Mobile devices have become pervasive in reach and constant in attention. What role does that availability have as a cause of, and potential solution to, crises in mental health and the care profession? And who falls between the cracks where technology falls short?
Dr Dianne Wepa from Charles Darwin University joins us again along side Dr Jabin from the University of Bradford to talk tech, therapy and professional care.
This episode includes discussion of suicide. Listener discretion is advised.
Read the original article: https://doi.org/10.1177/20552076231174307
Listen to their previous episode: https://doi.org/10.5281/zenodo.10213208
Image Source: Adobe Stock Images / Ladawan
Transcript
00:00:09 Will Mountford
Hello. I’m Will. Welcome to research pod.
00:00:12 Will Mountford
Based on what we know about our audience, there is a 65% chance that you are listening to this on a mobile phone.
00:00:19 Will Mountford
As a tool, mobile devices have become pervasive in reach and constant in attention. What role does that availability have as a cause of and potential solution to, the mounting crises of mental health and care sector staffing, and who falls between the cracks where technology falls short?
00:00:36 Will Mountford
Doctor Diane Wepa from Charles Darwin University joins us again alongside Dr. Jabin from the University of Bradford to talk tech therapy and professional care.
00:00:46 Will Mountford
As a note, this interview includes discussion of suicide and isolation, so listener discretion is advised.
00:00:56 Will Mountford
And joining me from Charles Darwin University is Doctor Diane Wepa and from the University of Bradford, Dr. Jabin. Hello to both of you.
00:01:02 Dr Md Rahman Jabin
Hello. Hello will.
00:01:04 Will Mountford
For listeners who have joined us in our previous episode, we’ll know a bit about Doctor Diane Wepa already, but Jabin, if you’d mind to give us just a few words about yourself.
00:01:12 Dr Md Rahman Jabin
I’m Doctor Mohammad Shafiqul Rahman jabin. Just call me Doctor Jabin. That’s fine. My field of expertise is cognitive system engineering route code analysis.
00:01:22 Dr Md Rahman Jabin
Also incident reports quality and improvement, patient safety and various types of systematic reviews, and I am an assistant professor in public health at the Faculty of Health Studies right now in the University of Bradford. I am also skilled in medical engineering, specializing in medical imaging and devices, and also have information technology systems.
00:01:43 Dr Md Rahman Jabin
And also skilled in cognitive system engineering and also have loving years of professional teaching experience in various dynamic education environments, including adult education, teaching experience in university and higher secondary school. The university teaching includes several health informatics.
00:02:01 Dr Md Rahman Jabin
And public health related courses, undergraduate and postgraduate levels both.
00:02:06 Dr Dianne Wepa
Jabin and I first met at the University of South Australia and I was coordinating a course called First People’s Health, which is the first year course within the Bachelor of Nursing and Midwifery and Allied Health and Job was one of the teaching team and I was really pleased to have him join us because he was able to bring.
00:02:28 Dr Dianne Wepa
A multicultural lens to.
00:02:30 Dr Dianne Wepa
With first peoples in Australia and so from there I moved to the UK to the University of Bradford and then a short while.
00:02:39 Dr Dianne Wepa
later Jabin joined me as well in the public health team, and so we’ve collaborated ever since. And with his focus on digital technologies and health informatics and our shared interest around improving health and well-being for people.
00:02:55 Dr Md Rahman Jabin
Just to add on Diane’s comments, but what I would say that he has, she has already given the background our history and been joining up and our collaboration as well. I would say that the entire idea of my research interest is based on the statement made by one of the health.
00:03:11 Dr Md Rahman Jabin
Expert in Australia named Enrique Guerra and what he states is that the very first rule of Informatics tells us to start with clinical problem we want solve rather than the technology we want to build. So that is the sort of things that actually help me and Diane to come together and work on.
00:03:32 Dr Md Rahman Jabin
What would we like to do in future, particularly from her field mental health perspective and my field, health informatics or digital?
00:03:40 Dr Md Rahman Jabin
Health or health information technology systems or for example, we are currently talking about something called a mobile app and for suicide prevention. So this is something that you know joining us together, I would say Yes, that they’re right into that.
