I was sent to an Irish convent boarding school when I was 7. I had no one to ask about all the issues that young people are able to talk about freely on MeeTwo. I would have loved to have had the app when I was a teenager. I suspect pretty much everything I do now has been informed by my own experience growing up, and how difficult it was to be able to talk openly and honestly about everything.
The app encouraging young people to help themselves by helping each other
MeeTwo is a multi award winning mental help app for young people. Its social media style app, like Twitter, but it is fully pre-moderated. A team of 10 moderators work from 7.30 in the morning to 11 at night, moderating every post and reply before it goes live. The app currently supports 25,000 young people aged 11-25 in the UK. MeeTwo is free to use and is available from the App Store, Google Play and the NHS Apps Library.
MeeTwo is based on the peer support model, so young people help themselves by helping each other. Young people will accept advice and information from their peers, much more easily than they do from parents, teachers or health professionals. Research shows that peer support helps the helper as much as it does the helped, so altruism creates a virtuous circle where everyone ends up feeling better about themselves.
The peer support model allows young people to transform their own difficult life experiences into useful advice for others. For example, a young person who has been to hell and back with depression can use that experience to comfort, sympathise and advise a young person who is just at the beginning of that journey. It turns something that has been incredibly difficult and traumatic into a life experience that can be used to help others.
A response to the rise in mental health issues
The escalation in mental health issues has been blamed on social media but we don’t see that in our data. In fact, social media rarely gets a mention. The issues that young people are dealing with are more to do with life pressures, family breakdowns, school stress, bullying, and body image. These are age-old issues that were there when I was a teenager, and will probably be there when my children’s children are teenagers.
There is certainly less stigma around asking for help now. Greater awareness of mental health issues means they are talked about more, and so more people seek to put a label on feelings that they can’t manage.
We see a lot of low-level anxiety and depression but most of it is non-clinical. However, MeeTwo is often given to young people who are on the Child and Adolescent Mental Health Services (CAMHS) waiting lists so we do have a growing clinical population.
From the front-end of the app, MeeTwo provides peer support, educational resources and a directory where young people can call helplines or explore other websites. But at the back-end, it’s much more sophisticated. Back-end data provides unique insights into what’s going on with young people, and when. We can slice that data through the year to understand, for example, what affects young people in March vs June. We can look at how feelings change when exams stress kicks in, or how panic attacks and suicidal ideation peak at the end of the holidays in August, and at the beginning the school term in September.
The popularity of MeeTwo confirms that there is a huge need for non-clinical safe support that can be accessed through a smartphone. MeeTwo is not a magic wand but it does give young people a space where they can talk anonymously about really difficult things before things reach crisis point. As an early intervention, MeeTwo can take some of the burden off the NHS and CAMHS.
A response to the Covid-19 crisis
The NHS predicts that an increased number of young people will develop mental health issues as a result of the current crisis, but for the next few months young people will NO LONGER be able to access mental health services unless they are already in the system. MeeTwo is ideally suited to support young people who might otherwise access tier 1 or tier 2 mental health support. Because MeeTwo is digital and our moderators and super peers work remotely, we are one of the few services who are able to operate normally in these uncertain times. In the short term, MeeTwo can help young people to cope with the emotional strain of the COVID-19 crisis but more significantly, MeeTwo can help prevent issues from escalating, protecting both the young person and the NHS over the long term.
Between Monday 16th and Friday 20th of March posting rates on the app increased by 50%. The number of posts requiring welfare support has doubled since the schools closed on Friday 20th of March. More than 30% of posts now relate to COVID-19. Through February, 80 people a day joined the app. On March 22nd, that number rose to 160 people a day even though we haven’t increased our advertising efforts. On Sunday 22nd of March there were an unprecedented 27 suicidal posts between 8.30am and 8pm.
From passion to purpose
As a psychologist and longstanding Times sex columnist, I wanted to develop an app that would allow teenagers to get sensible support and advice about sex and relationships. I teamed up with engineer and educational technologist Kerstyn Comley and we built a rudimentary app which we piloted in three UK secondary schools. The trials rapidly revealed that young people needed sensible support and advice about much more than sex and relationships and problems were generally complex and multi-layered. For example, the young person who is confused about his sexuality is living with parents who are homophobic, and is being bullied at school, so he has started to self harm. We realised that we needed to broaden out the platform to allow young people to talk about anything that was worrying them.
