Thank you to WMAHSN for providing this fantastic case study from their Meridian service.
BESTIE (powered by Wupwoo) is an interactive online platform built by Worcestershire Health and Care NHS Trust. It was designed by local young people, clinicians from the Trust, IT experts, an online design team and Child and Adolescent Mental Health Services (CAMHS). The project was led by the Service Lead for Psychological Interventions, Dr Ben Rogers.
The projects goal is to revolutionise the way children, young people and parents get access to online support for emotional wellbeing and mental health. BESTIE’s virtual world combines digital media, instant messaging, built- in- games and supportive information, all within an anonymous, safe platform.
Why did we need to innovate?
Half of all mental health problems manifest by the age of 14, with 75% by the age of 24. Almost 1 in 4 children and young people show some evidence of mental ill health (including anxiety and depression).
CAMHS provides specialist mental health services to children, young people and families within Worcestershire. CAMHS works with young people from 0-18 and provides a range of services including: CAST (consultation, advice, support & training), R4W (Reach 4 Wellbeing), ISL (integrated service for looked after children, CEDS-CYP (community eating disorders for children, young people and families), Learning Disability CAMHS. CAMHS fundamentally wanted to improve their design, delivery and knowledge on the digital world so that they could improve the services that they provide to young people and adults.
Therefore, the BESTIE app derived from the increasing recognition in CAMHS that there was a need for better understanding of the digital world, which is now used by many children and young people. CAMHS Service users and members of the Youth Board highlighted that whilst online resources for young people with mental health needs are increasing, many of them have been designed by adults. They also felt that the technology that the NHS have used is not comparable to the technology that they use in their daily lives, especially in terms of gaming and social media.
The ‘name’ of the app was also created by the Youth Board. BESTIE (powered by Wupwoo) was selected. The name also has a meaning behind its elements, which illustrates what is important to the Youth:
B – Balance
E – Energy
S – Support
T – Thrive
I – Interactive
E – Evolve
The app was therefore collaboratively designed, built and developed by clinicians, IT colleagues, web designers and the Youth Board in Worcestershire, due to the amount of mental health problems in young people and the need to understand the digital world better.
Impact and outcomes
There are many positive outcomes and impacts from the BESTIE project. Firstly, the app was collaboratively designed, built and developed by young people, clinicians and IT experts. This allowed an input of young people who welcomed the opportunity to share their expertise and experience. The project aims to help young people better manager their health needs and make services easily accessible.
There are five key ‘domains’ which the app was designed around to improve services for CAMHS users:
- Personalisation (e.g. the ability to personalise the product to the individual in terms of appearance, resources and information).
- Information (e.g. the ability to gain helpful information about mental health and wellbeing including videos, links, webpages as well as information about CAMHS services).
- Tracking how I am (e.g. the ability to track outcomes, mood, progress and goals).
- Social (e.g. the ability to use social contact such as peer mentors and online clinician-facilitated groups).
- Gaming and tech (e.g. the use of new technology, including games, smart devices and activities which support young people’s mental health).
These five domains were achieved through the app by the following:
- Users can create and personalise their own ‘My Bestie’ character. They can also browse different types of clothing and dress their own character. Furthermore, users can personalise their virtual space by decorating and furnishing it to their own style.
- An ‘information hub’, is where users can browse through a range of topics and can save them to their personal space. Information in the ‘Information Hub’ is regularly updated.
- Users can track their emotions and goals using their own characters. The BESTIE diaries can help users keep track of things going on in their life’s and can help to remind users of things they have been working on in CAMHS.
- There is also a social aspect to the app where users can talk to like-minded people and clinicians on the anonymous platform. Groups are by invitation in CAMHS and a clinician is always present in those groups.
- Games are also included, to help users have fun and find new ways of getting out the house and into the world with the activity games provided.
These five domains have helped young people with their emotional and mental wellbeing. For example, the key benefits that have come from the app allows individuals to:
- Improve awareness, reflection and understanding of own mental health needs and ways of managing these needs.
- Share own recovery stories (including the positive impact on Mental Health).
- Be able to use skills learned in CAMHS in real-world settings.
- Engage in the clinical therapy used, including in-between sessions.
- Connect with clinicians and young people in safe, online group settings.
- Increase use of outcome monitoring and engagement in tracking moods/emotions/goals.
- Access safe and clinically effective information.
- Track outcomes and goals.
- Improve self-reported self-esteem.
Overall, BESITE encourages users to engage in social, physical and health – related activities. There are two versions of BESTIE. One version aims to support young people who are accessing mental health services and provides them with online resources and tools to support their specific care plans, as well as resources which helps them track their mood, goals and progress – providing tailored help and guidance wherever needed.
The second version will be a public version of the app, which will also be available to download. This version will provide more generic advice and support for young people and parents.
The team also hopes that the information will serve the purpose of validating and normalising experiences. It could be that this potential increase in hope, understanding, motivation and psychological thinking would result in a decrease in the amount and type of severe order intervention.
Therefore, the app improves engagement of young people with mental health services by producing a safe digital space where they can interact with other users and mental health professionals.
BESTIE is currently being piloted and has been shared across the healthcare sector ahead of going live later this year. BESTIE is available via a web-app and will be available on the App Store and Android.
Plans for the Future
The development of the first public version of BESTIE has now been released via, web-app: https://www.camhsbestie.co.uk/. The Android and Apple App Store versions will be released soon.
Most of the development is now complete on the full version of the CAMHS app, which includes, Tracking and Diary Tools, Group Therapy and Chat modules.
Testing is also underway with the extraction of clinical data from BESTIE into our Electronic Patient Record.
The expected end date for this project is August 2021 which the team are currently on track for.
Moreover, our aim is to further spread awareness on mental health in young people and demonstrate how the BESTIE app can positively impact emotional wellbeing and mental health whilst reducing exposure to more harmful social media platforms.