Addressing digital exclusion in mental health services

With an acceleration in the use of digital tools in health and mental health services across the country, we identified a need to improve digital inclusion for people accessing our mental health services. 

Our research on the Isle of Wight with people with severe mental illness (SMI) highlighted the potential impact of digital exclusion on health. Some of the issues that were raised by participants included: 

• Health and social care making assumptions about a person’s digital skills.
• The specific impact of mental health difficulties on a person’s ability to access digital skills courses.
• The positive impact peer support could have in relation to increasing the level of digital inclusion.

Our project sought to bring research and QI together, testing potential solutions to promote digital inclusion.

When we began the project, it became clear that, even within our professional mental health teams, many staff were not confident with using technology. 

We had staff saying, ​‘I’m not confident with all this technology, I’m not up to speed,’ so there’s definitely a gap to fill there. 

To improve employees’ awareness of digital exclusion, its impact on health and how to promote inclusion, we co-designed a training session with people with lived experience of mental health and digital exclusion. 

This training was aimed at mental health staff and over 80 of our NHS mental health staff received this training. 

Staff reported that the training improved their awareness of the impact of digital exclusion.

We pulled together the local support that was already available into a physical signposting booklet and Padlet, working with the Isle of Wight Council Adult Learning Team and Age UK Isle of Wight.

Following the training, we developed a ​‘digital inclusion champion’ role for our mental health teams and have champions identified in five of our teams. 

The creation of digital inclusion champions has also fostered an interest in using tech in general – so much so that the recovery team are looking into creating their own app. 

We’ve built close links with our organisation’s technology-enabled care team and have been able to trial ideas like using Alexa on the ward to support with activities sessions.

We set out to co-design and co-deliver everything.

We knew that collaborating with partners across the Isle of Wight would be the best way to build on what was already in place, working alongside people with lived experience.

We were able to reach out to relevant stakeholders within the Isle of Wight community during our project launch day. 

Those in the NHS, voluntary and third sector were able to come together and share skills and information. 

We were then able to take this information and create a signposting booklet of services that both staff and those receiving support could access. 

We were trying to make sure we didn’t reinvent the wheel and have used the Learn My Way platform and received lots of support from organisations such as Age UK, adult learning at Isle of Wight Council and Digital Communities Wales.

Making lived experience a focal point of this project was also of huge benefit and working with organisations such as Ventor Wellbeing Cafe really helped to show the true impact of digital exclusion. 

Being able to partner with various organisations across Isle of Wight was a positive theme felt throughout.

We created a peer support digital coach role for someone with lived experience of mental health. 

This followed our research findings that one of the things that would help people with SMI to learn /​ improve their digital skills would be support from someone who really understood their challenges from a lived experience perspective.

We already had peer support workers, but this role was focused on digital coaching with a peer support element.

We created a job description as well as a programme of training, supervision and support. We also considered how this role might fit into the larger team and support mental health recovery as a whole through increased digital skills. 

This would support with the wider determinants of health as well as increasing patients’ self esteem.

Once the role was up and running and our peer support digital coach was seeing people on a one-to-one basis, we had some great feedback demonstrating the value of this type of role. 

Now that our peer support digital coach’s contract has finished we are hoping to sustain this by offering digital support as part of all peer support work roles in the mental health division.

In hindsight, we probably would have benefited from having more time to recruit and implement the project. Some of the challenges we have faced include: 

Struggling to access basic IT equipment – one of the frustrations has been that we have struggled to get the technology for our teams to use on the ground. We requested five or six tablets – mostly Android and one iPad. There was a delay in receiving these due to concerns about the safety and governance of the tablets and other barriers outside of our organisation’s control. 

Embedding a new role in the health system – promoting the role of the digital peer support coach and how they could support people open to our mental health teams took longer than anticipated. Our learning from this was that trialing a new role takes time and visibility. It requires building relationships within the teams as well as employing a range of different communication methods to help people see the potential benefit of the role. 

Recruitment times – it took longer than anticipated to complete the recruitment process, due to the time taken to get a new job role approved and matched for banding and for the candidate to complete the training and induction plan. We probably needed 18 months rather than 12 months to get the role in place and start to see results.

On a personal note, I really appreciated the amazing support from Q.

The reflective practice sessions were beneficial in giving me the space to reflect on the project and receive coaching to come up with my own solutions to challenges during the project. 

It was great to hear about other projects and connect with others exploring similar areas. 

The evaluation sessions helped me develop and refine my project logic model, which gave me more focus and direction. The follow-up sessions supporting with project evaluation definitely built my confidence in the process of evaluation.

We are contributing to the next peer support work away day in May to discuss digital inclusion within peer support work roles. 

We are also running a weekly digital skills drop-in session for our patients on our inpatient mental health wards and will establish a quarterly digital inclusion champions network for our staff. 

Digital Communities Wales have been very generous in sharing their training resources with us so we can use these to further upskill people. 

Our work has been shortlisted for a HSJ Digital award in the ​‘Digital equality, diversity and inclusion’ category and we will be presenting a poster of our work at the Mental Health Improve event in London in April.