Implementing e-mental health services for depression and anxiety

Implementing e-mental health services for depression and anxiety within the Australian mental health system

Authors: Carla Meurk; Janni Leung; Wayne Hall; Brian W Head; Harvey Whiteford

The University of Queensland

Growing evidence attests to the efficacy of e-mental health services. There is less evidence on how to facilitate the safe, effective, and sustainable implementation of these services. We conducted a systematic review on e-mental health service use for depressive and anxiety disorders to inform policy development and identify policy-relevant gaps in the evidence base.

We found that most studies reported on self-selected samples and samples of online help-seekers. Studies indicate that e-mental health services are predominantly used by females, and those who are more educated and socioeconomically advantaged. Ethnicity was infrequently reported on. Studies examining consumer preferences found a preference for face-to-face therapy over e-therapies, but not an aversion to e-therapy. Content relevant to governance was predominantly related to the organizational dimensions of e-mental health services, followed by implications for community education. Financing and payment for e-services and governance of the information communication technology were least commonly discussed. Details of our findings are published in the Journal of Medical Internet Research.

In conclusion, little research focuses explicitly on policy development and implementation planning; most research provides an e-services perspective. Research is needed to provide community and policy-maker perspectives. General population studies of prospective treatment seekers that include ethnicity and socioeconomic status and quantify relative preferences for all treatment modalities are necessary. Successfully establishing e-mental health care within the health system will depend on the skilful coordination of activities within clinical, community, research and development, and policy-making realms.

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