials as military-specific

Ensure safety and security of military children

35


The Five Tracks of MKC


Safety & Security Considerations

Major parent concerns4

Sexual predation on minors by adults

Bullying and harassment by peers

Harmful, problematic and illegal content

Child Online Privacy Protection Act of 1998 (COPPA)

DoD-specific concerns

Operation security

Cyberthreat

37


Activities Landing Page


Stress education

Stress management plans

Body awareness

Self-expression

Comic creator

Projects

Tell your story

Images from www.militarykidsconnect.dcoe.mil

Stress-Reduction Tools


Images from www.militarykidsconnect.dcoe.mil

Personal story videos – Real military youth sharing

how they coped with their parents’ deployment

– Military families discussing what it was like when their parent came home

– Commenting

Interactive map to learn culture of commonly deployed countries

Deployment daily – Tips on how to deal with all

parts of the deployment cycle

Normalizing Experience


Pre-moderated message

board

Commenting on dilemmas

facing military youth

Setting expectations

Connect: Peer-to-Peer Support


Focus on living with a

parent with an injury:

PTSD, TBI, physical injury

Animated graphic novels to

educate on family

adjustment

Real military youth

personal stories

Tough Topics Related

to Reintegration


Games as Distractors


Tough Topics:

Parents/Educator Tracks


Educators: Military Culture


Daily FB, Twitter posts to

increase engagement

Weekly blog

New videos

Reserve teens

personal stories

Teen tours

Moving microdocs

Moving animated

graphic novels

Connect: Social Media


Considerations

MHS monthly themes

National themes

Holidays

School events

PCS Timeline

Monthly themes/Audience

Planning

Increasing target audience

engagement with MKC

content on the website, in

social media and at events

Growing the MKC community

(military tweens/teens)

Increasing awareness/use of

MKC content among parents,

educators and providers

Key Objectives

MKC Marketing Plan


Digital ads, Google Adwords, Promote

FB posts, Feature focus…

Educator in-service package, Provider

guide

School and teen center posters,

brochures, movie ads

Professional conferences (MCEC,

USAFP), T2 visits, on-base events,

live social media events

Examples of Channels &

Media


Lessons Learned: Building a Military Teen Channel

Market directly to teens

on social media

Don't make the “voice” of

the communication

authoritarian or directive

Speak “with” them, not

“at” them

Don’t oversaturate use of

celebrities

Tie social media events with a pre-planned live event

More likely to generate comments when we ask (serious) questions

Difficult and expensive to target tweens

Visual style important

– Illustration vs. photo

– Military visuals

– Static vs. animated

49


Next Steps

Need further outcome studies

Continue to innovate to meet the needs of military youth

- Continuous re-evaluation of psychological needs

- New and innovative adoption strategies

- State-of-the-art technologies: augmented reality,

serious games, interactive digital stories, virtual reality

50


T2 Websites for Adults and Parents

National Center for Telehealth & Technology

(T2)

http://t2health.dcoe.mil

Parenting for Service Members and Veterans

http://militaryparenting.dcoe.mil

AfterDeployment

http://afterdeployment.dcoe.mil

Moving Forward

http://startmovingforward.dcoe.mil

DoD Websites for Kids & Teens

FOCUS World

http://www.focusproject.org/focus-world-intro

T2 Websites for Kids and Teens

Military Kids Connect

https://militarykidsconnect.dcoe.mil/

Military Kids Connect Facebook

http://www.facebook.com/MilitaryKidsConnect

Military Kids Connect Google+

https://plus.google.com/1012380438372759252

14/posts

Military Kids Connect You Tube

https://www.youtube.com/user/MilitaryKidsConn

ect

Sesame Street for Military Families

http://www.sesamestreetformilitaryfamilies.org/

Resource List: Websites

51

http://t2health.dcoe.mil/

http://militaryparenting.dcoe.mil/

http://afterdeployment.dcoe.mil/

http://startmovingforward.dcoe.mil/

http://startmovingforward.dcoe.mil/






https://militarykidsconnect.dcoe.mil/

http://www.facebook.com/MilitaryKidsConnect

https://plus.google.com/101238043837275925214/posts



https://www.youtube.com/user/MilitaryKidsConnect

https://www.youtube.com/user/MilitaryKidsConnect

http://www.sesamestreetformilitaryfamilies.org/


Wellness Apps for Teens (iOS & Android) Breathe2Relax

Positive Activity Jackpot

T2 Mood Tracker

Virtual Hope Box

http://t2health.dcoe.mil/products/mobile-apps

Wellness for Kids (iOS & Android) The Big Moving Adventure

Breathe, Think, Do with Sesame

Feel Electric!

Sesame Street for Military Families

Resource List:

Mobile Apps for Kids






Wellness Apps for Adults (iOS & Android) ACT Coach (iOS only)

Breathe2Relax

CBT-i Coach: Cognitive Behavioral Therapy for Insomnia

Concussion Coach (iOS only*)

CPT Coach (iOS only*)

LifeArmor

Mindfulness Coach (iOS only)

Moving Forward (iOS only)

Parenting2GO (iOS only)

PE Coach

Positive Activity Jackpot

PTSD Coach

Stay Quit Coach (iOS only*)

T2 Mood Tracker * Android pending VA release

Tactical Breather http://t2health.dcoe.mil/products/mobile-apps

Virtual Hope Box

Resource List:

Mobile Apps for Adults





Summary

During this webinar, participants learned to:

Define mental health literacy and how it relates to military youth.

Understand the latest research on mental health literacy and technology.

Integrate the use of Web- and mobile-based applications resources into outreach and clinical settings.

54


References - #'s 1-6

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Hall.

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Military Medicine, 174(10), 1033-1040.

3. Becker, S.J., Swenson, R.R., Esposito-Smythers, C., Cataldo, A.M., & Spirito, A. (2014). Barriers to seeking mental health services among

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5. Blasko, K. A. (2015). Military Kids Connect: Web-based prevention services for military children. Psychological Services, 12(3), 261-266.

http://dx.doi.org/10.1037/ser0000025

6. Burns, J. R. & Rapee, R. M. (2006). Adolescent mental health literacy: Young people’s knowledge of depression and help seeking. Journal of

Adolescence, 29, 225-239.

55



7. Calear, A. & Christensen, H. (2010). Review of internet-based prevention and treatment programs for anxiety and depression in children and

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http://download.militaryonesource.mil/12038/MOS/Reports/2014-Demographics-Report.pdf

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Easterbrooks, M. A., Ginsburg, K., & Lerner, R. M. (2013). Resilience among military youth. Future of Children 23(2), 99-120.

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connected adolescents in California schools. European Child & Adolescent Psychiatry, DOI 10.1007/s00787-015-0696-2

11. Gorman, G. H., Eide, M., & Hisle-Gorman, E. (2010). Wartime military deployment and increased pediatric mental and behavioral health

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13. Huebner, A.J., & Mancini, J. A. (2005). Adjustments among adolescents in military families when a parent is deployed. Final report to the

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58

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27. Siemer, C., Fogel, J., & Van Voorhees, B. (2011). Telemental health and web-based applications in children and adolescents. Child and

Adolescent Psychiatric Clinics of North America, 20(1), 135-153.

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Deanna Beech, Ph.D., M.A., B.S.

Child Psychologist

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