A comparison of Indigenous and non-Indigenous users of MindSpot: an Australian digital mental health service

Titov, Nickolai; Schofield, Carlie; Staples, Lauren; Dear, Blake F; Nielssen, Olav

doi:10.1177/1039856218789784

Cited by 43Digital Mental Health InterventionsMental Health Treatment and AccessIndigenous Health, Education, and Rights

A comparison of Indigenous and non-Indigenous users of MindSpot: an Australian digital mental health service

Titov, Nickolai, Schofield, Carlie, Staples, Lauren, Dear, Blake F, Nielssen, Olav·2019·Australasian Psychiatry

DOI 10.1177/1039856218789784

Open this paper in CoChat — free account

Abstract

Objective: To report on Aboriginal and Torres Strait Islander (Indigenous) users of MindSpot, a national service for the remote assessment and treatment of anxiety and depression. Methods: The characteristics and treatment outcomes of Indigenous patients who registered with MindSpot between January 2015 and December 2016, were compared with non-Indigenous users. Changes in psychological distress, depression and anxiety were measured using the Kessler 10-Item (K-10), Patient Health Questionnaire 9-Item (PHQ-9), and Generalised Anxiety Disorder Scale 7-Item (GAD-7), respectively. Results: Of 23,235 people who completed a MindSpot assessment between 1 January 2015 and 31 December 2016, 780 (3.4%) identified as Indigenous Australian. They had higher symptom scores, were more likely to live in a remote location, and a third reported no previous contact with mental health services. Fewer Indigenous patients enrolled in a treatment course, but those who did had similar rates of completion and similar reductions in symptoms to non-Indigenous patients. Conclusions: MindSpot treatments were effective in treating anxiety and depression in Indigenous Australians, and outcomes were similar to those of non-Indigenous patients. Services like MindSpot are a treatment option that can help overcome barriers to mental health care for Indigenous Australians.

Integrity signals

Registry

Crossref · 10.1177/1039856218789784

Cites

10 of 10 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

dMH interventions have potential to overcome access issues and address the unique and significant mental health needs of First Nations people in rural and remote areas.
“There is increasing recognition of the potential for digital mental health (dMH) interventions to overcome access issues and address the unique and significant mental health needs of First Nations people in rural and remote areas [6].”
From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [6]

Advantages and limitations of Internet-based interventions for common mental disorders
Andersson, G., & Titov, N. (2014) · World Psychiatry · doi:10.1002/wps.20083 · Cited by 1,160 · see citing works
Self-citation
Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial
Tighe, J., Shand, F., Ridani, R., Mackinnon, A., De La Mata, N., & Christensen, H. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013518 · Cited by 227 · see citing works
The first 30 months of the MindSpot Clinic: Evaluation of a national e-mental health service against project objectives
Titov, N., Dear, B. F., Staples, L. G., Bennett-Levy, J., Klein, B., Rapee, R. M., Andersson, G., Purtell, C., Bezuidenhout, G., & Nielssen, O. B. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416671598 · Cited by 183 · see citing works
Self-citation
Suicide in Indigenous People in Queensland, Australia: Trends and Methods, 1994–2007
De Leo, D., Sveticic, J., & Milner, A. (2011) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048674.2011.570310 · Cited by 103 · see citing works
Depression in Aboriginal men in central Australia: adaptation of the Patient Health Questionnaire 9
Brown, A. D. H., Mentha, R., Rowley, K., Skinner, T. C., Davy, C. P., & O’Dea, K. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-271 · Cited by 100 · see citing works
Procedures for risk management and a review of crisis referrals from the MindSpot Clinic, a national service for the remote assessment and treatment of anxiety and depression
Nielssen, O., Dear, B. F., Staples, L. G., Dear, R., Ryan, K., Purtell, C., & Titov, N. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0676-6 · Cited by 52 · see citing works
Self-citation
Socioeconomic disparities in the mental health of Indigenous children in Western Australia
Shepherd, C., Li, J., Mitrou, F., & Zubrick, S. R. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-756 · Cited by 43 · see citing works
PTSD Among Aboriginal and Torres Strait Islander People in Custody in Australia: Prevalence and Correlates
Heffernan, E., Andersen, K., Davidson, F., & Kinner, S. A. (2015) · Journal of Traumatic Stress · doi:10.1002/jts.22051 · Cited by 38 · see citing works
Traumatic brain injury amongst indigenous people: a systematic review
Lakhani, A., Townsend, C., & Bishara, J. (2017) · Brain Injury · doi:10.1080/02699052.2017.1374468 · Cited by 37 · see citing works
Evaluation of a culturally adapted training course in Indigenous e-mental health
Dingwall, K. M., Puszka, S., Sweet, M., Mills, P. P. J. R., & Nagel, T. M. (2015) · Australasian Psychiatry · doi:10.1177/1039856215608282 · Cited by 29 · see citing works

