Meet The Change Maker Supporting Thousands of Healthcare Workers With A Mental Health App

Please note: this article deals with topics that some may find distressing.

Luke Burchill is the man behind the Hive app rolling out at Royal Melbourne Hospital, providing healthcare workers with access to mental health support and resources.

When the first wave of COVID hit, Luke saw the deterioration of his colleagues’ mental health unfold. With no official toolkit or game plan to deal with the mental health impacts of a pandemic but a genuine concern for healthcare workers, Luke knew he had to do something.

Luke Burchill is the cardiologist at Royal Melbourne Hospital who led a team of 30 to develop an app that was created every step of the way with the end-user in mind: Australian healthcare workers living during a time of the coronavirus pandemic.

With the app’s initial roll out to the hospital community of healthcare workers at Royal Melbourne Hospital on November 30, we spoke to Luke about how the Hive app started and how he’s making a difference.

Image: Luke Burchill (Supplied)

First of all, can you talk us through what inspired you to start the Hive app?

“During the first wave of COVID, I experienced this dread, uncertainty, fear about what COVID was going to mean for my colleagues, and for me and my family. I was seeing those news stories from Europe, particularly Italy and Spain, and seeing healthcare workers with infections, and dying, but also healthcare workers talking about their inability to provide the quality of care, and the level of care they felt was morally right.”

“All of those things inspired me to bring together a team to come up with a solution, and what we came up with was the Hive app. The actual solution was then developed through a co-design process with the healthcare workers. All of those emotions and, recognising that I didn’t actually have a game plan or have a toolkit on which to draw on for something as significant as a major pandemic.”

I can’t imagine how difficult this was to get up and running. So How did you turn a mere idea into actually launching an app?

“What’s unique about this project is that the app is user-centred and co-designed. The ideas have been shared with healthcare workers themselves so that they can respond, and it’s actually their responses, their experiences, their needs, their priorities, that determine the design, the look and the feel of the app.”

“A lot of innovation is very top-down, you know, people who are experts come up with the idea and gets developed in an incubator and gets released into the wild. This is quite different in that co-design starts with grass roots and we start by listening and learning about our intended end-user. And to do that we used a range of measures, but really interestingly, we used photo elicitation where healthcare workers took photos of their daily experience. We also had interviews with the workers, and the app creation was based on these experiences, interviews and then we started to develop what the priorities for the app needed to be.”

“Some of those ideas aligned with our original starting point, but there were many new ideas that reflected the community’s needs and priorities. For instance, humour was something we heard quite early on that was desired from the community, however there were very specific needs of how that might be presented to them.”

Image: The Hive app interface (Supplied)

How does it work - how can healthcare workers actually seek support through this app?

“The three key components for the app are mental preparation and coping strategies; really focused tips and expert driven advice on things that can make a big difference. The second being emotional state tracking so that users actually keep on track of their how doing in terms of their emotional stress. And the third thing is to actually link to mental health support. We mapped all of the mental health information and content that is available for healthcare workers and made it as simple as four questions, so that they could filter through a series of questions and then be led to the mental health information and support that is most relevant to them, according to their preferences, and according to the kind of mental health problems they’re experiencing, and whether or not the support they are seeking is for themselves, an elderly parent, or perhaps their child that is struggling with COVID.”

Being a healthcare worker yourself, there’s no doubt you’d have a grasp on the medical industry and the highs and lows that come with it, as you get with every industry. Can you tell us why exactly the medical industry especially needs this app, is there currently not enough support provided to healthcare workers within the workplace?

“That’s a great question. What we know is that health care workers and hospital workers have - compared to the general community - have higher rates of mental health concerns – anxiety, depression, PTSD, substance use, and relationship difficulties arising from those things. Those issues are there at baseline before COVID, because our job does expose us to unique challenges and for some people, traumatic events that can be difficult to process.

