A: How can Beyond Blue influence the future of mental health care in Australia?
GH: An organisation like Beyond Blue has a unique opportunity to play a leadership role in challenging the current state because we influence policy and advocate for different types of policy. We've been pretty successful in attracting diverse sources of funding, including non-government funding, and using those funds to pilot services and initiatives that we think will make a real difference.
We’re not afraid to try new things and work differently, and we’ll back our ideas by putting our own skin in the game, too. We start by asking ourselves: “If a service or a support was to look different, what would that look like?” We will talk a lot to people in the community to understand their actual aspirations and needs, then do the research to develop new models. We’ll incubate these models, trial them in the real world and tweak them as we go. We’ll take it to a stage where these models can be independently assessed and evaluated, then we’ll build a business case around scaling them up and take that business case to governments. Then our role shifts to be one of working with and alongside governments and commissioning agencies to get these new models embedded into the system.
A: What role does technology play in your care models?
GH: We’re great believers in working alongside the clinical system. In some cases, though, people will feel supported without professional intervention. We design our models to ensure people there are different types of supports available for them, night and day, when they need them.
For instance, smartphone apps that are safe, evidence-based and available 24/7 when people need them, keeping them safe when they start to think about suicide. Services that can be accessed without a waiting list or a referral from a doctor. Services that can be advertised and referred to from Facebook advertising, linking people in online environments that are safe. Our online peer support forums are now visited by 1.6 million people a year and that is the fastest-growing area of our business.
These online interactions often provide people the motivation to make better choices, talk to their GP, let their family know what is actually going on. They may start exercising more, stop drinking so much and make positive lifestyle changes. Those are the kind of outcomes that I'm interested in achieving by harnessing technology.
A: How are you using data to understand those you serve—and serve them in new ways?
GH: Part of our challenge as an organisation is the fact that we do collect lots of data, but we are not always examining it and taking those insights and then applying them. That's something that we're looking to do better.
As Australia's best-known and most-visited mental health organisation, our vision for the future comes from a place of great humility. With the level of trust the community has in us comes huge responsibility, and we need to understand why people come to us, what they need from us and what is helpful to them when they get to us. We need to arrive at that understanding on the community’s own terms then give them what they need: services and supports; digital product and apps, referrals to other great initiatives and services from other organisations.
The idea is that we are a ‘big blue door’ – often the place where people start their journey towards recovery when they've got a mental health struggle. Take for example, if we've got a new mum who's Googling in the middle of the night, “Why don't I love my baby?”. She has this beautiful baby that she knows she's supposed to be having these feelings for and she's feeling completely the opposite. Amid her search in the middle of the night, up pops Beyond Blue, so she calls our support service and the counsellor talks to her about postnatal depression and refers her to information along with specialist, personal depression services.
That's a great service. But we know we could do so much better for that mum. We know that we've got online forums where she can connect with a bunch of other parents who've been through something similar and realise that she's not alone and this is actually really common. We can connect her to our early intervention program, where she doesn't need a doctor's referral. When her baby gets old enough to go to kindy, she might like her kindy to join Be You, our schools and early learning service initiative. When she returns to work, she may want to encourage her boss to focus on the mental health and wellbeing of the workforce. There are all these touch points available to her if she wants them. We want to be able to say, “Here's the range of things that may help. Take what you want and tell us what you want. Let's have a deeper relationship with you if that's what you want.”
A: Are you learning from other countries that are doing good things in mental health?
GH: Australians have led the way in things like wearables, personalised self-managed and online services which are either clinician-guided or have clinical oversight. As a sector, we need to be constantly open to embracing new technology and different ways of thinking, but always coming back to humanity, safety and quality. We can learn from others.
For instance, Dr. Barbara Stanley is a fantastic academic and clinician in the US who did a lot of work with veterans on suicide prevention and safety planning. She asked, “What are the things you can do to create a plan for an individual that keeps them motivated to stay alive through a temporary suicidal crisis?” She developed safety planning tools proven to be very successful with that population. Beyond Blue brought her over and we got her to do some work with us to try and turn that concept into a digital app for everyone.
We created a suicide safety planning app called, “Beyond Now”, which does exactly what a paper-based safety plan does, but on your mobile device. It’s with a user 24/7, on their bedside table, at the footy and on the bus. No one knows whether people are just looking at dog photos or actually keeping themselves alive. Users can upload pictures of loved ones and music that distracts or calms them. It has emergency contact details for trusted people who they can turn to in a suicidal crisis. It's shareable, so we encourage people to complete it with someone they trust and then share that plan with their health professional and with their family and friends so that they know that person’s suicidal triggers and the things that work for them to de-escalate a crisis.
We’ve had to work hard to encourage GPs and mental health practitioners to see this as part of their toolkit. So, when they’re writing up an antidepressant prescription, or when a person who sitting in their room has just talked about the fact that they want to kill themselves, those professionals encourage and help people to know about the app and use it.
A: How do you persuade your Board and other stakeholders that the future is a digital one and that investing in it will enhance the access of your services to the target population?
GH: I am in a fortunate position because my Board is really attuned to this. Beyond Blue was an early adopter of technology. We are certainly one of the first organisations to use social media as a way to change behaviour and to connect with people to influence and change their behaviour. We are one of the most followed NGOs in Australia on social media.
I've never had a problem with persuading my Board to invest in new ways of thinking and new technologies. But they do want to make sure that those types of investments balance scale with human connection. They want to make sure that we're not only thinking about online and digital, we are also thinking about equity. What about those people who don't have access to a reliable internet connection?
There’s not a pipeline of endless resources – we’re custodians on public and community funds. We've got to constantly make sure those investments are meeting the needs of the community and if they don't work, we should find that out quickly and respond.
A: How do you govern communication on your online forums?
GH: With our online forums, you have to join and by joining, you register, and you give us certain details. You don't use your real name, but you sign up to rules and our rules are pretty simple. Don't be disrespectful. Don't be abusive. Don't be homophobic. Don't be racist. Be aware. Remain anonymous. Don't promote products or medications.
We've got this fantastic triage system that we have built up over the years. Now, 90% of our posts just go straight through, but it wasn't always that way. We were always very risk averse when we first started the forums and we started by moderating 100% by using eyeballs on every single post.
Part of our learning has been to embrace technology and to use technology in really positive ways that allow the community to connect and have real-time, human conversations with each other.
A: Your organization clearly is changing lives every day. What do you like most about the work you do?
GH: It's got to be people and purpose. I know I have an incredible Board. I'm part of an incredible team, we have great partners and suppliers and it's a privilege to work for an organisation that has people with so much passion for what we do.
It's people that matter. Most importantly, the people who have had a need to use our services at some point in their lives. Not a day goes past that I don't meet somebody in the street or at an event where people come up and just say, “Thank you!” They see the Beyond Blue name and they say, “Thank you” and I ask, “What for?” and they say, “I wouldn't be here if it wasn't for Beyond Blue.” That is an incredible responsibility and privilege.