Improving treatment, consumer participation and advocacy with web-based approaches

Improving treatment, consumer participation and advocacy with web-based approaches Challenges and opportunities for AOD services

Paul Aiken, Evaluation & Communications Team Leader

@ReGenUChttp://www.facebook.com/ReGenUC

The issues

Challenges• Pressure on health funding• Expectation of ICT to increase efficiency• AOD service reforms• AOD sector slow to adopt new approaches

Opportunities• Internet now main source of health info• NBN, mobile access• Rise of ehealth/telemedicine & Web 2.0• Increased service accessibility

What does it mean?

Web-based (doing stuff online)• ICT enabled• Accessibility

• 24/7• Geography

Web 2.0 (applying good practice)• Participative• Interactive• Transparent

What’s ReGen been doing?

Treatment/Harm reduction• Website – screening tools• Bluebelly• Videoconferencing

• Assessment • Non-Residential Withdrawal• Case conferencing

Consumer Participation• Website – comments, consumer blog• Social media

What’s ReGen been doing?

Advocacy• Website/social media• Online publishing

Professional Development• Heads Together• Curation• Social Media

Treatment

Improving accessibility• Stigma• 24/7• Geography• Engagement (including via SM)

Service quality/efficiency• Capacity building• Referrals• Logistics

Challenges for AOD services

Challenges• Fear of the unknown• Lack of expertise• Cultural resistance• Not funded

Strategies• The medium is new, the practice isn’t• Encourage staff/consumers/supporters with

interest in ICT (project champions)• Small steps, support people through the

process & demonstrate the practical benefits as you go

• Future funder expectations (be prepared)

Consumer participation

Website• Reporting/transparency• Consumer blog

Social Media• Self-selecting• Alternative source of service feedback• Inclusion in consumers’ own networks• Extension of therapeutic contact

Challenges for AOD services

Challenges• Privacy (consumers & staff)• Stigma

Strategies• Respect peoples’ choice (opt in)• Validation, empowerment, advocacy

Opportunities• Opportunities for further engagement• Support communities (peers & workers)

Advocacy

Old media• Access to journalists• Raised profile through curation• Increased audience for unpublished

media releases

New media• Online publishing• Access to new audiences• Easy integration of web-based content

Challenges for AOD services

Challenges• Work/life balance• Brain explosion• Risk aversion• Privacy

Strategies• Develop a routine, set some limits• Take your time, share the load• Trust your staff, apply clinical practice

principles• Let staff/consumers make informed choices

Case Study 1: Assessment via videoconferencing

Case Study 1: Assessment via videoconferencing

Barriers to engagementAssessment• 3hr bus (return) to Wodonga, nearest

CHC

Withdrawal• 1.5 hrs to Wodonga• 4hrs (train) to Melbourne• Cab to hotel (overnight stay)• Cab to Williams House next day

Case Study 1: Assessment via videoconferencing

Barriers to engagement• Cost of travel• Time spent travelling• Multiple connections/unfamiliar

environment• Limited sense of what to expect• Separation from family/supports

Case Study 1: Assessment via videoconferencing

Benefits of videoconferencing• Reduced travel time – consumers,

family, workers• Improved quality of assessments• More timely responses• Better engagement with Williams

House staff & understanding of what to expect

• Capacity building with local staff• Virtual family visits

Case Study 1: Assessment via videoconferencing

Challenges• Changing practice• Resources

Strategies• Training/support, demonstrate benefits• Keep it simple

Opportunities• Increased collaboration with partners• Expanding to other services

Case Study 2: Twitter clinical contact (Karen*)

Karen – I admit it… I’m not in a good place right now and have plans to end everything on Friday

The world would be a better place without me..

There is no other way out…

After arguing with someone that I love most, I’m broken hearted and really upset

ReGenUC – hang in there :)

Karen – No can do..Already planned my way out

ReGenUC – OK, now we’re worried. Where are you? Is there anyone with you?

Karen – I’m not going to chicken out this time and nothing is happening until Friday

Case Study 2: Twitter clinical contact (Karen*)ReGenUC – just so we’re clear, what is happening on Friday?

Karen – On Friday I’m ending my life…theres just no point anymore

ReGenUC – OK, we’d really like to get someone to come and see you. How can they contact you?

Karen – I’m not seeing anyone. Have been since I was five.. Nothings worked so whats the point?!

ReGenUC – We know there’s not much we can do on this platform, but would really encourage you to call www.lifeline.org.au/Get-Help/

Is there someone who will be checking on you in the next couple of days?

Case Study 2: Twitter clinical contact (Karen*)

Karen – no one my family hates me I’ve ruined everything :(

ReGenUC – It sounds like you’re in a lot of pain at the moment. No easy answers but see how you feel tomorrow. Will you let us know?Karen – I will feel the same maybe worseReGenUC – We hear you. Will you let us know how you’re

doing tomorrow?Karen – ok

Who am I speaking to can I call whoever you are?ReGenUC – Sorry for the delay Karen. It’s Paul. I’ll DM you

now.

