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Choosing the Best Digital Mental Health Tools for Patients

Written by Clinical Psychologist Tania McMahon

Digital Mental Health tools and resources are becoming an increasingly important part of our mental health system. They provide effective, evidence-based intervention for patients with mild-to-moderate mental health symptoms, and they can be a fantastic option for patients who experience barriers to accessing face-to-face psychological care (e.g. finances, location, stigma).

However, with a huge selection of digital mental health tools available (e.g. there are an estimated 1400+ mental health apps on the app store), health practitioners face the challenging task of finding and selecting suitable tools for patients on platforms that lack regulation or reliable quality assurance (e.g. the star-rating system on the app store is easily exploited).

A major concern of many practitioners is the quality of the interventions provided by these digital services, as well as concerns about privacy and data security of highly sensitive information. To help address this, the Australian Commission on Safety and Quality in Health Care is undertaking a project to develop national safety and quality standards and a certification framework for digital mental health services. The goal of certification of services is to increase user confidence, increase usage and increase consumer choice in digital mental health services.

With this certification framework still a little while off, the onus is currently on health practitioners and users to individually assess the quality of digital mental health services. While this can feel like an overwhelming task, it doesn’t have to be! Here are a few helpful options, including questions you can ask and steps you can take to help make the right decision:

For Apps – use the Mobile App Rating Scale (MARS)

  • Researchers at QUT have developed and validated the world’s first known mental health app quality rating tool (the MARS), to provide a multidimensional measure of the quality of each app. The indicators include engagement, functionality, aesthetics, information quality, and app subjective quality.
  • More information about the MARS (including a free download of the tool) is available here.

For all other services (e.g. websites, online programs)

  • Is it user-friendly and engaging?
    • Is it easy to navigate and use? Is information easy to find?
    • Is it engaging and pleasant to use?
    • Is the information clearly communicated?
    • Will users want to access it enough to get the full benefit?
  • Is the content clinically safe?
    • There should be transparency about who owns the service and what the funding sources are (so that you can identify any conflicts of interest).
    • There should be transparency about how the content was developed and by whom (e.g. through university research or a government grant, and what the expertise of the content developers is). Services developed by government-funded bodies and institutions are likely to be the most reliable in terms of content and efficacy. Check out Head to Health for a searchable index of Australian, government-funded digital mental health services.
    • There should be some evidence as to the efficacy of the service - ideally a Randomised-Controlled Trial or other evaluative process. However, if not (as RCTs can be difficult to fund), digital adaptations of well-established efficacious treatment interventions (e.g. CBT) can generally be considered effective as long as the treatment is clearly communicated (i.e. something that claims to be online CBT clearly appears to be).
    • Are there any treatment elements that could cause harm?
    • There should be options for at-risk users to self-identify and seek further help (e.g. a ‘Get Help Now’ button that leads to Crisis Line information).
    • If there are health professionals involved in the delivery of the service (e.g. conducting telephone assessments, moderating online forums), do they have appropriate qualifications?
  • Does it protect privacy and is it secure?
    • Is the site secure?
    • There should be clear information about how personal data is used and protected.
    • The service should have a privacy policy stating that user information is not sold on to third parties.

To get started in your search for helpful digital mental health services, begin here:

  1. Check out the Australian government’s ‘Head to Health’ digital mental health gateway - https://headtohealth.gov.au.
  2. Search for some relevant services and try out one or two for yourself; evaluate them using the questions above (or the MARS, if it is an app).
  3. See if they would be suitable for your clients – if so, great! If not, head back to Head to Health and search for another.

 

 

Choosing the Best Digital Mental Health Tools for Patients2023-08-21T14:47:38+10:00

Using e-Mental Health to Help Our Clients

by Dr Tania McMahon

As part of the Australian Government’s recommended stepped care model of mental healthcare, ‘e-Mental Health’ services (low-intensity online mental health interventions and resources) are becoming a much more important part of our mental health system.

