JMIR Publications

ABSTRACT

Background:

Globally, there are fundamental shortcomings in mental health care systems, including restricted access, siloed services, interventions that are poorly matched to service users’ needs, underutilisation of personal outcome monitoring to track progress, exclusion of family and carers, and suboptimal experiences of care. Health information technologies (HITs) hold great potential to improve these aspects that underpin enhanced quality of mental health care.

Objective:

Project Synergy aimed to co-design, implement, and evaluate novel HITs, as exemplified by the InnoWell Platform, to work with standard health care organisations. The goals were to deliver improved outcomes for specific populations under focus and support organisations to enact significant system-level reforms.

Methods:

Participating health care organisations included: Open Arms – Veterans & Families Counselling (in Sydney and Lismore, New South Wales (NSW)); NSW North Coast headspace centres for youth (Port Macquarie, Coffs Harbour, Grafton, Lismore, Tweed Heads); The Butterfly Foundation’s National Helpline for eating disorders; Kildare Road Medical Centre for enhanced primary-care, and Connect to Wellbeing North Coast NSW (administered by Neami National) for population-based intake and assessment. Service users, families and carers, health professionals and administrators of services across Australia were actively engaged in configuration of the InnoWell Platform to meet service needs, identify barriers to and facilitators of quality mental health care, and highlight potentially the best points in the service pathway to integrate the InnoWell Platform. The locally configured InnoWell Platform was then implemented within the respective services. A mixed methods approach, including surveys, semi-structured interviews, and workshops, was used to evaluate the impact of the InnoWell Platform. A participatory systems modelling approach involving co-design with local stakeholders was also undertaken to simulate the likely impact of the platform in combination with other services being considered for implementation within the North Coast Primary Health Network to explore resulting impacts on mental health outcomes, including suicide prevention.

Results:

Despite overwhelming support for integrating digital health solutions into mental health service settings, and promising impacts of the platform simulated under idealised implementation conditions, our results emphasized that successful implementation is dependent on health professional and service readiness for change, leadership at the local service level, the appropriateness and responsiveness of the technology for the target end users, and, critically, funding models being available to support implementation. The key places of interoperability of digital solutions and a willingness to use technology to coordinate health care system use were also highlighted.

Conclusions:

Whilst the COVID-19 pandemic has resulted in widespread acceptance of very basic digital health solutions, Project Synergy highlights the critical need to support equity of access to HITs, provide funding for digital infrastructure and digital mental health care, and, to promote actively the use of technology-enabled, coordinated systems of care.