How the MeeTwo app works
Like most really difficult problems, the solution we finally arrived at seems blindingly simple now. MeeTwo is an app that combines peer support and preventative mental help tools within a safe social media experience. It teaches young people how to help themselves, by helping each other. It allows young people to turn their own difficult life experiences into useful support and advice for others. And because every new user is a new counsellor, it provides a uniquely scalable solution to the current mental health crisis.
MeeTwo is safe because it is 100% pre-moderated by humans who check every post and reply before they go live. Moderation begins at 7.30am and continues through to 11pm at 30 minute intervals. Moderators are paid, and they work remotely, so it’s a great job for people who have barriers to employment, or disabilities.
MeeTwo is anonymous so that young people can be completely honest about what is bothering them. Within the app, they shake their phone to generate a random three word name which is unique to MeeTwo. No personal information or identification is allowed, but users can @username to notify each other.
The app is designed to look and feel like social media but it is completely gender neutral. All visual hierarchies are stripped out and profile images are a simple coloured circle, which users can change. By creating an app that looks ‘cool’ and actively avoids all ‘self-help’ stereotypes, we have created an app that boys will engage with. At last count, 42% of our users were boys, which is an extraordinary measure of success.
MeeTwo is inclusive. Within the app trained ‘super peers’ ensure that every question gets a reply and no one is left out. Super peers are our secret weapon because the last thing we wanted was for a young person to pluck up the courage to post and then find that they were ignored. Superpeers are mainly psychology undergraduates and it’s a great role because it counts as work experience, so they get course credits for volunteering. Our wellbeing measure shows that being a super peer boosts self esteem by 30 percentage points.
Behind the scenes a team of experts pick up young people who are in crisis and help them to access real world support. Our experts come from a range of disciplines but are all mental health professionals.
Educational resources are developed in response to pertinent issues that are being discussed in the feed. Articles by authors and academics, as well as personal stories from users are also published within the app. We are currently running articles from The Lancet and Time Magazine as well as an interview with the UK’s top psychiatrist, Sir Simon Wessley.
The MeeTwo directory currently allows users to call helplines and explore third party support services. This is about to be updated rather spectacularly. The new directory will list the best helplines, support groups, apps, books, YouTube videos, Ted Talks, self help activities and products. Users will be able to search the directory by topic and populate their feed with resources which help with a specific issue. You can see the directory in. The MeeTwo Teenage Mental Help Handbook in attachments
Creative expression is an integral part of MeeTwo and our users can have their artwork published within the app (See two examples in attachments). In 2020, the billboard advertising company Clear Channel will run a digital exhibition of MeeTwo artwork in UK shopping malls throughout the UK.
The challenges of altruism and technology
It wasn’t easy to set up because altruism and tech don’t go together. Tech requires a huge amount of financial investment, but altruism is something that has traditionally been funded through the charity model. We struggled initially with what kind of business model to have. We thought about setting up as a charity but in the end, we decided that our ultimate goal was to be sustainable so we became a social enterprise. In terms of funding, our biggest challenge has been how to measure the benefit of prevention. It’s hard to measure an outcome that hasn’t yet happened, but case studies of our data show that MeeTwo users feel more supported and seek professional help sooner. In the short term, this improves their quality of life, but in the long term, it optimises their life chances.
Research is very important to us and our data is providing unique insights into youth mental health. We are currently collaborating on research projects with the Anna Freud Centre at University College London, the Department of Data Informatics at Sussex University and the Centre for Population Health.
MeeTwo has won a number of important awards and has been endorsed by the NHS Apps Library, Digital Health.London (NHS), Teach First and The Child and Adolescent Mental Health Services. In 2017, 2018 and 2019, MeeTwo was recognised as one of the 100 most inspiring education innovations in the world by HundrED. The MeeTwo app will represent British social enterprise at the next world fair EXPO2020.
We expect to double our user numbers in the next few months. We’re looking to expand first into Australia, this is because if we can have a team of moderators over there who can cover the night shift, we can offer 24 hour moderation. We also feel that from a physiological perspective, the dynamic of having young people in the UK who at 2am are feeling completely miserable, interacting with Australians who are in broad daylight and in a very different frame of mind we believe that could be a very positive dynamic. After Australia we’ll reach out to other English speaking territories.
The rewards of working on a project that helps so many young people is indescribable. The momentum we get from our young users just drives us to be more, do more and make the app better. We’re mesmerized by how great it is to have created something that really helps.