Flagged first, then by citations

Sorted by citations

Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review
Spanhel, K., Balci, S., Feldhahn, F., Bengel, J., Baumeister, H., & Sander, L. B. (2021) · npj Digital Medicine · doi:10.1038/s41746-021-00498-1 · Cited by 178 · see citing works
From Research to Practice: Ten Lessons in Delivering Digital Mental Health Services
Titov, N., Hadjistavropoulos, H. D., Nielssen, O. B., Mohr, D. C., Andersson, G., & Dear, B. F. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8081239 · Cited by 117 · see citing works
Self-citation
User characteristics and outcomes from a national digital mental health service: an observational study of registrants of the Australian MindSpot Clinic
Titov, N., Dear, B. F., Nielssen, O., Wootton, B., Kayrouz, R., Karin, E., Genest, B., Bennett-Levy, J., Purtell, C., Bezuidenhout, G., et al. (2020) · The Lancet Digital Health · doi:10.1016/s2589-7500(20)30224-7 · Cited by 108 · see citing works
Self-citation
Factors associated with treatment uptake, completion, and subsequent symptom improvement in a national digital mental health service
Cross, S. P., Karin, E., Staples, L. G., Bisby, M. A., Ryan, K., Duke, G., Nielssen, O., Kayrouz, R., Fisher, A., Dear, B. F., et al. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100506 · Cited by 57 · see citing works
Self-citation
Digital Health Solutions for Indigenous Mental Well-Being
Hensel, J. M., Ellard, K., Koltek, M., Wilson, G., & Sareen, J. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1056-6 · Cited by 61 · see citing works
The use and impact of digital technologies for and on the mental health and wellbeing of Indigenous people: A systematic review of empirical studies
Li, J., & Brar, A. (2022) · Computers in Human Behavior · doi:10.1016/j.chb.2021.106988 · Cited by 42 · see citing works
Connection to... Addressing Digital Inequities in Supporting the Well-Being of Young Indigenous Australians in the Wake of COVID-19
Walker, R., Usher, K. J., Jackson, D. W., Reid, C. L., Hopkins, K. D., Shepherd, C., Smallwood, R., & Marriott, R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18042141 · Cited by 44 · see citing works
Determining Priorities in the Aboriginal and Islander Mental Health Initiative for Youth App Second Phase Participatory Design Project: Qualitative Study and Narrative Literature Review
Povey, J., Sweet, M., Nagel, T., Lowell, A., Shand, F., Vigona, J., & Dingwall, K. M. (2022) · JMIR Formative Research · doi:10.2196/28342 · Cited by 26 · see citing works
The Social Gradient in Mental Health and Well-Being for Indigenous Older Adults Living in Rural Areas: A Cross-Sectional Comparison With Rural Non-indigenous Population in Chile
Sánchez-Moreno, E., Gallardo-Peralta, L. P., & Leyton, C. (2020) · Journal of Aging and Health · doi:10.1177/0898264320979201 · Cited by 23 · see citing works
Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People
Dingwall, K. M., Povey, J., Sweet, M., Friel, J., Shand, F., Titov, N., Wormer, J., Mirza, T., & Nagel, T. (2023) · JMIR Human Factors · doi:10.2196/40111 · Cited by 21 · see citing works
“There is increasing recognition of the potential for digital mental health (dMH) interventions to overcome access issues and address the unique and significant mental health needs of First Nations people in rural and remote areas [6].”
Self-citation
A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O. B., Dear, B. F., & Titov, N. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02486-3 · Cited by 22 · see citing works
Self-citation
From Digital Mental Health to Digital Social and Emotional Wellbeing: How Indigenous Community-Based Participatory Research Influenced the Australian Government’s Digital Mental Health Agenda
Bennett-levy, J., Singer, J., Rotumah, D., Bernays, S., & Edwards, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189757 · Cited by 16 · see citing works
Systematic review of Indigenous involvement and content in mental health interventions and their effectiveness for Indigenous populations
Lee, R., Brown, H., Salih, S. M. A., & Benoit, A. C. (2022) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/00048674221089837 · Cited by 9 · see citing works
Expanding our understanding of digital mental health interventions for Indigenous youth: An updated systematic review
