02/09/21
IoT holds the promise of innovative applications to help improve the mental health of users. However, the very nature of IoT, with overtones of surveillance and control, means that, if they are to be acceptable, any such applications must be built with the involvement and the consent of prospective users.
However, and in common with other areas of healthcare technology development, involving users is no easy matter, and itself requires innovation in terms of methodological approaches – the subject of this project.
The project involved academics (Dr Easton, Dr Claire Bentley and Dr Stephen Potter (University of Sheffield), Professor Belinda Lennox (Oxford University), representatives from an IoT technology company (Caburn Health) and patients with lived experience of mental health conditions.
We carried out a series of six workshops facilitated by a freelance storytelling practitioner (Ms Chrissy Bonham), using creative and innovative methods to consider how an IoT solution(s) to support mental (and physical) health may work, specifically for the purpose of goal setting in mental health recovery.
The goals of the project were to:
Identify challenges faced by people living with mental health conditions in relation to goal setting for recovery.
Identify what IoT technological solutions currently exist which could be used to help people with mental health conditions to set and monitor progress towards personal recovery goals.
Identify the barriers to and facilitators for using specific IoT-based solutions for specific mental health populations.
This project addressed the barrier of the lack of trust that this community of stakeholders has in IoT: by involving people with lived experience we will give this neglected community a voice. It also addressed the problem of insufficient interaction between technology and application domain specialists, with the specialists in this case being not only academic and healthcare experts, but also (and more importantly) those with lived experience of mental health issues and services.
The principal beneficiaries of this project are people with lived experience of mental health problems, and academic and industry partners who can learn from the knowledge exchange with the community.
During the project we conducted a scoping review to map current uses of IoT in mental health. We ran a series of six co-production workshops (five with members of the public with lived experience of mental health issues and one with academics, clinicians and industry partners). In the workshops we explored challenges of daily living, shared knowledge of IoT opportunities and identified barriers to potential applications.
The scoping review, to understand current use of IoT for mental health recovery, found that this area is still in its infancy. The only applications we found were in the area of dementia care (often considered a cognitive condition rather than a mental health condition).
The literature reviewed suggests that, in general terms, IoT in mental health could:
Allow people with mental health conditions to live more independently.
Allow long-term monitoring of an individual’s lifestyle and behaviour patterns in real-life settings.
Provide a means to detect changes in mental state or behaviour quickly and so intervene early.
Provide peace of mind to family members and carers.
These benefits could be provided with greater or lesser levels of intrusion and/or personal input from the person with the condition; and they could result in cost/efficiency savings for health and social care services.
There are also potential drawbacks to using IoT in mental health which need to be taken into account, including data security and privacy issues, the degree of interoperability of devices, and the readiness of patients, living and working environments, and services to incorporate IoT devices and data.
Through the workshops we explored the lived experiences of people with mental health conditions and generated storyboards around people’s experiences of living with mental health conditions in the areas of sleep, money, goal setting and suicide prevention (workshops one, two). We then used the storyboards to generate and frame discussion with industry, clinical and academic stakeholders about potential IoT options for people with mental health conditions (workshop three).
In workshops four, five and six we explored barriers to using specific IoT technologies for mental health conditions, and members of the public created three specific use cases for IoT in mental health which can be taken forward for further research.
We have a set of six storyboards which illustrate daily challenges for people with lived experience of mental health issues. The group considered a range of IoT solutions and this knowledge exchange was reported to be of value from members of the group. Three use cases for IoT in mental health were generated by the group and an additional storyboard of barriers was produced.
We have produced an animation in collaboration with Mojo Film, a Leeds-based CIC, that explains our process and the importance of stakeholder involvement when designing and developing digital health services. This was a successful collaboration and has led to further work together to increase dissemination of our activities (via eNurture funded project with Easton as PI).
Katherine Easton has secured additional follow-on funding from Pitch-In and the eNurture Network, in collaboration with a new industry partner, Mindwave Ventures (see the next section for details).
A journal paper for peer-review publication is in its draft stages.
We have engaged in successful knowledge exchange with members of the public directly in this area and will continue to do so in follow-on research.
As a direct consequence of this project a new collaboration has arisen between the University of Sheffield and Mindwave Ventures Ltd, a digital development company with special expertise in healthcare applications. This partnership has already secured further funding for two projects:
To disseminate development experience in this field through the design and delivery of four webinars, along with a follow-on hackathon to further develop the IoT use cases. This was funded by Pitch-In (project H16) and delivered in the period January–March 2021 (as described below).
To use similar co-production techniques to investigate applications of IoT with schoolchildren (funded through the eNurture Network, one of the UKRI Mental Health Networks, value: £26,000).
Moreover, we hope this collaboration will lead to further successful grant income; we anticipate developing a larger national UKRI funding bid in 2021–22.
After completion of this project, with Pitch-In support we ran a series of four weekly online webinars in early 2021, focusing on designing, evaluating and implementing digital health, chaired by Dr Betton from Mindwave Ventures – Pitch-In project ‘IoT and mental health: training sessions and hacking the system’.
We had a panel of speakers for each session who are nationally or internationally known for their work in the specific topic in question. The webinars were recorded and edited, and have been made available as Pitch-In health and wellbeing-theme resources.
We also ran a follow-on online hackathon with interested members of the audience to design use cases in the area of IoT and mental health.
The eNurture project commenced in summer 2021, and it is hoped that further collaborations will follow.
The collaboration between members of the public and the University worked very well. People with lived experience shared a great deal of knowledge about their experiences and hopes for the future use of IoT in supporting their mental health and daily life.
The collaboration between Kat Easton and Chrissy Bonham, the external facilitator, worked very well – the workshops were a success. Through Pitch-In Kat Easton has made links with Belinda Lennox at Oxford and the two have remained in contact regarding the project.
Throughout the project, it proved difficult to engage with industry in a meaningful way, despite the inclusion of an industrial partner. This may have been a result of time pressures/the pandemic, or maybe the value of the activities wasn’t clear to the stakeholders. In general, it seems clear that links between academia and industry in this area could be strengthened to facilitate knowledge exchange and co-creation (the follow-on Pitch-In project can be viewed as one attempt to forge these links).
Additional introductions and promotion of the events to industry/technologists may help in the future.
The animation that has been produced from the project is available on the resources page of the Pitch-In website.
Pitch-In has supported the sort of scoping and co-development exercises that, while everyone recognises their value, nonetheless tend to fall between the stools of academic and commercial funding: it’s too close to application for the former, and too much like academic work for the latter.
Dr Katherine Easton – the University of Sheffield
The University of Sheffield’s Centre for Assistive Technology and Connected Healthcare (CATCH)