Collaborative Learning Online between Health Professionals and Mental Health Service Users: What Works?
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Abstract
Background Mental health service users, in particular young people who self-harm, report difficulties in communicating with health professionals, and vice versa. Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and trust among members. Do anonymous online closed forums provide an environment in which service users and professionals can learn together? We report two studies: (i) Sharptalk and (ii) Stakeholders online.
Objectives In the Sharptalk project we sought to bring young people who self-harm and mental health professionals together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice. In the subsequent Stakeholders Online project we aimed to bring mental health service users and professionals together online to discuss e-health.
Methods In Sharptalk we recruited and allocated 77 young people aged 16–25 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums were to run for 6 months and were relatively unstructured. In Stakeholders Online we ran 3 one-week ‘courses comprising an initial interactive webcast, a discussion forum over the week, and a final webinar.
Results In Sharptalk, the young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private–professional boundaries, role clarity, duty of care and accountability. In the more structured environment of Stakeholders Online with given topics to discuss, the professionals and service users both participated.
Conclusions Health professionals were not ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous but unstructured and open-ended online setting. In a structured setting with given topics professionals participated with service users, but we had moved from an agenda set by the users to a professionally set agenda. Further work is needed to find the ‘middle ground’ where an online community can be more service user focussed but not ‘frighten away’ the professionals.
Objectives In the Sharptalk project we sought to bring young people who self-harm and mental health professionals together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice. In the subsequent Stakeholders Online project we aimed to bring mental health service users and professionals together online to discuss e-health.
Methods In Sharptalk we recruited and allocated 77 young people aged 16–25 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums were to run for 6 months and were relatively unstructured. In Stakeholders Online we ran 3 one-week ‘courses comprising an initial interactive webcast, a discussion forum over the week, and a final webinar.
Results In Sharptalk, the young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private–professional boundaries, role clarity, duty of care and accountability. In the more structured environment of Stakeholders Online with given topics to discuss, the professionals and service users both participated.
Conclusions Health professionals were not ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous but unstructured and open-ended online setting. In a structured setting with given topics professionals participated with service users, but we had moved from an agenda set by the users to a professionally set agenda. Further work is needed to find the ‘middle ground’ where an online community can be more service user focussed but not ‘frighten away’ the professionals.
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