Australian psychologists experiences with digital mental health: a qualitative investigation

“The rapid uptake of digital mental health (also termed e-mental health ) in the past two decades has transformed the landscape of service delivery by helping to overcome issues relating to accessibility, time constraints, stigma and cost (Carolan et al., 2017; Richards & Richardson, 2012).”

“More than 200 randomised control trials (RCTs) have been published on digital CBT programs, and most have indicated that iCBT is as clinically effective a treat-ment as conventional face-to-face treatment (Andersson & Titov, 2014).”

“In line with previous research (Cerga-Pashoja et al., 2020; Erbe et al., 2017), most participants perceived digital mental health as a method to increase accessibility, provide clients with flexibility and choice, extend therapeutic benefits and increase the effectiveness of treatment.”

“…of digitally mental health services with demonstrated efficacy for many types of mental health conditions and personal contexts (Baus & Bouchard, 2014; Hilvert-Bruce et al., 2012; Orman & O’Dea, 2018; Park et al., 2019; Tait et al., 2019; Titov et al., 2016; Werner-Seidler et al., 2019).”

“As client acceptability has been demonstrated as integral for use and adherence to digital mental health (Lal & Adair, 2014), the current findings extend this sentiment to clinicians and their role in implementing or introducing digital mental health into their practice.”

“Several studies have applied behavioural change and innovation adoption theories to the implementation of digital mental health (Feijt et al., 2018; Hennemann, 2017; Lovejoy, 2009).”

“Similar sentiment has been reported in previous qualitative and quantitative research as well (Erbe et al., 2017; Kemmeren et al., 2019; Topooco et al., 2017).”

“…a proliferation of digitally mental health services with demonstrated efficacy for many types of mental health conditions and personal contexts (Baus & Bouchard, 2014; Hilvert-Bruce et al., 2012; Orman & O’Dea, 2018; Park et al., 2019; Tait et al., 2019; Titov et al., 2016; Werner-Seidler et…”

“…increased pressure on an already lagging infrastructure and skill base of digital solutions in mental health care, whilst these experiences were beyond the remit of the current study aims, it is important to reflect on how these may have flavoured the interviews conducted (Balcombe & De Leo, 2021).”

“…of digitally mental health services with demonstrated efficacy for many types of mental health conditions and personal contexts (Baus & Bouchard, 2014; Hilvert-Bruce et al., 2012; Orman & O’Dea, 2018; Park et al., 2019; Tait et al., 2019; Titov et al., 2016; Werner-Seidler et al., 2019).”

“…of digitally mental health services with demonstrated efficacy for many types of mental health conditions and personal contexts (Baus & Bouchard, 2014; Hilvert-Bruce et al., 2012; Orman & O’Dea, 2018; Park et al., 2019; Tait et al., 2019; Titov et al., 2016; Werner-Seidler et al., 2019).”

“However, blended modalities have been less-frequently researched compared to purely digital mental health interventions (Titzler et al., 2018).”

“…using digital mental health products; our insights into the perspectives of those without prior experience were limited; thus, support for digital mental health may reflect the well-established relationship between prior experience and acceptability of digital mental health (Gun et al., 2011).”

“Several studies have applied behavioural change and innovation adoption theories to the implementation of digital mental health (Feijt et al., 2018; Hennemann, 2017; Lovejoy, 2009).”

“This has been made especially salient during the COVID-19 pandemic where access to traditional healthcare was impeded (Molfenter et al., 2021; Ojha & Syed, 2020).”

“The delivery of digital mental health within routine practice is dependent on practitioners’ attitudes and engagement with these resources (LaMonica et al., 2019; Sinclair et al., 2013).”

“However, content derived from other types of therapy, such as interpersonal therapy, psychodynamic therapy, structured writing techniques and eyemovement desensitisation, has also proven effective for many types of mental health concerns (Donker et al., 2013; Johansson et al., 2013; Lange et al., 2003; Reynolds et al.…”

“…of digitally mental health services with demonstrated efficacy for many types of mental health conditions and personal contexts (Baus & Bouchard, 2014; Hilvert-Bruce et al., 2012; Orman & O’Dea, 2018; Park et al., 2019; Tait et al., 2019; Titov et al., 2016; Werner-Seidler et al., 2019).”

