Help at hand to use digital mental health

There is a need to do better when it comes

to ready access to mental health support, argues Dr Jan Orman from the Black Dog Institute.

Contrary to expectations, we have not had a digital mental health revolution.

Yes, we have developed any number of useful digital tools, some of them with a good body of evidence to support their efficacy, but we are still struggling to have them accepted by patients and practitioners alike, and we continue to struggle to work out how to use them in our practices.

Australia has led the way in the development of evidence-based digital resources and treatment programs. We live and work in a vast country, often with huge distances between patients and their professional care.

GPs in both metropolitan and rural and remote areas (if there are GPs there at all) struggle to find mental health support for their patients. And, as is happening everywhere else in the world, the need for mental health care is rising as the prevalence of psychological distress and mental illness rises in the community post-pandemic.

Telehealth boon

These days, thanks to the pandemic, we have telepsychology and telepsychiatry, and it’s been a great step forward. But these services remain expensive, often with long wait times and, while many with mental health issues benefit from them, not everybody needs or can afford the intensity of treatment they provide.

The rising rates of psychological distress tell us that there is something missing.

Do we need another layer of professional support in our communities? A big injection of well-trained mental health nurses, for example, who can live and work in communities providing skilled care and support. Or do we need GPs with better training in mental health and a better understanding of how to use the available resources?

Since 2001, when MoodGYM burst onto the scene with a promise of a revolutionary way of helping people build their psychological resilience, the way we think about digital resources has changed. Therapy programs, once considered to be stand-alone self-help programs with excellent results in research trials for people suffering mild to moderate anxiety and depression, have been difficult to sell (even for free) in the real world.

Initial engagement and continuing adherence have been major problems. Recent research has shown that most people need a person involved to kick start their use of these programs and to coach them through to the point where they are benefiting from the content.

We are now moving away from “online self-help” to a model of “blended care” where online resources are incorporated into face-to-face care.

There’s plenty of room for GPs to be involved in their patient’s use of digital mental health resources. If we can find an efficient way to incorporate digital resources into our care of people in distress, maybe we can be helpful to them without burning ourselves out. We just need to do a little bit of work to acquaint ourselves with what’s available and how to use it.

The trouble for most GPs is that getting acquainted with the use of digital mental health resources requires time and effort – initially about what is available in the way of evidence-based digital therapy, then to think about which of their patients would benefit from these programs. Most GPs find that it is time well spent in terms of efficiency, confidence and patient outcomes.

Aiming to raise health practitioner awareness and knowledge of digital mental health, the Australian Government in 2013 funded the eMHPrac (e-Mental Health in Practice) initiative. As part of this project, Black Dog Institute provides training and resources to support health professionals in the use of digital mental health.

The institute has recently launched a new free Health Professional Resource & Education Hub – a custom-built platform providing health professionals with access to evidence-based digital resources, including training modules, webinars, podcasts and e-Mental Health in Practice content.

There is also a highly engaged online Community of Practice in which practitioners can connect with peers and share their knowledge and experience of working in mental health care.

There to use

It is imperative to make use of all the resources available if we are going to meet demand and provide high quality information for both patients and practitioners. Online portals can direct you to resources appropriate for a range of ages, disorder and cultures. You can refer to the Guide to Digital Mental Health Resources available at https://www.emhprac.org.au/ resource/a-guide-to-digital-mentalhealth-resources/ for information. These resources make a reliable and valuable addition to the practitioner toolbox.

ED: The Black Dog Institute Health Professional Resource and Education Hub is available for free for AHPRAregistered health professionals. Visit blackdog.org.au/cop to register