JMIR Publications

ABSTRACT

Background:

A large number of Australians will experience mental health challenges at some point in their lives. However, in many parts of Australia, the wait times to see General Practitioners (GPs) and mental health professional can be lengthy. With increasing internet use across Australia, online interventions may help increase access to timely mental health care. As a result, this is an area of increasing research interest and the number of publicly available online interventions is growing. However, it can be confusing for clinicians and consumers to know which resources are evidence-based and will best meet their needs.

Objective:

To determine the range of web-based mental health interventions that address depression, anxiety, suicidal ideation and/or general mental wellbeing and are freely available to Australian adults, along with their impact, acceptability, therapeutic approach, and key features.

Methods:

The PRISMA guidelines for scoping reviews (PRISMA-ScR) guided the review process. Keywords for the search were depression, anxiety, suicide, and wellbeing. The search was conducted using Google as well as key intervention databases Beacon, Head to Health and e-Mental Health in Practice. Interventions were deemed eligible if they targeted depression, anxiety, suicidal ideation and/or general mental wellbeing (e.g., resilience, stress) in adults, were web-based, written in English, interactive, free (i.e., at no cost to user) and publicly available. They also had to be guided by an evidence-based therapeutic approach.

Results:

Fifty-two eligible programs were identified. Of these, nine programs addressed depression, 15 anxiety, 13 general mental wellbeing and 13 addressed multiple issues. Only two programs addressed distress in the form of suicidal ideation. The most common therapeutic approach was Cognitive Behavior Therapy. Half the programs guided users through exercises in a set sequence and most programs enabled users to log on and complete the activities on their own, without professional support. Just over half of the programs had been evaluated for their effectiveness in reducing symptoms and six were being evaluated at the time of writing. Program evaluation scores ranged from 44% to 100%, with a total average score of 85%, indicating that the programs were generally of good quality.

Conclusions:

There are numerous online programs for depression, anxiety, suicidal ideation, and general wellbeing, freely and publicly available in Australia. However, gaps identified include a lack of available online interventions for culturally and linguistically diverse (CALD) populations, and programs that employ newer therapeutic approaches such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT). Despite most programs included in this review being of good quality, clinicians and consumers should pay careful attention when selecting which program to recommend and use, as variations in the levels of acceptability and impact of publicly available programs do exist. Clinical Trial: Open Science Framework, 2020, https://osf.io/rg9fj