People with disabilities helped design new youth mental health referral tool
Researchers in Greater Manchester have credited the central role of stakeholders with disabilities when testing the usability of a digital referral tool for child and adolescent mental health services (CAMHS).
A new digital tool for referring children and young people to NHS CAMHS was reshaped after testing by a group of stakeholders with lived experience of disability, according to a study published in Frontiers in Digital Health.
Researchers from GM.Digital, a partnership between Greater Manchester Mental Health NHS Foundation Trust (GMMH) and the University of Manchester, have been developing a new digital tool to improve the quality of referrals received by CAMHS. The project, known as EN-CAMHS2, is looking to enable young people, parents, carers and professionals to all contribute to the same referral form, and reduce confusion and distress in the referral process.
The team worked closely with stakeholders and focus groups to develop the tool, including a Pan-Disability Digital Accessibility Group (PDDAG) of 12 people, including individuals with chronic pain and fatigue, physical disabilities, neurodivergence and visual impairment, to test the new referral tool being developed as part of the NIHR-funded EN-CAMHS 2 project.
The group took part in two rounds of workshops testing how easy it was to use the tool, first trialling the tool and then reviewing the changes made in response to their feedback. As a direct result, the research team redesigned multiple aspects of the tool, including the multi-factor authentication process, alternative text for screen reader users, along with clearer wording, simplified consent screens, a progress bar and improved navigation throughout the form.
The study also tested how long the form took disabled and non-disabled stakeholders to complete, finding no difference in completion times between the two groups, challenging an assumption among some stakeholders that disabled users would need longer.
The researchers note that, due to recruitment constraints, the study was unable to include people whose first language is British Sign Language, and recommend that future digital health research embed accessibility expertise, including BSL users, from the earliest stages of design. The team worked with the Manchester Deaf Centre to produce a BSL explainer video for the tool in the meantime.
The authors of the Frontiers in Digital Health publication recommend that usability testing with disability advisory groups should become routine practice across digital mental health research, alongside compliance with the Web Content Accessibility Guidelines (WCAG) 2.2, which they describe as a minimum starting point rather than a sufficient standard on its own.
The full paper, “Inclusive design in digital mental health: stakeholders with disabilities must be central to usability testing,” by Tranter H, Giles N, Price T, et al., is published in Frontiers in Digital Health (2026), and is freely available open access. You can find out about the EN-CAMHS 2 project by visiting our study page or by visiting GM.Digital’s website here.