00:03:55 Will Mountford
The main thrust of today’s conversation in our interview is examining mental health in a global context.
00:04:04 Will Mountford
I imagine it’s been a rough couple of years for mental health in the global context, the world has undergone .
00:04:10 Will Mountford
Several seismic shifts and it’s continuing to change at a rapid pace and people are very connected and we hear a lot about people’s well-being. We see a lot of that instability in society and in people.
00:04:24 Will Mountford
And from your perspective, with the academic mindset, what do you see as the state of the world in terms of
00:04:34 Will Mountford
Global mental well-being, especially in relation to how technology and social media and apps are providing either connection or instability in a very, very quickly changing world. Maybe Diane, if you’ll start off with some of the the general psych stuff.
00:04:52 Dr Dianne Wepa
Ohh sure, I think we’re never gonna go back to pre pandemic time.
00:04:57 Dr Dianne Wepa
I think the world has moved, you know, good or bad from that experience because it really has changed a lot of our behaviours in terms of how we work. You know how we engage with each other, even how we travel. And so I think the digital space is probably moved along a lot faster than it would have if we didn’t have the.
00:05:17 Dr Dianne Wepa
Pandemic, because we say we’re a connected.
00:05:21 Dr Dianne Wepa
Globe, you know, at the moment and I think the pandemic brought that along a lot quicker than it should have. It was tracking along at a certain speed and I just think it exponentially escalated because of the pandemic. Would you add to that jab?
00:05:34 Dr Md Rahman Jabin
Yeah, I’m not a big expert of mental health, but what I would say just to have the connection, what Diane has just said now, for example, over the past nine years, my research interest focuses exclusively on combining the fields of health information technology, which I would say abbreviation is hit.
00:05:53 Dr Md Rahman Jabin
Systems solutions and their management in healthcare, particularly with the focus, the quality of care and patient safety. So patient safety is my concern during my PhD. What we find, although the host of mainly technical problems were expected so more than half, which is 58% of the issues were identified to be generated by failures of.
00:06:14 Dr Md Rahman Jabin
Human performance, so human practice, were found to cause more deleterious effects than technical factors. So for example, 6 instances of severe patient harm, four were triggered by human.
00:06:27 Dr Md Rahman Jabin
Factors including two patient deaths. So in this term, this is where that eye and Dan would connect, you know, in terms of our expertise and build probably a new research focused area that we have been working on and we would like to see a new field of area that we can build on.
00:06:48 Will Mountford
Could I ask you to tell me just a bit about the national and international rates of incidents and strategies towards suicide, self harm and how much they reflect that changing social media technology use? Is there anything that’s related to, you know, those kids on their phones being at more risk or having a higher incidence or?
00:07:11 Will Mountford
Is it intergenerational?
00:07:13 Dr Dianne Wepa
Such a complex question, isn’t it?
00:07:15 Dr Dianne Wepa
And it it does require a bit of detail in the response and so if we start in England, the 5275 deaths by suicide occurred in England in 2022. So that’s the equivalent of 10.6 suicides per 100,000 people. That’s according to the Office of National Statistics
00:07:34 Dr Dianne Wepa
And so I must take my hat off to England because the launch of the suicide prevention strategy and action plan in October the 10th, 2023 was wonderful because it was looking at a whole.
00:07:49 Dr Dianne Wepa
System approach and not just locating suicide in the health sphere or education or the workforce. And so if you go to the website on gov.uk, you can download the suicide prevention strategy action plan. And there are many, many areas that the government wants to do to address suicide.
00:08:10 Dr Dianne Wepa
Prevention, because I think they do recognise that there are many risk factors as you said. You know young people on their phones and and we’re so connected. So you can’t just make that one variable. It could be a contributing factor and just the.
00:08:23 Dr Dianne Wepa
And have taken that on board very seriously and put £100 million towards the action plan and that that is really, really wonderful. And I think related to that see as we are talking about young people, there’s an online safety bill in England that is still not translated into.