“What we know is that many healthcare workers do not access the support they need. The reasons for this are stigma surrounding mental health, as well as the culture we as hospital workers have; we are meant to be sort of stoic and just suck it up, you know, have a good game face, because “that’s part of working in healthcare”. And this is where the app comes in. We don’t really have services that have been developed to specifically tailored to what we need. And if they do exist, they’ve been highly siloed, there’s something for doctors and something for nurses, but there isn’t necessarily something for the hospital worker community. What we are trying to do is put that info in the healthcare worker’s hands. We are also trying to draw attention to the central importance of the GP as someone who is the best help for coordinating our care.”

Image Source: Unsplash

It’s amazing to see someone identifying this issue in the industry and taking action to make change in the world. Do you have anything else planned or coming up in this space?

“We have had some interest from other healthcare networks in both VIC and other states. At this time, we are looking at how to scale the app and translate it to those other healthcare networks so that it is a cost effective, shared resource. The goal is to reach as many healthcare workers as we can. Thinking about how we make this affordable for other healthcare networks and also how we build an evidence base around the app and what it does in fact achieve for those who use it.”

“So, starting on November 30, we will have the wider roll out at the Royal Melbourne Hospital, and it will be offered to 10,000 workers. We’ll the be evaluating the use of the app and how it effects users’ mental health.”

As this app works to provide access to mental health support for all health care workers in Australia, can you describe the very first moment that you realised your work was making a real impact?

“There’s been an interesting part of the app creation, where we employed film makers who were out of work because of COVID, to film the interviews we did as part of our research. The brief was to create a short film that was more or less a gift in response to the experiences being shared by the healthcare worker.”

“Those short films have now been completed and we have a series of eight. The series is called ‘Respond’ and the beauty of this is that the film has gone back to the healthcare worker and we have reflections from both the healthcare worker and the film maker, and I’m seeing this really personal impact of this collaboration where healthcare workers are reflecting on their own stories because of what the film makers have been able to achieve and what the healthcare workers have been talking about. They’re speaking with pride about what they’ve been able to achieve, despite the challenges of COVID, and they’re almost responding to a past version of themselves. They’re telling us about things that lead us towards a conversation about post-traumatic growth. So that has been really gratifying to see. Just sharing those stories of their experiences is leading to some sort of emotional processing and healing for these healthcare workers.”

What has been your proudest moment to date with this app?

“Just knowing that we’ve got a live date of November 30 and that it’s going to be in people’s hands from that day on. I think it’s taking it from an idea to actually being in people’s hands, that makes me feel very proud. I have led a team of over 30 people to get to this point and we’ve been through some really difficult times with COVID. I’ve also been working myself as a doctor in Royal Melbourne Hospital, which was heavily impacted by COVID and just being able to get to this point and see that it’s going to have a life and have this reach across the community. I’m really proud.”

What advice do you have for other people wanting to get involved in supporting mental health and suicide prevention in Australia?

“I think that we all have something to bring to this space. I think the more diversity we have among those discussing these problems the better. I am originally a country boy, I’m a member of the Victorian Aboriginal community, I look after young adults with heart disease that have a high rate of mental health concerns, these are the different reasons why I am in this space. But I think mental health and suicide prevention takes all of us, so the more people wanting to draw attention and remove the stigma, the better. The single piece of advice is just don’t forget the GPs and their roles in mental health and suicide prevention. I’m all for the larger organisations that are now leading advocacy around mental health and suicide, but I think the role of the GP is one we need to acknowledge and invest in also.”

Image Source: Unsplash

Before we leave you for today, we’d love to know, if you had one message or piece of advice for health care workers struggling right now, what would it be?

“One great thing I have learnt through this collaboration is paying attention to the balance between your resources and your demands. When our demands are overwhelmed and we don’t have enough resources, that’s when we go into threat mode. But when we can re-balance and have our resources so that they’re in excess of our demand, that’s when we can actually rise to the challenge. And sometimes it’s not only about finding extra resources but breaking down the demand into smaller pieces. That might just mean breaking your day down, it might sound silly but even to an hour at a time when you’re having a really difficult day, whether that is 15 or 30 minutes at a time and thinking about what resources you can draw on to get through what you need to get through. So, resources versus demands, and it’s important to pay attention to where that balance is in your daily life.”

If you’re looking for support, please call Lifeline on 13 11 14.

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