Online therapies are increasingly being used in Australia. In a recent article, two major providers of digital mental health services shared their experiences and learnings following a number of years of service provision. Digital Mental Health Services (DMHS) were provided to adults experiencing depression and/or anxiety through two initiatives: MindSpot, a service run through Macquarie University in New South Wales supported by funding from the Australian Government, and the Online Therapy Unit run through the University of Regina in Canada.
In both these settings services are provided free of charge by registered or provisional registered mental health professionals (including graduate students working under supervision). The authors of an article published in The Journal of Clinical Medicine share their insights in 10 lessons gained from the provision of digital mental health services to more than 130,000 people. The 10 lessons provided are organised into four levels of service provision which we have captured here and are expanded on in the published paper.
The 10 lessons
Working with consumers
Lesson 1: DMHS can improve access to care with many users not previously accessing mental health services.
Lesson 2: DMHS deliver more than treatment with the provision of information, assessment, triage and referral services all providing value.
Lesson 3: DMHS are used by a broad cross-section of the community and especially those who are less likely to use traditional services such as indigenous peoples, those from rural and remote communities and low-income earners.
Working with therapists
Lesson 4: DMHS require specialised therapist skills that are different from those associated with the provision of traditional mental health services including in communicating effectively as well as attending to the subtle nuances and dynamics.
Lesson 5:DMHS require specialised clinical processes that are highly planned and structured.
Operating digital mental health services
Lesson 6: DMHS require specialised systems and skills for robust governance and organisational operations and management.
Lesson 7: Digital mental health clinics evolve as part of growth but also frequent changes in research, technology and priorities.
Working with health systems, funders and policymakers
Lesson 8: Integrating DMHS within health systems is challenging due to the complexity of the health system, resistance to change and the demand for continual engagement.
Lesson 9: DMHS may change the mental health system through data-driven influence on policy and funding decisions.
Lesson 10: DMHS are not a panacea with traditional face-to-face services, as well as blended services, all playing their own important part in the provision of mental health services.
What of the future?
The number of people receiving DMHS is growing and this is likely to continue into the future. DMHS complement current models of assessment and treatment, and are increasingly being customised to address particular issues and to cater for specific population groups. With the provision of DMHS now largely accepted in the community and by the Government and other key stakeholders the field is growing and evolving. Maintaining high-quality services with rigorous governance structures and accountability will be important to ensure the provision of safe and effective services.
doi: 10.3390/jcm8081239