00:08:44 Dr Dianne Wepa
Legislation just yet, and a key debate within the bill, is a term we call legal but but harmful. And so the question remains like will families have to deal with children who die by suicide as a result of this safety bill come online? Safety bill coming into effect.
00:09:03 Dr Dianne Wepa
So what instigated that was the death of a 14 year old girl, Molly Russell, in 2017 after she saw content about suicide and self harm and that catapulted her story into British history. So her father Ian Russell later found, after she died, that his daughter had engaged in Pinterest and Instagram over 130 times.
00:09:25 Dr Dianne Wepa
A day and saved images of young people cutting themselves and sharing ideas about self.
00:09:31 Dr Dianne Wepa
And the online safety bill it’s been in draft since 2019, and it’s publicized as a promise to help keep children safe and tackle online abuse. So the premise, legal but harmful, is hotly contested by companies like Meta, who own Pinterest and Instagram, and they’re required to remove harmful content.
00:09:51 Dr Dianne Wepa
So legal but harmful currently only applies to adults engaged in online content and focuses on buyer.
00:09:59 Dr Dianne Wepa
Aware, but that only requires companies to alert the customer to harmful material and content promoting self harm is explicitly identified in the bill, along with the physical and psychological harm and online search warrants. A last minute addition to the bill advocated by Ian Russell and the Molly Russell.
00:10:19 Dr Dianne Wepa
Foundation is seen as a win for families and so.
00:10:23 Dr Dianne Wepa
Even though there’s all this activity, there’s like 10,000 apps online that are meant to help people with mental health distress. And yet people like Molly were still not protected from social media platforms that cause more harm than good with their algorithms that follow the young person.
00:10:42 Dr Md Rahman Jabin
Just add on demand statistics and explanation. I would say that more than 700,000 people actually lose their life to suicide every year and the world is not on track to reach the 2030 suicide reduction targets by WHO World Health Organization.
00:11:00 Dr Md Rahman Jabin
So HO do advocate for countries to take action to prevent suicide, and ideally that should be through a comprehensive national suicide prevention strategy. Government and communities can contribute to suicide prevention by implementing life, life or WHO’s approach in order to start suicide prevention.
00:11:21 Dr Md Rahman Jabin
So that countries can.
00:11:22 Dr Md Rahman Jabin
Build on it and further to develop a comprehensive national suicide prevention strategy. Also, the guide is for all the countries with or without national suicide prevention strategy, so national or local focal points for suicide prevention, mental health, alcohol etc. And also community stakeholders.
00:11:42 Dr Md Rahman Jabin
Should come together with the vested interest or may already be engaged, probably so they should come together in order to implement suicide prevention activities.
00:11:53 Dr Dianne Wepa
Yeah. To add to that, Australia’s suicide prevention plan expired in 2023 and they haven’t renewed.
00:12:00 Dr Dianne Wepa
And the New Zealand suicide prevention strategy expires in 2024, so I think there’s a watch and wait approach happening at least with those two countries in terms of England’s very bold.
00:12:15 Dr Dianne Wepa
Approach to this this issue and so I do think there are some really good takeaways that the other countries could easily implement from the UK strategy example, reducing the amount of paracetamol people can buy in shops would be one approach like a quick win and whether you know the school curriculum could have.
00:12:35 Dr Dianne Wepa
Suicide and self harm prevention workshops. So in England they’re looking to have half the schools have mental health support teams, for example, in place by April 2025 and then all state schools after that. And so those sorts of strategies and actions can actually be achieved quite quickly. Yeah. And then it goes through to middle-aged men.
00:12:56 Dr Dianne Wepa
As well that but harder to reach because it’s interesting, we tend to think young people don’t we when we hear of this topic. But in the UK at least, it’s the top killer of men is by death by suicide and even just the language. It’s death by suicide, not committed suicide. So that would be even in the discourse.
00:13:12 Dr Dianne Wepa
Of all of us, we could change the language around it. Although the online safety bill does actually make it still illegal to die by suicide. So you know there’s a bit of an anomaly there.
