Using the Internet to enhance the treatment of depression

Robertson, Lucy; Smith, Michael; Castle, David; Tannenbaum, Dennis

doi:10.1080/j.1440-1665.2006.02315.x

Cited by 80Digital Mental Health InterventionsTelemedicine and Telehealth ImplementationMobile Health and mHealth Applications

Using the Internet to enhance the treatment of depression

Robertson, Lucy, Smith, Michael, Castle, David, Tannenbaum, Dennis·2006·Australasian Psychiatry

DOI 10.1080/j.1440-1665.2006.02315.x

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Abstract

Objective: Deficiencies in Australia's mental health systems persist despite over a decade of mental health reform. Recent developments in ehealth provide the opportunity to facilitate health reform and improve services. This paper presents preliminary findings from the implementation of a comprehensive e-health system, called RecoveryRoad, which was designed to augment the routine clinical treatment of depression. Methods: Depressed patients (n = 144) were referred to RecoveryRoad from a public hospital and public and private clinics in Perth, Western Australia. Online features included secure e-consultations, progress monitoring questionnaires, psychoeducation and evidence-based therapy. Treating clinicians had online access to patients’ progress monitoring outcomes and e-consultations. There were two types of adherence reminders: automated email reminders and personalized case management delivered by email and telephone. Results: Adherence to the system was high (from 53% to 84%, depending on the modality of reminder), and self-reported medication adherence was over 90%. Average depression severity declined from severe to mild by the eighth session, a large effect (d = 1.0). Both clinicians and patients were generally satisfied with the programme and reported that it improved clini-cian–patient relationships. Clinicians also reported that it helped patients to better manage depression. Conclusions: Preliminary findings support the feasibility of comprehensive e-health systems in enhancing the delivery of mental health care.

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Several research studies show the combination of DMHIs with psychotherapy sessions or health professional support may improve symptoms of depression, anxiety, panic disorder, comorbid depression and alcohol use, and hoarding disorder.
“In principle, blended care could work in Australia, as several research studies show the combination of DMHIs with psychotherapy sessions or health professional support may improve symptoms of depression [46-48], anxiety [48], panic disorder [4950], comorbid depression and alcohol use [51], and hoarding disorder [52].”
From Needs and Expectations for the myNewWay Blended Digital and Face-to-Face Psychotherapy Model of Care for Depression and Anxiety (Part 2): Participatory Design Study including Mental Health Professionals (2025) · cites this paper as [47]
Several of these studies have small sample sizes or no control group for the condition that includes a DMHI combined with psychotherapy or health professional support.
“However, several of these studies have small sample sizes [464852] or no control group for the condition that includes a DMHI combined with psychotherapy or health professional support [474950].”
From Needs and Expectations for the myNewWay Blended Digital and Face-to-Face Psychotherapy Model of Care for Depression and Anxiety (Part 2): Participatory Design Study including Mental Health Professionals (2025) · cites this paper as [47]
Adding online sessions or modules to regular face-to-face psychotherapy can increase adherence and effectiveness but also increases costs and workload among professionals.
“While recent studies have shown that adding online sessions or modules to regular face-to-face psychotherapy can increase the adherence and effectiveness of a patients’ treatment, it also increases costs and workload among professionals [17-19].”
From Blending online therapy into regular face-to-face therapy for depression: content, ratio and preconditions according to patients and therapists using a Delphi study (2014) · cites this paper as [19]
Other studies on the combination of online sessions and personal support only investigated support through e-mail or instant messaging.
“Other studies on the combination of online sessions and personal support only investigated support through e-mail, or instant messaging (e.g. [19,36-38]).”
From Blending online therapy into regular face-to-face therapy for depression: content, ratio and preconditions according to patients and therapists using a Delphi study (2014) · cites this paper as [19]
Australian research on blended care is limited; preliminary results indicate that blending digital and face-to-face therapy may improve symptoms of depression and anxiety.
“Australian research on blended care is limited; however, preliminary results align with studies in other countries [14,21,22,24] and indicate that blending digital and face-to-face therapy may improve symptoms of depression [49-51] and anxiety [51].”
From Needs and expectations for the myNewWay blended digital and face-to-face psychotherapy model of care for depression and anxiety (part 1): participatory design study including people with lived and living experience (2025) · cites this paper as [50]

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Authors: Robertson, L., Smith, M., Castle, D., & Tannenbaum, D.
Affiliations: Sentiens, West Perth, WA, Australia
The University of Melbourne (AU)
Corresponding author: Castle, David
ORCID: Smith, Michael
Castle, David
Venue: Australasian Psychiatry
Publisher: SAGE Publications
Published: 2006-12
Volume: 14
Issue: 4
Pages: 413-417
ISSN: 1039-8562 (ISSN-L)
1440-1665
DOI: 10.1080/j.1440-1665.2006.02315.x
OpenAlex: W2143647423
Cited by: 80
References: 24
Citations by year: 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2021: 6 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 7 · 2015: 1 · 2014: 5 · 2013: 8 · 2012: 4
FWCI: 6.43
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Australasian Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords: depression treatment, e-health, online therapy, e-consultation, medication adherence, progress monitoring, psychoeducation, provider satisfaction, patient satisfaction, clinician-patient relationship, mental health service delivery
MeSH terms: Depressive Disorder, Major, Major Depressive Disorder, Humans, Patient Compliance, Referral and Consultation, Time Factors, Treatment Outcome, Internet

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