JMIR Publications

ABSTRACT

Background:

Mental Health Online, MindSpot and THIS WAY UP are three Australian government funded digital mental health services (DMHSs). These services are free for consumers and deliver a range of (depression and anxiety disorder) psychological assessments and interventions using the internet, with or without clinician support. This study examines the uptake and effectiveness of these services.

Objective:

This study examines the uptake and effectiveness of these services.

Methods:

We used three data sources to examine the performance of the three DMHSs: (1) aggregated routinely collected service data to describe uptake of the three services; (2) peer-reviewed and grey literature reporting treatment outcomes; and (3) treatment outcome data from one evaluation conducted by Mental Health Online. The second and third data sources were used to analyse the effectiveness of the three DMHSs compared to other mental health treatment programs (Australian primary, public, and low intensity mental health care; UK stepped psychological care). We generated pooled mental health symptom (Cohen’s D) effect sizes for each service’s clinician-supported and self-directed treatments and compared those with effect sizes we calculated for the alternative treatment programs.

Results:

The three DMHSs provide treatment (among other service offerings) to significant numbers of consumers and therefore contribute to improving overall access to mental health care in Australia. Clinician-supported online treatment significantly improved the mental health of consumers who use these services (Mental Health Online, d=0.95; MindSpot, d=1.42; and THIS WAY UP, D=1.04) and self-directed treatment by Mental Health Online produced a moderate reduction (D=0.59) in anxiety disorder severity ratings. Clinician-supported treatments produced improvements in mental health symptoms that are close, or equivalent, to most (face-to-face, phone, and stepped- or symptom severity matched- mental health care) comparison treatments examined.

Conclusions:

Mental Health Online, MindSpot and THIS WAY UP are producing clinically significant improvement for consumers experiencing psychological distress and anxiety and depression symptoms. The magnitude of improvement produced, especially via clinician-supported treatment, is comparable with more resource-intensive face-to-face treatment options. DMHSs are not intended to serve those with more severe anxiety and depression symptoms who may be better served through other components of the mental health system (e.g., the larger-scale Better Access program, state-funded public mental health services and the not-for-profit sector).