While there is increasing acceptance that there is no health without mental health and mental health is more than the absence of mental health disorders (WHO), there are limited large-scale, brief interventions to address mental health needs and to promote community well-being across whole populations. Roughly one in four of all U.S. adults currently struggle with mental illness, and about half will develop a mental health disorder in their lifetime (CDC). A large majority of adults do not access treatment or wait to access treatment during a behavioral health crisis. Taking a public health, systems-level approach to addressing common mental health disorders can help to prevent onset, or to lead people to treatment and community resources earlier in the condition.
As communities (and indeed our society) change, so must the strategies employed to reach them. While community-based, in-person programming provides quality touch-points with individuals, behavioral health technology is increasingly being used for both large-scale information dissemination and individual-level intervention, such as smartphone apps. The introduction of the first ever mental health screening kiosk is a balance between traditional face-to-face interactions and innovative technologies.
Design Challenge
The concept for the first ever mental health screening kiosk was in response to a design challenge set forth by the Scattergood Foundation in Philadelphia to best integrate mental healthcare into retail clinics (similar to a MinuteClinic®). While screenings around common physical health issues, such as high blood pressure, have existed in retail clinics for some time, the focus on mental health screenings has been lacking. Furthermore, simply training providers on the benefits of screening and asking them to incorporate into daily practice may not address the issue entirely. With the tremendous amount of stigma surrounding mental health, there was a clear need to identify a method where the intervention itself served as a stigma-reducing marker.
The mental health kiosk incorporates technology via the screenings delivered through a tablet while encouraging direct contact with a person for the next steps. This revolutionizes the way health as a whole is addressed at a retail clinic. The introduction of the mental health kiosk in a retail clinic setting allows every person who walks through the doors of the clinic to have access to both mental and physical health resources, demonstrating a truly integrative approach. A physical kiosk would be located directly outside of the retail clinic, placed next to a blood pressure cuff. A wall-mounted tablet with the screening would also be placed in the waiting room of the retail clinic, ensuring that conversing about mental health became part of the clinic’s daily routine.
The mental health kiosk was developed through a collaborative effort between Screening for Mental Health, the Philadelphia Department of Behavioral Health and Intellectual disAbility Services, and the Thomas Scattergood Behavioral Health Foundation. The pilot kiosk launched in August 2014 within a Philadelphia ShopRite grocery store, positioned next to a blood pressure cuff kiosk, and outside the QCare retail clinic and pharmacy.
Ideally, mental health screenings will become a part of a normal check-in with a provider. In the meantime, this kiosk and tablet accomplish a few important things beyond normal methods to reach people about their mental health. The kiosk itself sends the meaningful message to the community that mental health is important, and help is available. The screenings themselves are free through the kiosk, allowing the public access to important information regarding their health.
Second Generation
The initial pilot location provided invaluable information on how to turn the mental health kiosk into a sustainable program. The result was the development of the MindKare® kiosk program, which includes a second-generation kiosk, created with the help of outside manufacturers, and a thorough review of the readiness of sites to implement the program.
The freestanding kiosk uses an interactive touch screen display providing users with a seamless experience as they navigate through the online screening platform. The kiosk screens for depression, bipolar disorder, generalized anxiety disorder, alcohol use disorder, eating disorders, posttraumatic stress disorder and suicide. The kiosk does not provide a diagnosis but rather expresses that individuals have signs and symptoms that may be consistent with a diagnosis, along with many local and national resources for seeking help.
For the MindKare kiosk to be successful a host site has to be dedicated to making it a priority, which may require a shift in organizational culture toward mental health. In addition to the physical kiosk, organizations will be expected to undergo a thorough readiness review to ensure that they are equipped to launch a successful program. Furthermore, organizational capacity to launch programming is one thing, the ability to take on an emerging method of mental health education and awareness is quite another. Previous programming experience, flexibility and the willingness to boldly engage in a proof of concept initiative are all priority qualities for potential host sites.
Drexel University became the first college to implement the MindKare kiosk program and is a model for successful implementation. The University was already working to reach students earlier to help diagnose mental health issues and to capture students that would not normally access the University’s counseling center. The kiosk became a way to increase mental health awareness and visibility of resources.
The University determined that the student Recreation Center was the best place to put the kiosk as it is a well-trafficked area and it can be accessed by students, faculty, staff and the greater community. Those interested in taking a mental health screening have the option to take the screening at the kiosk or to take a screening via Drexel’s online screening site. The kiosk has cards that provide the screening site web address for those that want to take a screening on a computer, tablet or mobile device.
Since Drexel introduced the kiosk on campus in May 2015, it has had close to 1,000 screenings both at the kiosk and the on the Drexel screening site. The University has also promoted its effort both on and off campus, received press coverage in local and national publications and spoken at national conferences.
The University fully embraced the concept of having a kiosk on campus and was prepared to incorporate it into existing programming and generate awareness for this new mental health concept.
What’s next?
By the close of 2015, MindKare kiosks will be placed in institutions of higher education and healthcare clinics in Philadelphia; they will help create access points for mental health support in rural North Carolina communities; and they will also be placed throughout select counties in Ohio to bolster awareness regarding available services.
This phase of the program will again provide valuable information on how to continue to evolve the program to meet the needs of sites and users.
We and our partners are committed to moving forward and identifying and working with additional sites to incorporate the kiosk into their mental health programming. Thus far, we have determined that there is an interest and need from organizations that want to enhance their current programming, provide greater access to information about mental health and send a message that mental health is important to their communities.
Commitment to Innovation
For more than two decades, Screening for Mental Health has developed programs to educate, raise awareness and screen individuals for common behavioral and mental health disorders and suicide. As technology rapidly advances and communities evolve, we continue to look for new ways to bring online mental health screenings to more people. The MindKare kiosk is an example of this as we combined technology and programming innovation to bring organizations a new way to reach those in need of mental health information and resources.
We are proud to be at the forefront of mental health awareness and screening initiatives and plan to continue our mission of providing innovative mental health resources and linking those in need to quality treatment options.