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Health

The new trial reducing hospitalisations and suicides in young adults

Ezra* was admitted to hospital ten times last year.

"My mental health started getting really bad five years ago," the 19-year-old said.

"I could barely work, I wasn't studying.

"I had to drop out [of university] because I was really sick."

They grapple with five mental health issues; Gender dysphoria, anorexia nervosa, borderline personality disorder, generalised anxiety disorder and chronic depression.

One-in-five Australians live with a mental or behavioural condition, according to the Australian Bureau of Statistics.

About $2.9 billion is spent admitting people to public hospitals for mental health services, according to the Australian Institute of Health and Welfare.

For three years, Ezra checked in and out of hospitals.

Then their psychologist recommended an innovative research trial.

This year, Ezra was admitted to hospital just once.

The Australian-first trial Unwired aims to lower hospitalisations and suicides in people with mental illness aged 16 to 25 by spotting the warning signs of psychotic relapses early.

The trial, conducted by the Prevention, Early Recovery and Intervention Service (PIERS), is based in Parramatta.

It involved fifty people using an Embrace2 wearable wrist device over six months to measure their stress, activity and sleep data.

About half of the people would have this data uploaded daily to their psychologist, who could intervene with treatment before their mental health deteriorated. 

Professor Anthony Harris, the trial's lead researcher, said the treatment was tailored to those taking part. 

"You don't get to be seen by this team unless you've tried to kill yourself, cut yourself a lot, or had an illness like bipolar disorder or schizophrenia," Professor Harris said.

Psychologist Ahmed Tohamy said the data from Ezra's wearable influenced their therapy sessions and helped personalise treatments.

"We were looking for the big spikes ...(the) sustained spikes," he said.

"Then I take that to Ezra and say, 'Oh, look, look at this. Do you know what happened here? Can we talk about that?' "

Analysing the patterns can prevent another trip to hospital, he said.

The data helped jog the memories of participants, Mr Tohamy said, prompting them to talk about an experience they might have otherwise forgotten, or simply didn't want to talk about.

It also maps breakthroughs during therapy sessions, as the data revealed emotional sessions led to periods of stability thereafter.

"I remember it being amazing," Ezra said.

"We were able to sort of identify when my stress would peak, like if I was at work during the day, or if I was just at home and I had an argument with my parents.

"Then we were able to use that data and come up with ideas on how to manage it, like how to get better sleep, how to manage stress at work, how to manage stress in any situation."

Understanding disturbances in his sleep helped improve their rest, Ezra said.

But not all of the participants showed the same improvement.

This was especially the case for participants who didn't have a case manager analysing their data, Mr Harris said.

"We could see, for a couple of days, this young woman's sleep just completely disintegrated," he said.

"We could see her relapse."

"She became psychotic and had to be readmitted into hospital."

Mr Harris believes the findings from the ongoing trial could be applied to help prevent relapses when they're most likely.

"So we're going to be going back and looking at people after they're discharged from hospital," he said.

"The first couple of weeks after discharge ... is the highest risk time for relapse."

He hopes to do this with a wearable device that has longer battery life.

Some participants who are struggling with their mental illness forget to charge the Embrace2 wearable every few days.

Mr Harris said one goal was to have a smart watch with seven days battery life, so that case managers could charge it during weekly therapy sessions.

Another idea was to tap into the data already gathered by popular Apple and Android smart watches.

"With time, we'll just use the devices people have got (already)," he said.

"That's the goal."

Ezra completed the trial in June and no longer wears the Embrace2.

They're now a support worker at PIERS helping people with their mental health.

"I still do [feel really bad] and I think that's sort of part of the recovery with a mental illness," they said. 

"[But] now I have strategies in my tool box where I sort of know how to manage it beforehand."

*Ezra is not their legal name.

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