“it’s the small changes that enable people to do things differently” — dr. victoria betton, mhabitatBack
Jennifer Lee O'Brien
Dr. Victoria Betton, programme director of mHabitat, visited our office one day to tell us about tech and what it can do for health care practitioners, patients and citizens. She arrived in black and white creepers. At her side was Bibi, a black and brown cavapoo.
For the most part, Bibi was quiet. Victoria was not quiet, and dressed her compelling, versed opinions with an animated, affable energy. When we sat down to talk, she passed us Bibi’s lead, and all through our interview Bibi sat beside us, silent. We were impressed with her professionalism and tried to remember the last time we sat silent, consciously, for forty minutes.
Lately, we’ve been thinking a lot about digital, which is probably because everyone is talking a lot about digital and we all have been, haven’t we? For a long time, really? Like twenty years at least. But incredibly, no one’s bored of the conversation. We all just want more and more of it.
And by ‘we all’ we mean: executives in suits, executives in hoodies, students, art directors, baristas, bus drivers, philosophers, our parents. Whether it’s smartphones or smartbooks or smartcars or smartmoney it’s all tech, tech, tech and what would we do without Google, or Paypal or Uber? Strange words and good brands are so much our everyday and we want more and tech wants more because tech needs to know everything we’re doing, liking and watching so it can get better for us, and for the people making it.
Tech is the coolest, cleverest girl at the party and it wants to be up close and personal with you, as close as it can get. It wants a forever relationship where you can grow and change and get better together. It wants commitment, it wants love. And we all love it, right now.
Right now, we’re sharing dream space with a future we imagined as children under the influence of writers who imagined it as adults. Think about it. Driverless cars are happening; just check your safety features. Artificial intelligence is just an efficient, robotic workforce. Tech is the everyday.
In the everyday, tech reminds us what we ate six years ago; it projects our faces across the world to a family five hours in the future; it transmits Cher’s emoji-laden thoughts to our bedroom. For some of us, an iPhone alarm is our first foray into the day; the Ripple-toned reminder that we are here, existing and awake with the whole world, right there in the palm of our hands. It’s awesome, and alarming. But tech can do even more than that; it can improve our health. And that’s so important to the everyday that even Cher can’t compete.
When people talk about digital health in the United Kingdom, often they’re talking about Leeds. And whether they know it or not, they’re talking about Victoria.
“Leeds is a really good place for digital health,” says Victoria. “Outside of London, Leeds is where all the national health bodies, like NHS England and NHS Employment are based. We’ve got NHS Digital here; we’ve got a load of different health tech providers who are really vibrant in the SME community.
“Despite the potential and the affordances of digital technology to keep us in touch, being close by and having those conversations face-to-face counts for a lot,” she adds.
Victoria didn’t start out in tech. Back in 1998, she began an undergraduate degree in English Literature at the University of Leeds. She graduated, and did a Master’s in Women’s Studies in Bradford. After that, she did a Master’s in Social Work in York.
“And then I moved into the NHS doing corporate roles,” says Victoria.
In 2002, Victoria began a role as Deputy Director of Partnerships & Innovation as part of the NHS. A few years later, she founded the Arts and Minds network, an organisation that connects Leeds art royalty, like East Street Arts, West Yorkshire Playhouse and Opera North, with mental health services in the city.
“It was about brokering people who are accessing health services into the arts community, and the arts community thinking about health and care issues,” says Victoria. “Out of that we decided to have a little bit of a celebration, which turned into a festival.”
Along with members of the Arts and Minds network, Victoria launched the Love Arts Festival, that ran over seven weeks with fifty events in the city, from exhibitions to parties and talks.
In a guest blog post to Storying Sheffield, a community project from the University of Sheffield on storytelling, community, arts and wellbeing, Victoria wrote: “I was secretly sceptical about whether arts organisations would be up for connecting with a mental health and wellbeing festival. Would they think it a bit dry? A bit un-sexy? How wrong I was. We were genuinely stunned by the interest, support and enthusiasm from just about everyone we spoke to. And once we got speaking to people we couldn’t stop.”
Victoria tells us about the stigma around mental health and how common it is to experience a mental health problem. She’s excited by the creative, interesting ways people have been talking about mental health. “These conversations don’t need to be preachy,” she says. “They’re about people coming together and sharing and learning. Love Arts was a really nice, creative way to have those sorts of conversations.”
The first Love Arts Festival was in 2011, the same year Victoria began a PhD at the University of Leeds on social media and mental health. She was interested in the ways people spoke to each other online. Why was it so much easier for Twitter users and forum members to share stories and connect with strangers? She wanted to find out more.
“I got really interested in how in a day-to-day work environment, online social networks weren’t really discussed or part of the conversation,” says Victoria. “But then you go online, and there’s loads of groups of people supporting each other, having conversations about mental health, deliberating the politics of mental health online, and I just found that really fascinating.”
In March 2013, Victoria co-authored an eBook called Social Media in Mental Health Practice, a guide to all the fancy online networking tools that a lot of health and social care practitioners were already using at home, as discreetly as possible. Victoria wanted them to know that they weren’t just invited to the online party — they were on the guestlist as VIPs. Health care professionals were like the rockstars who showed up late to a sold-out festival where thousands of eager fans have been waiting in muddy hordes debating the music.
