Australia’s mental health care system has long been fragmented and under-resourced, with services falling well short of demand [1]. Mental health consumers often receive inconsistent and sporadic treatment delivered by independent services, with little collaborative decision making or multidisciplinary continuous care [2]. At particular risk are young people who do not respond to brief interventions and are unable to access continuous care [3], and those who deteriorate under care [4-6]. Coordination between crisis and ongoing care providers is also poor, with medical staff in emergency departments expressing clear learning needs in developing care plans for patients presenting with mental health problems [7]. The advent of a novel coronavirus and its resulting global COVID-19 pandemic has added additional strain to Australia’s mental health services with increasing demands for crisis support and intervention [8-11], highlighting the need for a revolution of current mental health service delivery [12].

The World Economic Forum has recently called for the “…rapid deployment of smarter, digitally-enhanced health services…” as a means of potentially addressing demand issues and facilitating effective care coordination [13]. The recent Australian Productivity Commission’s inquiry into mental health also recommends that technology should play a larger role by improving access to the right services at the right time [14]. Moreover, it has been proposed that digital solutions may be a viable method of delivering personalized and measurement-based care to young people, transcending the often-narrow focus on symptom or risk reduction [15]. While there are ethical, data security, and privacy challenges that must be addressed in relation to the implementation of technology-based solutions [13], it has been noted that staff resistance to change and perceived technological complexity frequently present as barriers to the uptake of health information technologies (HITs) [16]. Consequently, education and training that foster engagement and address the use of HITs in practice are essential for successful adoption and optimization of technology-enabled solutions in clinical practice [17]. This increasing need for training and upskilling of clinicians working in digitally enhanced mental health services has not been addressed in the existing literature, which has previously been limited to training specific to clinicians’ disciplines, treating specific diagnoses, or intervention modalities [18-20]. As such, there is an urgent need for education and training in the effective use of digital health solutions to meet the increase in demand for mental health services and facilitate effective care coordination across a multidisciplinary workforce.

Researchers at The University of Sydney’s Brain and Mind Centre (BMC) have developed the Youth Mental Health (YMH) and Technology Program, which adopts an innovative digital health solution to prevent further progression of mental ill-health for young people in care [21]. This digital health solution includes two key components. The first is the BMC Youth Model, a highly personalized (ie, treatment targeted to address individual needs) and measurement-based (ie, data-driven) model of care generated from over 10 years of longitudinal research led by the BMC to assess multiple clinical and functional domains in young people presenting for mental health care and treatment [22,23]. This cohort includes 6743 young people aged 12 to 30 years, which was analyzed to uncover initial underlying neurobiology of mental ill-health in young people [24]. Findings were reported through a supplement of research articles that explore the associations between the multiple clinical and functional domains, neurobiological measures, as well as clinical, social, and functional outcomes [22]. The BMC Youth Model explicitly aims to prevent the progression of emerging and mixed syndromes into more complex and severe forms of illness and to facilitate symptomatic and functional recovery. The second is an HIT — such as the InnoWell Platform, which is listed on the Australian Register of Therapeutic Goods — that is a customizable digital toolkit to assist assessment, monitoring, and management of mental ill-health and maintenance of well-being by collecting, storing, scoring, and reporting personal and health information back to consumers and their health professionals to promote collaborative care partnerships [25]. Though we reference the InnoWell Platform as an exemplar HIT, it is important to note that the BMC Youth Model can be facilitated via any HIT so long as its design has been guided by similar clinical and scientific concepts to provide highly personalized and measurement-based care.

The education and training program has been designed to encourage the adoption of highly personalized and measurement-based care in clinical practice, to ensure young people get the right treatment at their first point of entry into care. Specifically, the program focuses on teaching youth mental health professionals how to assess, monitor, and manage complex needs and illness pathways. The education and training program now delivers information via multimodal tools, including online seminars, case study webinars, and in-service workshops. The HIT is referred to throughout the training, as it aids in facilitating highly personalized and measurement-based care (including assessment of clinical stage, pathophysiological mechanisms, and multidimensional needs) and supports the choice of treatment options while tracking a young person’s progress.

This paper briefly describes the education and training program and outlines a protocol for an evaluation study to assess the effectiveness of education and training on the adoption and optimization of use of the digital health solution in service delivery.

As of September 2020, clinicians and their services were being recruited to this study. Data collection is expected to be completed and the first results to be submitted for publication in 2021. Results will then be disseminated to the participants, the public, and researchers through publications in journals and presentations at conferences.

This paper details a comprehensive protocol for an evaluation study to assess the effectiveness of the education and training program on the adoption and optimization of use of the digital health solution to provide the knowledge and skills to assess, monitor, and manage the complex needs of young people presenting with mental ill-health problems.

Evaluations of education and training programs within mental health generally focus on the perceived usefulness of such programs, increased knowledge, and confidence in using acquired skills, but frequently neglect assessing the impact on changing clinician knowledge, skills, behaviors, and client outcomes [35]. By using the Kirkpatrick Evaluation Model [29], this study will assess the effectiveness of the education and training program in meeting the learning needs of clinicians (Reaction), increasing clinicians’ knowledge of youth mental health (Learning), clinicians adopting the digital health solution in standard clinical practice (Behavior), and improving service performance (eg, efficiency, clinical safety, and clinical outcomes; Results).

While the evaluation protocol will produce valuable insights, there are limitations that should be noted. First, the measures of knowledge and skill rely on self-rating, which are subjective and may be influenced by the participant’s level of self-awareness [36,37]. Second, it is generally recognized as being quite difficult to objectively measure the competence of mental health practitioners [37]. Last, the Kirkpatrick model is not without its flaws; for example, it has received criticism for being overly simplified and lacking an ability to provide information about how training can be improved [38]. Nevertheless, the Kirkpatrick model has been successfully utilized in prior mental health training [30] and will provide data in a way that can guide further research.

The research protocol presented here is the first of its kind to explore the education and training of mental health professionals in the use and benefits of technology-enabled solutions. As such, it has the potential to have a significant impact on determining how mental health professionals are trained as technology becomes more integrated into their practice [13,14]. The quantitative and qualitative data obtained from this study will be used to iteratively adapt and improve the education and training program in order to ensure that young people get the right care the first time and to prevent further progression of mental ill-health while in care. These results will also guide the creation of additional education and training resources to keep participating clinicians engaged and to the ensure sustainability of the digital health solution. Future resources may include a case study workbook and the creation of a community of practice that could provide a shared context for practitioners, enabling dialogue between practitioners who might not ordinarily have the chance to interact [39]. Further, our education and training team is currently exploring a more sophisticated online interactive platform to promote ongoing customized learning with participating youth mental health services.

Ultimately, this research will help teach mental health professionals how to facilitate a highly personalized and measurement-based model of care. This may therefore guide clinicians to help young people recover from low functioning associated with subthreshold diagnostic presentations and prevent progression to more serious mental ill-health.