00:13:31 Will Mountford
Well, to flip my previous question on its head, when we talk about global approaches, the global platforms to look at the community LED approach, individuals or very small close community.
00:13:43 Will Mountford
Is there much in the way of technology LED initiatives there, Dan, I’m wondering if I can draw on any of your experience and research working with indigenous Maori communities in New Zealand or if there’s any other First Nations indigenous peoples initiatives that would be worth highlighting.
00:14:01 Dr Dianne Wepa
Yes, some of the research I’ve been doing recently around what’s called the digital divide.
00:14:07 Dr Dianne Wepa
And so from a mental health perspective, that is actually a contributing factor towards feelings of loneliness and isolation. And this was very much highlighted during lockdown. And so if we look at the what is the digital divide, it’s basically the gap between those who have access to technology and having the confidence to use technology compared to those.
00:14:28 Dr Dianne Wepa
Without it, due to social factors such as race, gender.
00:14:31 Dr Dianne Wepa
Education or location. So in my New Zealand study, I interviewed indigenous populations in very remote areas because they have less access because of the lack of like cell phone towers, for example, to access their healthcare services. And it was really interesting. I thought it would be all very negative the.
00:14:52 Dr Dianne Wepa
Findings which which it is of course, however, the resilience which we talked about last time on research pod came through especially with the older population and that they were actually able to adapt to their remoteness with digital technology. So that’s not to.
00:15:08 Dr Dianne Wepa
Say, oh, well, that’s fine. You know, people in remote areas are Hardy and they can cope because that’s a narrative as well. Although we did find that the sense of community is a lot stronger in a lot of these communities. So they will be more creative in terms of, for example, in the study I did, they would go to a local school to use their Internet.
00:15:28 Dr Dianne Wepa
Access if they weren’t able to have it in their individual homes and they would use their strong cultural connections with each other to rely on their intergenerational approach of having younger people. If they’re if they live.
00:15:40 Dr Dianne Wepa
To assist with them. So I think it’s interesting that we think some communities may not be that resilient, will be able to access digital technologies with that. I think it really does depend on the sense of connectedness that already exists within especially First Nations communities.
00:15:57 Dr Md Rahman Jabin
In one of the studies recent study that I and Dan, we have been doing what we found is that there is a wish for a better healthcare system to access healthcare needs and information.
00:16:08 Dr Md Rahman Jabin
And by the Murray people, so there’s a clear need for communication improvements and a better system in the place and particularly it happened during the COVID you know, so they would like to reach the healthcare providers in a more accessible way. So they expect the use of information and information sharing hubs could be better utilized.
00:16:28 Dr Md Rahman Jabin
And for community links that could help their work and the clients as well so.
00:16:35 Dr Dianne Wepa
Yes. And that piece of work jabin and I are doing right at the moment. We’re yet to put the article together, that’s to develop a proof of concept digital solution, especially for those communities because when I was in New Zealand in February, Cyclone Gabrielle hit the country. So the major city, Auckland and then my small region on the East Coast of the North Island.
00:16:57 Dr Dianne Wepa
Hawkes Bay we had no cell phone towers for like a week, so people couldn’t use their phones besides the electricity being cut off.
00:17:05 Dr Dianne Wepa
So it was really interesting time to be interviewing participants during that stressful time because I was interviewing them about the pandemic and how they were coping with the digital issues back then. And then we just happened to be in the middle of a a cyclone. And so they were very kind to me and they still took part in the interviews. And So what?
00:17:25 Dr Dianne Wepa
Is coming out of that now is a like Jabin says that the people want a digital solution that isn’t relying on the net.
00:17:32 Dr Dianne Wepa
So is there something you can download on your phone that perhaps has your basic identifying information or health information that is saved in your phone so you could bring it up maybe as an image that doesn’t need to go to the Internet. So if you have to go to a pop-up clinic or pharmacy and prove your identity or your health condition.
00:17:53 Dr Dianne Wepa
There would be something there that you don’t have to verbally, especially if elderly people tell them all of your information. Because in Australia and New Zealand you know we don’t have an NHS, so there’s no one health system. So it’s a lot of manual handling around health information. So I think that would be really exciting. The next stage for Japan and I to seek out.
