In response to null findings like these, people often say 'We need to improve engagement'. Do coproduction, make the app more fun, etc I advocate for an alternative: young people are telling us they don't like or want this, and we should listen to them. - ThreadSky

lucyfoulkes.bsky.social • 57 days ago

In response to null findings like these, people often say 'We need to improve engagement'. Do coproduction, make the app more fun, etc

I advocate for an alternative: young people are telling us they don't like or want this, and we should listen to them.

Comments

carolinejmolloy.bsky.social•52 days ago

Couldn’t agree more. The other response I’ve seen (alarmingly, endorsed by the then head of research at DHSC) is that we should simply reduce the evidence requirements, specifically, reduce the need to consider the people who dropped out of the trial, as significant.

cjmccabe.bsky.social•52 days ago

It's a well established approach in the DHSC. Pushed in the drugs evaluation world for industrial policy purposes (regulatory capture) and now bleeds into other areas of health policy. If data overwhelms your prior - throw away the data. I'm not even sure they realise they have abandoned science.

carolinejmolloy.bsky.social•52 days ago

Interesting, yes I think the Guardian article i question showed exactly that process, I wish I could find it now! God knows what MHRA are up to atm, I’ve lost track of the consultations as been focused elsewhere for a while, but wrote about this (and much related) a few years back.

carolinejmolloy.bsky.social•51 days ago

Here https://www.eurozine.com/a-computer-is-all-you-need/

carolinejmolloy.bsky.social•51 days ago

I see they’re currently rebooting the NHS Apps Library 😬

cjmccabe.bsky.social•51 days ago

God help us all.

Knowledge is costly, but ignorance is much more so.

cjmccabe.bsky.social•51 days ago

It's a continuous battle. https://www.nature.com/articles/543174a

True for drugs and all other health care interventions.

carolinejmolloy.bsky.social•51 days ago

Dang I really need to subscribe to Nature

cjmccabe.bsky.social•51 days ago

I have a copy if you'd like to read it - one of the upsides of working for a university.

carolinejmolloy.bsky.social•51 days ago

From what I recall of that article it appeared to me that the drive towards apps was quite deliberately designed to hoover data, strip out pesky doctor gatekeeping of drugs to only actually sick people, & shift the dial on evidence / trial ethics by talking of “labs” & “sandboxes” & ofc “nudges”

cjmccabe.bsky.social•51 days ago

Regulatory capture.

I'm not against risk based regulation - in fact I am all for it - but it needs to be done well; where the risk of harm from uncontrolled access is explicitly factored into the evaluation.

lucyfoulkes.bsky.social•57 days ago

For me, these new findings are exceptionally useful for suggesting we should stop universal MH interventions in schools, and focus on one-to-one, targeted and directed interventions instead. @jackandrews.bsky.social and I argue this is more detail below

https://doi.org/10.1111/camh.12753

lucyfoulkes.bsky.social•57 days ago

Lastly: congrats to the authors on what must have been an enormous amount of work (134 schools! 😥), and thank you for the important contribution this will make to the field

(fin)

louisemewton.bsky.social•57 days ago

One of the issues for us in Aus is that mental health prevention is embedded in our curriculum. We want to replace that with an evidence based option. Universal mental health prevention is happening anyway in our schools. So we need to find something that works!

lucyfoulkes.bsky.social•57 days ago

Thanks - I agree that's so tricky. It's a shame that whoever is making that decision (that universal prevention must be in the curriculum) isn't looking at the evidence. It's sad because it wastes young people's time and they don't want to do it 😔

therewithal.bsky.social•50 days ago

I always wonder whether decision makers have any lived experience of powerlessness and/or mental health challenges.

louisemewton.bsky.social•57 days ago

Thanks Lucy - it is tricky! Our kids need to learn about mental health and how to manage it. It's just working out the best way to deliver it. At the moment, our curriculum does not do it well. I'm hoping we'll get there though!

j-dot-stan.bsky.social•56 days ago

Regardless, curriculum (i.e., ELA, math, sci, history, etc) is not the best place to try to add on mental health!

j-dot-stan.bsky.social•56 days ago

In my experience, most young ppl are ok & don't need/want interventions. Some are ok, but go through a rough patch & need brief help. A very small minority need 1:1 ... and in ALL cases young ppl communicate their needs (behaviorally &/or w words).
(I'm a sch social worker (reg. nyc hs))

sthelen.bsky.social•56 days ago

Okay but what if nothing works and you just spin your wheels for decades looking for an easy solution for all adolescent mental health

drandreahoward.bsky.social•56 days ago

📌

pompoustakes.bsky.social•57 days ago

Just a thought on this: isn't 121 CBT going to be right up there on the list of things AI can offer instead of human practitioners?

lucyfoulkes.bsky.social•57 days ago

Yes, and that's not necessarily a bad thing. The research would need to be done (I suspect it already is), but this approach might be helpful if a) people want it and b) they have heightened symptoms. But that's a separate question to whether schools can make young people do it who don't want it

pompoustakes.bsky.social•57 days ago

Thanks. I know I shld try to read it, but do you happen to know if they filtered out the participants that did engage & whether there was any beneficial effect there?

lucyfoulkes.bsky.social•57 days ago

pompoustakes.bsky.social•56 days ago

Whatever about the characterising numbers, the graph, especially regarding the high engagers, looks all over the place.
And "complicated by significant symptom differences at baseline" sort of begs the question 'what sort of differences & why were they particularly complicting: what were they?'

j-dot-stan.bsky.social•56 days ago

THIS. ^^^^ Maybe listen to people when they say words with their mouths. I am school social worker in a regular nyc high school (i.e., anyone can go, it is free) - and 1000% THIS.

collaterly.bsky.social•51 days ago

hear, hear!

Comments

Posting Rules

Reply