ARTEMIS: How are you? A digital platform for assessing mental health

A digital platform using Computerised Adaptive Testing (CAT) to measure and assess the mental health and wellbeing of vulnerable frontline welfare service users. It provides realtime data and reduces the time, response burden and costs to collect sensitive and more holistic information in the hurly burly of live policy settings.

Professor Peter Jones, Director of the NIHR ARC East of England and Professor of Psychiatry at the University of Cambridge.

The Covid19 crisis led to rapid increases in unemployment across the globe threatening to create a second pandemic of mental ill health especially among those who find themselves-out-of-work. The costs of mental health in the UK alone are estimated at £105.2 billion / year. Even before COVID-19, 23% of those on Jobseeker Allowance (JSA) in the UK were suffering common mental health issues, nearly half of those on Employment and Support Allowance (ESA) described poor mental health as the primary reason for being unable to work.

Millions of people routinely interact with frontline welfare services such as job centres yet little robust, realtime and accurate information is collected concerning their mental health (MH) and wellbeing (WB) given time and capacity constraints. Routine frontline services, policy decision makers and researchers are hampered by lengthy pencil and paper questionnaires and batteries of measures that are not appropriate for quickly collecting sensitive information in the hurly burly of routine, live-policy settings with vulnerable client groups. In these contexts, the time demands on staff and clients, research participants’ own vulnerabilities and the financial costs of administering lengthy questionnaires present significant operational, resource and fiscal challenges for collecting health and wellbeing data.

The main beneficiaries of our platform will be the public and decision makers delivering frontline welfare services. People using employment and welfare services such as Job Centres Plus or seeking mental health support from local
charities will see a step-change in the burden of assessments. Computer
adaptive testing (CAT) greatly reduces the time required to identify
any health and wellbeing needs that can be incorporated into the
response of these government services. By increasing efficiency and reach of measurement, all parties benefit.

A digital platform which allows for the acceptable and efficient measurement of mental health and wellbeing issues in people claiming benefits will help to facilitate access to routine services such as improving access to psychological treatment (IAPT) or psychological wellbeing services (PWS). Interventions implemented by DWP and charities such as MIND can use the platform to establish a core set of health and wellbeing measures. This will help harmonise outcome indicators and allow for greater comparability across departments, improving policy monitoring and quality of service delivery. The platform together with the routinely collected data in contexts such as job centres, employment providers and mental health support centres, will allow evaluation of new systems at pace and scale.

ARTEMIS: How are you? Will identify, prevent and support the recovery of millions of people who face mental health challenges as a result of the social and economic fallout of the Covid19 pandemic. As our policy partners state 'the effects of the pandemic in terms of unemployment and mental health have not yet been felt'. Therefore, the testing and potential roll out of the platform arrives at a time to provide much needed capacity to already over stretched frontline welfare services.

The underlying principal of our team and platform is to turn acadamic knowledge and evidence into pragmatic and useful applications that benefit those on-the-receiving end of policy and crisies such as Covid-19. We also aim to use this knowledge translation to enable policy decision makers and those running frontline public services to save time and money in responding to crises. Improved policy capacity will help millions of people who routinely interact with these services on a daily basis via better and evidence based signposting and referral to appropriate support.

We will explore free-to-use options for welfare charities, NGOs, schools, universities and academic researchers. This will greatly increase the coverage and identification of mental health issues among the population.

The main beneficiaries of the platform are vulnerable groups such as those recently made unemployed as a result of Covid19 response policies. Those using employment and frontline welfare services such as Job Centres or mental health support charities will see a step-change in the burden of assessments. Computer adaptive testing (CAT) greatly reduces the time required to identify any health and wellbeing needs that can be incorporated into the response of these organisations. By increasing efficiency and reach of measurement, all parties benefit.

The development of a methodological assessment tool allowing the acceptable and efficient measurement of mental health and wellbeing issues in people claiming benefits will help to facilitate access to routine services such as improving access to psychological treatment (IAPT) or psychological wellbeing services (PWS). Interventions implemented by DWP and charities such as MIND can use the assessment method to establish a core set of health and wellbeing measures. This will help harmonise outcome indicators and allow for greater comparability across departments and agencies thus improving policy monitoring and quality of service delivery. Professor Peter Jones and our NIHR parrtners have established links within IAPT services. This allows us to coordinate the integration of the assessment method.

