JMIR Publications

ABSTRACT

Background:

Measurement-based care (MBC) uptake is suboptimal in mental healthcare, limiting key opportunities to facilitate data-driven symptom monitoring and progress feedback. This misses critical opportunities for enhanced patient-clinician communication and early intervention.

Objective:

To understand young people’s changing perspectives, engagement, and value-add of the digitally-enabled MBC over time.

Methods:

As part of a randomised controlled trial, an added human support, the digital navigator (DN), provided technological and engagement assistance for young people to integrate an online platform (digitally-enabled MBC) as part of usual care. The DN conducted 118 semi-structured interviews with 73 young people (mean age 22.7 years, SD = 2.7) at baseline and 3-, 6- and 12-months follow-up visits.

Results:

We found that the majority of the young people were enthusiastic about incorporating digitally-enabled MBC in care when they understood its potential to facilitate collaborative care with clinicians and enhance self-awareness about their mental health. Notably, the DN’s support was effective in fostering this understanding at the initial stage of implementation. However, it was evident that the lack of clinician involvement in MBC posed a risk of disillusionment to young people’s sustained engagement. As reported, clinician uptake of digitally-enabled MBC was poor, limiting its perceived value-add and sustainability.

Conclusions:

Digital technology shows significant potential for implementing MBC into mental health care. Young people want to use digitally-enabled MBC in their care and DNs can facilitate implementation through ongoing engagement and technical support. However, successful MBC implementation depends on broader systemic factors, particularly clinician and service engagement. Future research should examine how to address these contextual barriers and optimise DN support for implementation and sustained engagement.