Evaluating the Spanish version of the Mental Health eClinic (MHeC-S) an e-health system for improving the mental health and wellbeing of Spanish-speaking young people based in Australia

The Spanish version of the Mental Health Clinic (MHeC-S) is currently comprised of five essential elements: 1. Landing page and triage system to ensure young people with high distress access urgent care immediately and appropriately 2. Comprehensive online self-report assessment. 3. A detailed dashboard of results 4. Booking system to make timely appointments with health professionals attached to MHeC and, 5. Video-visit to allow for short structured interviews. This element also allows the health professional to suggest relevant apps and etools (including UBWELL) to the young person as a means to improve their symptoms as well as track their progress over time. The length of each video visit (online interview) will be approximately 15 minutes. Interviews in which participants disclose suicidal ideation will require more time in order to provide a safety plan and emergency contact numbers as per duty of care. These interviews will take approximately 25 minutes. NATURALISTIC (CLINICAL TRIAL) Potential participants will be screened for the study via the MHeC-S. On its landing page, participants can click the “GET STARTED” button. From here they are directed to a simple screening questionnaire, which confirms age (between 16 and 30 years), Spanish as native language, location currently based in Australia and then regular access to a smartphone (iPhone or Android) and the Internet. If potential participants meet all eligibility criteria, they are then redirected to the online Study Information Sheet and Participant Consent Form followed by “CREATE ACCOUNT (or enrolment)” Participants will then complete a 45-minute self-reported assessment regarding their physical and mental health. On completion, the MHeC-S generates a comprehensive dashboard of results and recommends the user book a ‘video visit’ in the following days; in the meantime, a participant is encouraged to download and use UBWELL [UBWELL is an app developed by the Brain and Mind Centre, that allows users (participants) to track (or self-monitoring) their physical activity, sleep patterns, mood, energy, diet, weight and other behaviours. Participants can connect UBWELL with the MHeC-S, which displays their data on the MHeC-S dashboard. The participant would be invited to download the UBWELL app (currently available in the App Store and Google Play, free of charge), connect it to the MHeC-S platform and collect their data 4 times per day. This process is completely optional]. Participants will then have a ‘video visit’ with a native Spanish-speaking (research) child and adolescent psychiatrist , who will provide direct feedback about the participants’ results. Optionally, participants can book a second ‘video visit’ appointment where their progress, symptom reduction and share plan will be further assessed (and subsequent pathway to care established if so required). At any time during the course of the study, if a participant is identified as being a significant risk of serious harm, they will automatically be provided with emergency service details as well as with specific advice as to how to access appropriate counselling, support or formal health care. USER TESTING One-on-one 90-minute user-testing sessions where young people/ supportive others and health professionals will be invited to test the MHeC-S using scenarios and lists of tasks. FOCUS GROUPS Finally a total of four (three-hour) focus groups will be conducted to explore SROI via Theory of Change (including inputs, activity, outputs, outcomes and impacts). Two focus groups will be conducted prior to the naturalistic (clinical trial) evaluation of the MHeC-S – one with young people/ supportive others and one with health professionals; and two focus groups will be conducted post the naturalistic (clinical trial) evaluation of the MHeC-S – one with young people/ supportive others and one with health professionals. The user testing sessions will run throughout the duration of the trial, as they are independent of the intervention (clinical trial) and focus groups. It’s important to clarify that there are three types of research activity – focus group (pre and post trial), clinical trial and user testing. Invitation to participate in a research activity is as follows: FOCUS GROUPS Pre – trial: All participants (young people, health professionals and supportive others) will be invited to the pre-trial focus group. Post – trial: Only young people who have participated in the clinical trial or user testing will be invited to the post – trial group. All of these young people would have used the online system and therefore can offer views/opinions about the system. NATURALISTIC (CLINICAL TRIAL) Young people will have the option of participating in the clinical trial or the user testing, but not both. USER TESTING Young people (who have not participated in the clinical trial), health professionals and supportive others will be invited to the user testing sessions.