00:18:13 Dr Dianne Wepa
Funding to look at a proof of concept digital solution that would probably be an app or QR code that goes somewhere you know to gather your information, and you’d have to look at the privacy issues as well. And we’d like to pilot that with probably a small health provider in New Zealand to get, you know, permission.
00:18:31 Dr Dianne Wepa
And then look at. Yeah. How does that person carry around that digital wallet, as it were, of their health information? That doesn’t necessarily rely on connectivity to be used?
00:18:43 Will Mountford
Now you touched on something there with the towers in Japan, if I could ask you to just go over a few points on separating in technological terms, the hardware, software apps, commercial versus medical devices. When we talk about technology in health, what are some of the the scopes of these terms here?
00:19:01 Dr Md Rahman Jabin
Yeah. So from a PhD study what my research explored is the HIT which is health information technology, software and hardware technology both, and how informatics helped them work. The merging of these fields its best because the advent and the rapid advances in HID system.
00:19:21 Dr Md Rahman Jabin
Has made the entire healthcare.
00:19:24 Dr Md Rahman Jabin
A truly complex sociotechnical system than ever before. So what I would say, no matter what changes are instituted, whether human or technical, component in such complex system like healthcare, no matter what new, unforeseen, unexpected problems always arise. So while in Australia the research during my doctoral degree was based on approach.
00:19:45 Dr Md Rahman Jabin
Of learning from failures, examining things that had gone.
00:19:49 Dr Md Rahman Jabin
Strong, particularly in relation to HIV systems used in medical imaging. So our idea was to form a basis to prevent and manage similar problems in future and that focused on identifying and characterizing healthcare quality and safety issues by collecting and analyzing already existing.
00:20:10 Dr Md Rahman Jabin
Incidents or adverse events reports, so the impact, what I would say for example, although a host of mainly technical problems was expected, as I said earlier during my interview, more than half of the issues were identified by contributed by human factors. So.
00:20:30 Dr Md Rahman Jabin
The appreciation of the bigger picture was necessary to address the underlying mechanism of those issues as commissioning to a new HIV system or properly embedding.
00:20:41 Dr Md Rahman Jabin
And existing system can have enormous implications for both staff and patients. When I talk about underline factors, it’s not very common for the layman terms or and the underlying factors mostly lie in the software related issues. For example, system configuration interface with other software systems or components.
00:21:02 Dr Md Rahman Jabin
Software functionality, data storage, and backup record migration software not accessible.
00:21:09 Dr Md Rahman Jabin
Or not available network server down or slow etc. So these are the underlying factors that from a layman perspective is not very well understood most of the time. So when I was doing my research and I found that these terms are very complicated even for the healthcare professionals and they don’t need to be actually very much.
00:21:29 Dr Md Rahman Jabin
Expert on these hardware and software issues, but what I come up is that they do need a robust training facilities so that the healthcare professionals and in the wider context like the end users, whoever.
00:21:46 Dr Md Rahman Jabin
Use these apps or technology. They need training. Yeah, they need to be trained.
00:21:51 Dr Md Rahman Jabin
Well, what I would say in terms of the incident reporting systems out there that would comprise E prescribing issues as well. So would you would like to suggest a unit based reporting system since each healthcare department has its own type of problems at the local level.
00:22:06 Dr Md Rahman Jabin
So because the HD systems are interconnected to each department, the provision of these HD incidents should be made at.
00:22:15 Dr Md Rahman Jabin
Early stage, so therefore we would emphasise on ensuring a standard incident reporting system at the national level and even for suicide prevention as well. So the incident reporting system in the UK, for example, has been centralized with the national Patient Safety Agency. But in countries like Sweden, I haven’t seen that there is a lack of standard reporting system. The structure of healthcare incident reporting.
00:22:37 Dr Md Rahman Jabin
Systems varies locally, regionally and nationally. For example, they have different incident reporting systems and which are decentralized using different digital systems such as.
