Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 3, 2021
Date Accepted: Jul 27, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mental Health Screening in General Practices as a Means for Enhancing Uptake of Digital Mental Health Interventions: An Observational Cohort Study
ABSTRACT
Background:
Digital mental health interventions will play a critical role in managing the mental health impacts of the COVID-19 pandemic. Thus, enhancing their uptake is a key priority. General Practitioners (GPs) are well-positioned to facilitate access to digital interventions, but tools that assist GPs in identifying suitable patients are lacking.
Objective:
This study evaluated the effectiveness of a web-based mental health screening and treatment-recommendation tool (‘StepCare’) for improving the detection of anxiety and depression in general practice, and subsequently, uptake of digital mental health interventions.
Methods:
StepCare screens patients for symptoms of depression (PHQ-9) and anxiety (GAD-7) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for mild-to-moderate symptoms. Patients (n=5,138) from 85 general practices across Australia were invited to take part in screening.
Results:
Depression and/or anxiety was detected in 43.1% of patients screened (one quarter were previously undiagnosed/untreated). The majority (89.5%) of previously undiagnosed/untreated patients had mild-to-moderate symptoms and were candidates for digital mental health interventions. Although less than half were prescribed a digital intervention by their GP, when a digital intervention was prescribed, over two thirds of patients used it.
Conclusions:
Implementing mental health screening in general practices can increase patient access to digital mental health interventions. Although GPs prescribed digital interventions less frequently than in-person psychotherapy or medication, the promising rates of uptake by GP-referred patients suggests that GPs can play a critical role in championing digital interventions and maximising the associated benefits.
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