With 1 in 5 Australians experiencing mental health difficulties, low intensity interventions can provide an ideal option for individuals with mild-moderate mental health symptoms where other options (e.g. psychologist referral, medication) might not be suitable. However, e-Mental Health services need not be an either-or choice when compared with face-to-face treatment. In fact, e-Mental Health services can fill multiple roles in the space between an individual seeking help from their GP and accessing treatment with a Psychologist, from initial psychoeducation and increasing acceptability of face-to-face services for first-time help-seekers, to crisis support between appointments, to providing interim support and brief intervention for busy periods where they may be on a waitlist.

Below is a brief guide to the range of e-Mental Health services available (Table 1), as well as an outline of the various roles e-Mental Health can play, and which services are most appropriate.

All listed programs have been developed by credible sources, such as the Australian Government, universities, and national nongovernment organisations.

Table 1. e-Mental Health Service categoriesHere is an outline of some of the ways e-Mental Health can be used to help our clients:

 

Head to Health
(https://headtohealth.gov.au/)

Previously ‘mindhealthconnect’, this is the Australian Government’s portal to mental health information and e-Mental Health services. It enables consumers to search for information and receive advice about their mental health needs.

 
Telephone and Webchat Telephone and online chat services, most often free and used for crisis support, information-seeking, or brief counselling.
  • Lifeline
  • Kids Helpline
  • eHeadspace
  • Suicide Callback Service
  • Beyond Blue Support Service
Psychoeducation Websites Freely accessible websites providing mental health information, and often general tips and strategies for wellbeing.
Online programs Online self-guided courses that are either transdiagnostic (i.e. targeting common core mental health symptoms), or address a specific problem (e.g. Social Anxiety, PTSD). Some programs offer limited guidance from a therapist via phone or email. The majority of programs are free, with a few being low-cost.
Apps Easy and convenient to use (as they are mobile- or tablet-based). However, due to the number of apps available on the market and the relative ease in creating them (compared to the more comprehensive online programs), many do not have experimental validation. As such, it is important to thoroughly check the content and credentials of any app before referring to it.
  • BeyondNow Suicide Safety Planning app (developed by Beyondblue)
  • MoodPrism and MoodMission (developed by Monash University)
  •  AIMhi Stay Strong App (developed by Menzies School of Health Research for practitioners developing a mental health plan with ATSI clients)

 

1. As crisis support:

  • Telephone and webchat services are a great option for clients to contact if they need immediate support out of hours or between appointments with their healthcare professional.
  • Apps such as the BeyondNow Suicide Safety Planning app can help clients and their healthcare professional create a strong, structured plan for dealing with ongoing crises and distress.

2.     Psychoeducation for first-time or hesitant help-seekers:

  • Head to Health, the government’s mental health information portal, is a great place to direct clients to in the first instance.
  • Psychoeducation websites are fantastic tool for providing information about general stress and wellbeing, specific diagnoses (e.g. generalised anxiety, eating disorders), or specific problem areas (e.g. parenting, relationship issues, work stress) to first time help-seekers.
  • Online programs (particularly the transdiagnostic programs that don’t focus on a specific diagnosis, such as myCompass) are a great option for help-seekers who are hesitant or uncertain about face-to-face mental health intervention.

3.     Interim support:

  • If clients are on a waitlist or aren’t able to access timely support due to situational circumstances, online programs and apps can provide a great option to help them start working on their wellbeing in the meantime (which also means they can hit the ground running when they are able to commence face-to-face intervention).

4.     To complement face-to-face treatment:

  • Online programs and apps can help build on the skills being taught in therapy, such as CBT strategies, mindfulness and positive psychology. Whilst using these resources as a complementary tool can involve a little extra work on the part of the clinician (i.e. to be able to get to know the programs available and find ones that complement their work), it can really help to strengthen and reinforce the work done in session.
Using e-Mental Health to Help Our Clients2023-08-21T15:02:35+10:00

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