00:22:48 Dr Md Rahman Jabin
Energy, platina, Lisa, etc. So these incident reporting systems are not liable to any accustomed healthcare quality standard, also causing being under operational oversight of the system used in the healthcare. So we would like to propose a resolution is that it can be resolved.
00:23:08 Dr Md Rahman Jabin
By reinforcing the quality standard of the incident reporting systems at the national level, and probably a viable management is the only way that we could overcome the challenges encountered at regional level.
00:23:21 Dr Md Rahman Jabin
So yes, in order to respond, defiance about the E prescribing system, so the issues of the E prescribing system, which also part of HID incidents issues. So that could also be done if we particularly focus on the management of incident reporting systems. In this way the way that.
00:23:40 Dr Md Rahman Jabin
I see it now.
00:23:42 Will Mountford
Well, to pick up on something down that you mentioned towards the end of your previous answer, it seemed to be leading quite maybe towards the strength within me app from the 2020 paper ask you to fill in some of the details about that in terms of our quick methodology, some of the scope and assessment and how the connectivity of that one.
00:24:02 Will Mountford
To other social media platforms was useful, informative, open, perhaps more research questions.
00:24:09 Dr Dianne Wepa
Sure, the app is considered one of the better apps alongside the American military. Have an app too called. You may have heard of the movie The Hurt Locker, and they have an app called the Hope Box. So it’s a play on word. Yeah, hope box. And so the themes that come through with these very.
00:24:29 Dr Dianne Wepa
Successful apps such as Strength within the app and the Hope Box app is that the engagement with the user is very high.
00:24:37 Dr Dianne Wepa
And so they tend to have like avatars. You can develop your phone tree, as it were. It’s very you can personalize it so you can have people identify that you have like a traffic like system. So say if you’re feeling OK in a good mood, you could push the button and with a thumbs up. So it’s like a self checking that your mood is OK.
00:24:57 Dr Dianne Wepa
And then that can actually go to your therapist or your support person.
00:25:02 Dr Dianne Wepa
And then if you’re not feeling that great, but just want people to know.
00:25:06 Dr Dianne Wepa
Umm, I’m not that great you can. You know, you push another button that’s sort of like an Amber Alert almost. And then of course, then the red means I really need help. And then it can engage you with the the phone numbers that you want to to ring people. And so I think, yeah, that app is very, very good.
00:25:23 Dr Dianne Wepa
And is working more towards Co design with the service users. So the the 10,000 apps that I reviewed, none of them use true Co design methods.
00:25:32 Dr Dianne Wepa
Analogy you would have focus groups say or end users would be involved in the testing of an app. That kind of thing, but they weren’t involved end to end. So from the very beginning of there’s an issue. We need to help and you know working right through. And so the research that I did with the University of Bradford Group service users or they they liked the name.
00:25:52 Dr Dianne Wepa
Experts bike.
00:25:53 Dr Dianne Wepa
Experience. They preferred that term has been very positive and so we’ve all published the articles that have come out of our study and that’s again working towards a proof of concept for digital solutions for suicide prevention because a lot of apps they’re created. But then there’s no way to evaluate them like, does the person feel better?
00:26:13 Dr Dianne Wepa
And then they no longer use it. So that’s a sign of success. Or is there a way to evaluate it? And the best kinds of apps, such as strength within me app, have a therapist that works with the person, so it.
00:26:26 Dr Dianne Wepa
Really is better if there’s a mental health provider involved in that app and then they introduce the app to.
00:26:33 Dr Dianne Wepa
A person, so it’s done in a, you know, a team collaborative way as opposed to people randomly just downloading apps and hoping for the best. So I think you do need some sort of professional partnership for these apps to really work.
00:26:46 Dr Dianne Wepa
That we’re talking about the pointy end of mental health, as in suicide prevention.
00:26:50 Dr Dianne Wepa
Not necessarily. Mood type of apps that you know track your mood. That’s OK. However, you know you want more than just sign posting to a website or a phone number you when you want to talk to someone or even use the chat function. We found that in our research that people said to me this experts by experience. If I go online.