Our original ARTEMIS: Education and the technological developments that have arisen out of this have provided crucial realtime information on the effects of the pandemic on health and wellbeing of school children and university students in the region. This learning is being used in the development of ARTEMIS: How are you? for frontline welfare services. We aim to pilot this platform in year one across the East of England in collaboration with our policy partners. Thousands have already been made redundant in the region and now face poverty and mental health issues. Our platform can help service providers accurately identify their needs and provide a more robust method by which to signpost and refer people to more appropriate support.

ARTEMIS: How are you? Not only helps address the fallout of the current pandemic but provides the robust basis by which to monitor the mental health and wellbeing of people across frontline services as well as those in workplaces. After initial testing in the region we aim to integrate the platform into national public services. This national test and trialing provides the ultimate grounding and evidence for transferring the platform for use in other settngs such as US welfare services.

ARTEMIS for Education, ARTEMIS: How are you? are digital platforms that allow for data and indicators to be collected in realtime with instant feedback for users and those running services. With our in built data analytics we and public service providers can easily monitor trends and track individual mental health and wellbeing on a day-to-day, weekly or monthly basis. This will allow them to identify and respond immediately to any vulnerable individual. ARTEMIS for Education has already received positive feedback in terms of usability.

A fundamental part of our pilot testing in the East of England is an inbuilt and within trial research component that examines the econometric and cost benefit of the How are you? Platform as opposed to the business as usual methods employed by frontline welfare services for collecting 'social information' and supporting / referring those with mental health issues to support. This will demonstrate time and cost savings but more importantly provides information on service users satisfaction levels and any changes in their mental health and wellbeing.

The qualitative feedback and support we have received from policy partners demonstrates that the platform is urgently needed to help government and those affected by the Covid-19 economic fallout.

To minimise implementation risks to the deployment in live policy settings such as frontline welfare services with vulnerable groups we have continually engaged a range of high-level policy and academic stakeholders. They provide quality assurance, safe guarding and ethical clearance of the platform pilot testing that will facilitate the implementation in routine policy operations.

Many academic research projects that aim to transfer ideas into policy fail due to a lack of understanding of the day to day operational issues which policy makers face such as data security, IT infrastructure pecularities of government departments and above all the dynamic and changing needs of service users.

Our ARTEMIS team and the advisory board we have assembled have years of experience in working with and advising government departments and ministers across contexts and have run many large-scale randomised controlled trials (RCTs) of social policy and mental health interventions.

Our direct policy links and the support will enable the pilot testing results to be channelled directly back to decision makers ensuring quick, pragmatic changes to the platform if issues arise. Our series of policy and service user workshops and interviews will ensure all feedback is integrated into platform development.

National Institute for Health Research, Applied Research East of England

University of Cambridge, Departments of Sociology and Psychiatry.

We are in consultation with frontline public services such as DHSC, DWP, JCP, PHE and MIND mental health about formalising affiliations/partnerships.

Effusion: Design company: https://www.effusion.co.uk/

Cambridge Psychometrics Centre: https://www.psychometrics.cam....

1. Network exposure
MIT Solve and the Cambridge network of 500+ cross-sector leaders and its media and policy connections will be help facilitate partnership and funding opportunities particularly with government and private sector organisations. We seek to test and scale the platform for usage in US welfare serivces, private sector workplaces and further afield in humanitarian settings. The MIT solve network is vital in this regard.

2. Technical Assistance
Our years of multidisciplinary academic research and in-house technological development provides a strong technical basis for the platform. However, to scale up and transfer the platform to countries such as the US and for usage within private sector organisations and humanitarian agencies we require guidance and support from MIT Solve and Trinity Challenge partners such as Google, BIT, Facebook, McKinsey, and Bay Area Global Health Alliance among others. These partners provide a unique 'test and learn network' to further refine and improve the usability of the platform across settings.

3. Monitoring & Evaluation

ARTEMIS: How are you? Provides realtime feedback and data on mental health. This enables us to immediately identify any vulnerable individuals. In addition we have embedded an econometric and cost benefit analysis into our pilot testing.

We seek support across all of the following areas: access to new markets; funding; mentorship and/or coaching; board members or advisors; monitoring and evaluation;

Organisations such as Google, Bill and Melinda Gates, Bay Area Global Health Alliance, BIT and McKinsey can provide crucial support and guidance in scaling our platforms within UK government and knowledge transfer to the US frontline public and private sectors organisations.