“Digital mental health is defined as internet-based and/or digital technologies (e.g. smartphone applications) that are used to provide therapeutic content directly to consumers, with or without involvement from a trained mental health practitioner (Batterham et al., 2015).”

“Critically, growing demand for mental health services in Australia—and worldwide—is impossible to meet without leveraging digital technology (Aboujaoude et al., 2020).”

“Several studies have applied behavioural change and innovation adoption theories to the implementation of digital mental health (Feijt et al., 2018; Hennemann, 2017; Lovejoy, 2009).”

“The rapid uptake of digital mental health (also termed e-mental health ) in the past two decades has transformed the landscape of service delivery by helping to overcome issues relating to accessibility, time constraints, stigma and cost (Carolan et al., 2017; Richards & Richardson, 2012).”

“However, content derived from other types of therapy, such as interpersonal therapy, psychodynamic therapy, structured writing techniques and eyemovement desensitisation, has also proven effective for many types of mental health concerns (Donker et al., 2013; Johansson et al., 2013; Lange et al., 2003; Reynolds et al.…”

“…of digitally mental health services with demonstrated efficacy for many types of mental health conditions and personal contexts (Baus & Bouchard, 2014; Hilvert-Bruce et al., 2012; Orman & O’Dea, 2018; Park et al., 2019; Tait et al., 2019; Titov et al., 2016; Werner-Seidler et al., 2019).”

“The delivery of digital mental health within routine practice is dependent on practitioners’ attitudes and engagement with these resources (LaMonica et al., 2019; Sinclair et al., 2013).”

“Similar sentiment has been reported in previous qualitative and quantitative research as well (Erbe et al., 2017; Kemmeren et al., 2019; Topooco et al., 2017).”

“Despite the mostly positive attitudes held by participants in our sample, practitioner resistance remains a barrier to uptake (Batterham et al., 2015; Clough et al., 2019; Knott et al., 2020; LaMonica et al., 2019).”

“This has been made especially salient during the COVID-19 pandemic where access to traditional healthcare was impeded (Molfenter et al., 2021; Ojha & Syed, 2020).”

“However, little is known about how allied health professionals are using digital mental health resources within Australian practices (Bagarić & Jokić‐Begić, 2020; Cerga-Pashoja et al., 2020; Dijksman et al., 2017; Reynolds et al., 2015).”

“Another study interviewing 11 European psychologists found that when compared to traditional face-to-face delivery, blended treatment fostered increased client engagement and added flexibility and choice to the therapy process (Cerga-Pashoja et al., 2020).”

“However, there remain several barriers to digital mental health services reaching its full capability (Aboujaoude, 2018; Orman & O’Dea, 2018).”

“Current government policy recommends digital mental health as a first step in treatment for subthreshold and mild presentations of common mood disorders (Department of Health and Aged Care, 2021; Gunn et al., 2018).”

“Despite the mostly positive attitudes held by participants in our sample, practitioner resistance remains a barrier to uptake (Batterham et al., 2015; Clough et al., 2019; Knott et al., 2020; LaMonica et al., 2019).”

“However, there remain several barriers to digital mental health services reaching its full capability (Aboujaoude, 2018; Orman & O’Dea, 2018).”

“These findings are consistent with a larger study that demonstrated that 81% of healthcare professionals had not heard of the Head to Health platform (Sturk et al., 2019).”

“…been criticised for their inability to offer ongoing monitoring of client progress and alternative sources of support if a prescribed digital mental health intervention is not meeting the client’s needs (Rosenberg et al., 2020), blended models of delivery may be able to address these criticisms.”

“The perceived impersonal nature of tele-mental health, privacy concerns, and poor audio quality and internet connectivity are concerns for young people, adults, and clinicians delivering tele-mental health services alike [16, 17, 19, 22–25].”

“Prior research also supports our finding that mental health professionals preferred DMHIs to be free or low-cost for clients [26,60].”

“This lack of personalization negatively affects user engagement [11,25] and is a barrier for mental health professionals using these programs in practice [39].”

“Thirdly, digital mental health solutions offer a variety of options in the treatment space [10].”