00:27:10 Dr Dianne Wepa
I want to stay online. I don’t want to be signposted to somewhere else, so the use of peer support workers that can go on the chat.
00:27:20 Dr Dianne Wepa
Action is seen as very important and the Samaritans are very active in that space. They have a very good website and you know that sort of functionality. So I think it’s all about keeping people engaged as well as some signposting. But you know it it needs more than just one solution.
00:27:37 Dr Md Rahman Jabin
Just to add on that, I’d suggest that what I would say that we need a panel of experts to review those apps that have been designed to help patients and also experience suicidal ideation. So for each of the app, there should be guidance on several background factors. Practitioners should also consider when recommending apps for the patients.
00:27:57 Dr Md Rahman Jabin
And most importantly about the panel of psychologists should share their own ratings. Probably reviews and thoughts for the apps which are already in the market today. So I think this would sort of ease the ratings of airport evaluation of app. What Dan was talking about so far now.
00:28:21 Will Mountford
Well, that leads to the notion of the next generation of technology in apps, in things like generative AI, chat bots for therapeutic services. And this is something that is being trialled, is being deployed by certain companies and on certain services already.
00:28:38 Will Mountford
Do you see there being a want or need or a use case for those? Would you feel comfortable with them being a prominent part of future strategy response?
00:28:51 Dr Dianne Wepa
I think from my perspective, we must lean in towards these new technologies. They’re not going away, but we do need safeguarding around them as well. Yeah, because people are turning to generative AI for all sorts of things, although the chat bots, I think the feedback I’ve had is that a person wants a real person to be chatting with.
00:29:12 Dr Dianne Wepa
As you can tell, the chat bots you know, they they’re not really gonna be 100% human to human contact. And so I think the approach of having peer support workers who are online chatting with someone is the ideal. Although I think the AI.
00:29:27 Dr Dianne Wepa
They could probably help triage the conversation somewhat and with the suicide prevention strategy in England, they’re actually introducing training to people that work in like the pensions Department, because they’re finding that people who are lonely and more marginalized in society, if they’re talking to someone about their.
00:29:48 Dr Dianne Wepa
Financial situation, you know, they’re fearing heading towards suicidal thoughts or behaviours. The conversations can actually be picked up by.
00:29:56 Dr Dianne Wepa
The workers that are on the frontline in those departments, so that’s kind of like a hidden area. We don’t think necessarily about people picking up on that in those departments, those government departments. And so there’s going to be some training, a two day like mental health first aid training for government workers who deal with the marginalized populations.
00:30:17 Dr Dianne Wepa
And and then know where to support them to seek out that help. And there’s meant to be some technologies behind that so that the phone conversations pick up keywords.
00:30:27 Dr Dianne Wepa
And so if they bring up a red flag, then that helps the person on the phone know where to navigate that person. So I’d say AI would help in that sense to pick up and hear key phrases that would be otherwise missed by the human hair, especially if someone’s not trained in that area. So I think those first line responders would probably.
00:30:47 Dr Dianne Wepa
Benefit from AI as a.
00:30:51 Dr Md Rahman Jabin
Yeah, I I’ve heard the news. A Belgian man who recently died by suicide after chatting with an AI chatbot on an app called Chai. So I’m not quite sure about how it would fit, how it would be affected. But as I said earlier, even though I have the expertise of technology, but I mostly focus on.
00:31:12 Dr Md Rahman Jabin
Not building more and more technologies, but rather than solving the problems you know around those technologies which are already existing.
00:31:21 Will Mountford
For someone who needs to make changes in their lives, or someone whose choices could influence the lives of many other people, what should they know coming away from today’s conversation and the research that you are all doing together?
00:31:33 Dr Dianne Wepa
Going back to the England suicide prevention strategy, with the whole systems approach, I actually think one of the take away messages today is if people seriously thought about doing the mental health first aid course and you can either do the short one so like 3 hours, which I went to that one as a health professional just to see what it would be like and it was.
00:31:54 Dr Dianne Wepa
Very well run. This was in Australia and it was run by Saint John.