“Loads of practitioners are really quite enthusiastic about tech and they use it a lot in their personal lives, but when they bring it into their professional context it all completely disappears and they get worried about things like risk, getting into trouble and about doing the wrong thing,” says Victoria.
“The policies and procedures don’t enable them to use technology. We’re all about helping remove some of those constraints, putting in the enablers and then helping practitioners work out for themselves — along with their professional guidelines — about how they can use social networks and the internet in their day-to-day practice.”
Victoria noticed an even bigger problem, which was actually getting it to happen. For the most part, health organisations liked tech. They wanted to become pals, but didn’t know how. Tech companies had a thing for health organisations too, but try as they might, the conversations had while waiting in line at the coffee shop never seemed to last.
“There are loads of tech companies and digital innovators who want to do stuff in health but they don’t understand the complexity of health systems and how you get stuff embedded in day to day workflow of clinical practices,” says Victoria.
She decided to do something about it, so she founded a company called mHabitat.
“We found this gap that we could occupy where we could help tech companies collaborate with practitioners and academics and all sort of work together. We found this space in the middle where we can help collaborate and help good things happen, and solve real world problems rather than problems that people hope exist but don’t in practice or reality.”
In 2015, Victoria wrote an article about free public WiFi in hospital settings for the British Medical Journal. She went head-to-head with a GP, who argued against it.
For many of us, days tick along with the help of pals like Lord Messaging Service, Ms. Work Calendar, DJ Shared Documents and the very banter-less Mr. Mobile Banking. And, for the most part, we hang out with this strange group of comrades through invitation via our number one keeping-you-alive-at-4am-forever-friend: our smartphone. Which is wireless.
The difference between a good day and a bad one can be the number of tiny curved bars lighting up at the right-hand corner of our phones. We need WiFi, which is why it’s everywhere we need it to be.
Except in a lot of hospitals.
“I think the biggest concerns when we’re talking to people who are worried about accessing the internet, either as practitioners or as patients or citizens, are about privacy and data. And it’s important that we take these things seriously,” says Victoria.
“For many people, going into a hospital environment is a massive interruption to their day to day lives, and we know that boredom is associated with poorer outcomes and poorer experiences of services, and we also know that it’s very boring being in a hospital waiting around in a clinic.
“Having access to public wifi, where you can carry on with day-to-day things, keep in touch with family, check-in with your children if you’re going to be late, those are all small things that can make a difference to somebody’s experience.”
These small things are important; while there are always proto-Zuckerbergs or new-wave Musks working hard, coming up with grandiose plans that would take years to implement, Victoria is concerned with the changes that can happen right away, and change the everyday. She tells us it’s called frugal innovation: just doing the basics of what you need.
“It’s the small changes that enable people to do things differently. So I’m really interested in SMS and text messaging, because we know that well over 90% of the population have access to a smartphone. So if we want to avoid increasing inequality and make digital accessible to as many people as possible, let’s use the technology that’s most accessible.”
Victoria tells us about mHabitat’s recent make-tech-friendly project, run with Leeds and York Partnership NHS Foundation Trust for a dementia and older people’s mental health ward. They installed public WiFi and brought smart devices into the ward. Occupational therapists used iPads to do reminiscence work, nurses used them to help patients with online shopping.
“We had a family that was using a Facebook group and taking videos with their family member, so that everyone could keep in touch with their mum and see how she was doing,” says Victoria.
“I think there’s all sorts of fascinating stuff about virtual reality and artificial intelligence, but I’m just really interested in the basics and the simple stuff, if we want to reach as many people as possible. Quite often those are simple things we haven’t really got embedded within health and social care.
“There’s something about starting where people are at, while also imagining the future and thinking about that really wizzy, exciting stuff as well.”
Starting where people are at is also about starting at home. Use the internet wrong and you’ll meet the dark side of Dr. Google, who will drag your health question down the search engine drain and return it to you from its murky waters as a symptom-creature of monstrous proportions. But use it right, and you can find a whole community sharing stories about how to get better, and stay better.
A good example of this is Sue Sibbald, a service user consultant in Sheffield who set up a Twitter account in 2012 to start conversations around Borderline Personality Disorder. At 9pm every Sunday, Sue logs onto Twitter and chats with other Twitter users affected by the diagnosis, about everything from coping tools, to misinformation, building a support system to their favourite films.
“I guess what the internet affords us is the opportunity to receive information not just mediated by professionals but to connect together and support each other,” says Victoria. “It’s a big beast, the NHS, and it can be very confusing for people. I think the more we can encourage accountability, the more we can have conversations online between citizens, patients and practitioners.
“There are already some amazing health and care practitioners on Twitter, using it in really interesting and creative ways. I think it’s a way of opening up transparency and accountability, making public and professional conversations. I think it’s really, really healthy to have those sorts of debates in the public domain, I think it can only be good.”
Victoria leaves our office, Bibi at her side. Off to change the everyday, one meeting and conference at a time, for the people that need it the most.
Originally published in The City Talking: Leeds — issue 39