Case Study 2: Twitter clinical contact (Karen*)

Challenges• Privacy• Location/jurisdiction• Referral pathways

Strategies• Private contact asap• Know your consumers/followers• Integrate with existing intake systems

Opportunities• Remote monitoring via SM postings • Visible practice

Case study 3: FB clinical contact (Rosie*)

Rosie – HiReGenUC – HiRosie – I am drinking. Even all the things I said. That I would

not. ReGenUC – Sorry to hear it. Do you have plans in place for

the weekend?Rosie – YesReGenUC – Good. Our after hours service is available if you

need some extra support tonight and over the weekend: http://

www.regen.org.au/mediareleases/415afterhoursreleaseReGenUC – I've let Matt at the after hours service know you

might be calling him (9497 1122). If you're ok over the weekend, maybe give our Triage team a call on Monday?

Case study 3: FB clinical contact (Rosie*)

Rosie – I am doing catalysts... please don't tell them.. as I will. Thank you for your support..ReGenUC – No problem Rosie. This is the first week of the

program isn't it? The first weekend is a risky period for lots of Catalyst participants. Keep your supports close until

Monday and don't forget to call Matt if you need extra help. The Catalst team will be fine on Monday. There won't be any judgement there. Lapses happen, they're

a part of the process. The key is to get back on track ASAP. Good luck :)Rosie – Yes. I do understand this all. But just now it hurts...Rosie – Hope you get paid well to be on the other end of this

support. Rosie – It's appreciated.

Case study 3: FB clinical contact (Rosie*)

ReGenUC – Yes. Sorry for telling you what you already know. Don't beat yourself up about it. You can't undo it. Try not to let the guilt take over and turn a lapse into a relapse. Focus on getting back to where you want to be.ReGenUC – Thanks, but this work is part of my donation to ReGen. It's Paul, btw :)Rosie – Wow.. such kindness. Thankyou. But do you notify them of my situation tonight. Or is this in confidence? Paul are you a trained voluntary worker?? If so... Thankyou even more for your time tonight.. RozReGenUC – I'm an employee, but the social media part of my role inevitably involves some after hours activity. Most of our staff go above and beyond their job descriptions. This is the way I do it. I'm just happy you're able to get in touch. Our conversation is in confidence as no-one else will be checking our FB account over the weekend. I'll check with the Catalyst team on Monday to make sure you're in (and safe), if you haven't come in, I'll get them to give you a call. Is that ok?

Case study 3: FB clinical contact (Rosie*)

Rosie – I will be in Monday. But I do NOT give my permission ... for you to inform them of this contact now.

Rosie – With this forum of social media of contact.. I would not do it .. if I felt compromised by doing it after hours.

ReGenUC – Understood. I'd only do it if I was concerned for your safety. I'm happy to talk with you about this on Monday if you like. If you want to see me, you can get one of the Reception staff to page me. You can see who I am here: http://

www.regen.org.au/education/education-advocacy-staff I also run our Twitter account.ReGenUC – Definitely doing it via FB messages (or DMs on Twitter) is the best way: keeping it out of public view. I've worked in our

clinical services and am bound by the same code of conduct as our counsellor a and the Catalyst team. I would only go against your wishes if I had reasonable grounds to fear for

your (or someone else's) safety.

Case study 3: FB clinical contact (Rosie*)

Rosie – Ok. I will put myself to bed. Thankyou. There is no self harm occouring. Except for drinking. But at least I AM

talking with you Paul. Thankyou. Please do NOT inform the program. This is what I have to do.ReGenUC – Understood. Take care of yourself Rosie :)Rosie – Thank you. Thank goodness your on the limited.. haha payroll.ReGenUC – No problem. I should probably go to bed too. Night.--------------------------(following day)ReGenUC – Hi Rosie, it's Paul. Are you ok? (Just checking)Rosie – Went to sleep. Thankyou.

Case study 3: FB clinical contact (Rosie*)

Challenges• Splitting• After hours contact

Strategies• Clinical knowledge• Links to available services

Opportunities• Program retention – live lapse response• Visible practice

ReGen’s top ten SM tips for new (and old) players

The basics1. Open an account2. Get to know the platform3. Learn about the community4. Introduce yourself (when you’re ready)5. Be friendly and engaged6. Be authentic and consistent7. Think about what will interest people8. Be responsive (especially to criticism)9. Be persistent10.Acknowledge your mistakes

Ten things to avoid

1. Don’t overthink it2. Don’t broadcast3. It’s not all about you4. Don’t be needy or annoying5. Don’t confuse controversy with debate6. Don’t expect to ‘go viral’7. Don’t do gimmicks8. Don’t chase celebrities9. Don’t copy ‘Brand X’10.Don’t obsess about security

What can AOD organisations do?

1. Allow comments on their website2. Think mobile3. Encourage more consumer

participation4. Adopt a culture of transparency5. Encourage staff to use SM6. Recognise SM expertise amongst staff7. Decentralise – trust your staff8. Be willing to take (calculated) risks9. Recognise the costs (but do it anyway)10.Integrate web 2.0 approaches across

your organisation

Join the conversation

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