00:31:58 Dr Dianne Wepa
Other places run them like universities, run them as standard, and also the University of Bradford. I knew there student support surfers ran that, so I think as I said before, leaning in towards it like instead of saying oh, I wouldn’t know what to do if someone said that they wish they didn’t weren’t living anymore. You know those sort of statements or.
00:32:18 Dr Dianne Wepa
The world would be better off without them, so I think we could all take responsibility and be more educated about the factors that lead towards people having that sense of hopelessness, because it really is a sense of hopelessness that makes people.
00:32:33 Dr Dianne Wepa
That they had no other option than to take their own lives or self harm, and so that would be something I think no matter who you are, if you were able to find an agency and a lot of them are free as well or in the workplace, basic mental health first aid course and then there are the free phone numbers as well. Samaritans and UK and Ireland.
00:32:53 Dr Dianne Wepa
Free phone 116123.
00:32:56 Dr Dianne Wepa
It’s UK and Ireland, Samaritans free phone 116123 and also in Australia they have the lifeline number 131114 and Lifeline and New Zealand it’s 0800 Lifeline. So those are just the three examples there. If people feel that maybe listening to this session.
00:33:16 Dr Dianne Wepa
To do more in that space. And so there are some sort of mantras as well that the experts by experience have really, I’ve felt quite humbled listening to their lived experience and you know, you may have heard it about nothing about us without us. And so that resonates no matter who you are as a.
00:33:37 Dr Dianne Wepa
Person that we will consume health services somewhere along the track.
00:33:42 Dr Dianne Wepa
And also another mantra is looking if, especially if you’re a provider of health services is.
00:33:49 Dr Dianne Wepa
Focusing on the interaction, not the intervention. Sometimes it’s actually the interaction that counts. Feeling heard as opposed to the intervention. So especially with health services, it might be you. You have the operation for the broken arm or something you know, so you have the intervention.
00:34:04 Dr Dianne Wepa
Before you receive the medication. But because we’re human beings, it’s the interaction that actually stays with us, and we remember the manner that someone spoke to us or their, you know, where they were, just rude.
00:34:15 Dr Dianne Wepa
You know, so you might be having a bad day, but you know all those little sort of we could even call them microaggressions. For some people, that’s enough for them to feel a sense of hopelessness. And then they’re on this dark pathway to wanting to self harm. So just those little things would be great for the listeners to hear. And then the research that we’re.
00:34:35 Dr Dianne Wepa
Mentioning and we can provide the.
00:34:37 Dr Md Rahman Jabin
And also I can just see that the government of UK, they have suicide prevention strategy action plan for next five years, 2023 to 2028 and that include development of a new nationwide near real time suspected suicide surveillance system also identifying opportunities to improve the quality of intelligence and the data that is used to improve.
00:34:59 Dr Md Rahman Jabin
The knowledge and prevents suicide in that manner. Apart from the government, I’ll I’ll just add creating protective environments, for example reducing access to lethal means or creating healthy organizational policies and culture as well and also reduced substance.
00:35:16 Dr Md Rahman Jabin
Rules and community based policy and practices, so community based policies and practices is very important in in this regard.
00:35:24 Dr Dianne Wepa
And even the workforce, like our psychological safety, sometimes we, as healthcare professionals worry so much about the people we serve and our own psychological safety sometimes is not always looked at. So there’s more research in that space around nurses and thoughts of suicide. You know, something just came out the other day. I was looking at.
00:35:42 Dr Dianne Wepa
And so, you know, who cares For the carers, that’s something we all need to be kinder to each other, which we did that in the pandemic, but we seemed to have straight away from that somewhat.
00:35:54 Dr Md Rahman Jabin
So I think we should also think of to cover mental health conditions within the health insurance policies and increasing provider availability in underserved areas or rural areas and also provide rapid and remote access to health. So this would create safer suicide care through.
00:36:14 Dr Md Rahman Jabin
Systems change, I believe.
00:36:17 Will Mountford
Doctor Jabin, doctor Dianne, thank you so much. For your time today.
00:36:20 Dr Md Rahman Jabin
Thank you.
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