Mental Health Screening in General Practices as a Means for Enhancing Uptake of Digital Mental Health Interventions: Observational Cohort Study.

anxiety depression digital mental health general practice screening

Journal

Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882

Informations de publication

Date de publication:
16 09 2021
Historique:
received: 03 03 2021
accepted: 27 07 2021
revised: 07 07 2021
entrez: 16 9 2021
pubmed: 17 9 2021
medline: 30 9 2021
Statut: epublish

Résumé

Digital mental health interventions stand to play a critical role in managing the mental health impact 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. This study aims to evaluate the suitability of a web-based mental health screening and treatment recommendation tool (StepCare) for improving the identification of anxiety and depression in general practice and, subsequently, uptake of digital mental health interventions. StepCare screens patients for symptoms of depression (9-item Patient Health Questionnaire) and anxiety (7-item Generalized Anxiety Disorder scale) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for patients with mild to moderate symptoms. Patients (N=5138) from 85 general practices across Australia were invited to participate in screening. Screening identified depressive or anxious symptoms in 43.09% (1428/3314) of patients (one-quarter were previously unidentified or untreated). The majority (300/335, 89.6%) of previously unidentified or 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, more than two-thirds of patients reported using it. Implementing web-based mental health screening in general practices can provide important opportunities for GPs to improve the identification of symptoms of mental illness and 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 suggest that GPs can play a critical role in championing digital interventions and maximizing the associated benefits.

Sections du résumé

BACKGROUND
Digital mental health interventions stand to play a critical role in managing the mental health impact 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 aims to evaluate the suitability of a web-based mental health screening and treatment recommendation tool (StepCare) for improving the identification of anxiety and depression in general practice and, subsequently, uptake of digital mental health interventions.
METHODS
StepCare screens patients for symptoms of depression (9-item Patient Health Questionnaire) and anxiety (7-item Generalized Anxiety Disorder scale) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for patients with mild to moderate symptoms. Patients (N=5138) from 85 general practices across Australia were invited to participate in screening.
RESULTS
Screening identified depressive or anxious symptoms in 43.09% (1428/3314) of patients (one-quarter were previously unidentified or untreated). The majority (300/335, 89.6%) of previously unidentified or 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, more than two-thirds of patients reported using it.
CONCLUSIONS
Implementing web-based mental health screening in general practices can provide important opportunities for GPs to improve the identification of symptoms of mental illness and 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 suggest that GPs can play a critical role in championing digital interventions and maximizing the associated benefits.

Identifiants

pubmed: 34528896
pii: v23i9e28369
doi: 10.2196/28369
pmc: PMC8485187
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e28369

Informations de copyright

©Alexis E Whitton, Rebecca Hardy, Kate Cope, Chilin Gieng, Leanne Gow, Andrew MacKinnon, Nyree Gale, Kathleen O'Moore, Josephine Anderson, Judith Proudfoot, Nicole Cockayne, Bridianne O'Dea, Helen Christensen, Jill Maree Newby. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.09.2021.

Références

BMJ. 1998 Aug 1;317(7154):307-12
pubmed: 9685274
Aust N Z J Psychiatry. 2014 Jun;48(6):571-8
pubmed: 24413807
Aust J Gen Pract. 2018 May;47(5):289-296
pubmed: 29779298
Br J Psychiatry. 2018 May;212(5):279-286
pubmed: 29587888
Br J Psychiatry. 2017 Feb;210(2):119-124
pubmed: 27908899
Diabetes Res Clin Pract. 2018 Jan;135:120-127
pubmed: 29155122
Prim Care Companion J Clin Psychiatry. 2009;11(6):339-43
pubmed: 20098526
J Med Internet Res. 2011 Jun 15;13(2):e39
pubmed: 21676694
J Med Internet Res. 2017 Sep 15;19(9):e306
pubmed: 28916506
J Affect Disord. 2015 May 1;176:9-17
pubmed: 25682378
Ann Intern Med. 2007 Mar 6;146(5):317-25
pubmed: 17339617
Soc Psychiatry Psychiatr Epidemiol. 2019 Feb;54(2):255-276
pubmed: 29947863
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
Lancet Psychiatry. 2021 Mar;8(3):202-214
pubmed: 33571453
Aust N Z J Psychiatry. 2017 Dec;51(12):1227-1239
pubmed: 27733709
BMC Psychiatry. 2017 Jun 13;17(1):218
pubmed: 28610561
Arch Intern Med. 1998 Sep 14;158(16):1789-95
pubmed: 9738608
Med J Aust. 2008 Jun 16;188(S12):S119-25
pubmed: 18558911
Psychiatr Serv. 2017 Jul 1;68(7):660-666
pubmed: 28196461
JAMA Psychiatry. 2017 Apr 1;74(4):351-359
pubmed: 28241179
Br J Gen Pract. 2019 Mar;69(680):e164-e170
pubmed: 30559111
BMC Psychiatry. 2013 Nov 18;13:312
pubmed: 24237617
Aust Health Rev. 2020 Dec;44(6):873-879
pubmed: 31662177
Lancet Psychiatry. 2020 Jun;7(6):547-560
pubmed: 32304649
BMC Psychiatry. 2016 Dec 5;16(1):432
pubmed: 27919234
BMC Fam Pract. 2019 Feb 14;20(1):28
pubmed: 30764778
Psychiatr Serv. 2015 Oct;66(10):1043-50
pubmed: 26130001
Cogn Behav Ther. 2018 Jan;47(1):1-18
pubmed: 29215315
Br J Gen Pract. 2021 Jan 28;71(703):e85-e94
pubmed: 33431380
Ann Gen Psychiatry. 2020 Sep 15;19:52
pubmed: 32944058
Psychother Psychosom. 2020;89(3):174-184
pubmed: 32069463

Auteurs

Alexis E Whitton (AE)

Black Dog Institute, Randwick, Australia.
University of New South Wales, Randwick, Australia.

Rebecca Hardy (R)

Black Dog Institute, Randwick, Australia.

Kate Cope (K)

Black Dog Institute, Randwick, Australia.

Chilin Gieng (C)

Black Dog Institute, Randwick, Australia.

Leanne Gow (L)

Black Dog Institute, Randwick, Australia.

Andrew MacKinnon (A)

Black Dog Institute, Randwick, Australia.

Nyree Gale (N)

Black Dog Institute, Randwick, Australia.

Kathleen O'Moore (K)

Black Dog Institute, Randwick, Australia.

Josephine Anderson (J)

Black Dog Institute, Randwick, Australia.
University of New South Wales, Randwick, Australia.

Judith Proudfoot (J)

Black Dog Institute, Randwick, Australia.
University of New South Wales, Randwick, Australia.

Nicole Cockayne (N)

Black Dog Institute, Randwick, Australia.

Bridianne O'Dea (B)

Black Dog Institute, Randwick, Australia.
University of New South Wales, Randwick, Australia.

Helen Christensen (H)

Black Dog Institute, Randwick, Australia.
University of New South Wales, Randwick, Australia.

Jill Maree Newby (JM)

Black Dog Institute, Randwick, Australia.
University of New South Wales, Randwick, Australia.

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