Hicks, L. J., Toombs, E., Lund, J. I., Kowatch, K. R., Hopkins, C., & Mushquash, C. J. (2024) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x241239715 · Cited by 15 · see citing works
Involvement of Indigenous young people in the design and evaluation of digital mental health interventions: a scoping review protocol
Povey, J., Raphiphatthana, B., Torok, M. H., Nagel, T. M., Shand, F., Sweet, M., Lowell, A., Mills, P. P. J. R., & Dingwall, K. M. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01685-7 · Cited by 12 · see citing works
Predictors of functional impairment at assessment and functional improvement after treatment at a national digital mental health service
Cross, S. P. M., Karin, E., Asrianti, L., Walker, J., Staples, L., Bisby, M. A., Nielssen, O. B., Kayrouz, R., Fisher, A. C., Dear, B. F., et al. (2023) · Internet Interventions · doi:10.1016/j.invent.2023.100603 · Cited by 12 · see citing works
Self-citation
Measuring Mental Health Service Accessibility for Indigenous Populations: a Systematic Review
Zhang, L., Hou, X., & Liu, Y. (2024) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-023-01899-6 · Cited by 10 · see citing works
Satisfaction, engagement, and outcomes in internet-delivered cognitive behaviour therapy adapted for people of diverse ethnocultural groups: an observational trial with benchmarking
Sapkota, R. P., Valli, E., Dear, B. F., Titov, N., & Hadjistavropoulos, H. D. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1270543 · Cited by 10 · see citing works
Self-citation
Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review
Skaczkowski, G., van der Kruk, S., Loxton, S., Hughes-Barton, D., Howell, C., Turnbull, D., Jensen, N., Smout, M., & Gunn, K. (2022) · JMIR Mental Health · doi:10.2196/31018 · Cited by 9 · see citing works
“A rapid review of the evidence for each of these programs’ evaluations is provided in Multimedia Appendix 4 [10,12,17,42-151].”
Background
Characteristics and Treatment Outcomes for Patients of a Digital Psychology Service in Regional and Remote Parts of Australia
Staples, L., Dear, B. F., Nielssen, O. B., & Titov, N. (2025) · Australian Journal of Rural Health · doi:10.1111/ajr.70032 · Cited by 7 · see citing works
Self-citation
Antidepressant medication use by patients accessing a national digital mental health service
Staples, L., Asrianti, L., Karin, E., Kayrouz, R., Cross, S. P. M., Bisby, M. A., Fisher, A. C., Dear, B. F., Titov, N., & Nielssen, O. B. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.042 · Cited by 6 · see citing works
Self-citation
Effectiveness of internet delivered cognitive behaviour therapy provided as routine care for people in the depressed phase of bipolar disorder treated with Lithium
Nielssen, O. B., Staples, L., Karin, E., Kayrouz, R., Dear, B. F., & Titov, N. (2023) · PLOS Digital Health · doi:10.1371/journal.pdig.0000194 · Cited by 5 · see citing works
Self-citation
Development and Pilot Testing of an Internet-Based Version of the Unified Protocol That Targets Positive Affect Regulation: A Treatment Development Report
Eustis, E. H., Nauphal, M., Jaso, B. A., Spencer-Laitt, D., Woodard, L. S., Farchione, T. J., & Barlow, D. H. (2024) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2024.07.003 · Cited by 5 · see citing works
Do people residing in low socioeconomic areas engage with and benefit from digital mental health services?
Staples, L., Dear, B. F., Nielssen, O. B., & Titov, N. (2025) · Internet Interventions · doi:10.1016/j.invent.2025.100865 · Cited by 4 · see citing works
Self-citation
Screening Aboriginal and Torres Strait Islander fathers’ mental health through a digital parenting programme
Hammond, C., Adams, M., So, J., StGeorge, J. M., & Fletcher, R. J. (2025) · Health Promotion International · doi:10.1093/heapro/daaf197 · Cited by 1 · see citing works
The Effectiveness, Facilitators, and Barriers of Digital Mental Health Services for First Nations People in Australia: Systematic Scoping Review
Zhai, S., Goodman, A. G., Smith, A. C., Diminic, S., & Zhou, X.-Y. (2025) · Interactive Journal of Medical Research · doi:10.2196/80386 · Cited by 2 · see citing works
The Weathering Well App, A New Low Intensity Digital Mental Health Intervention for Australian Farmers: Formative ResearchPreprint
Raphiphatthana, B., Sweet, M., Dingwall, K. M., MacDonald, A., & Nagel, T. M. (2021) · Research Square · doi:10.21203/rs.3.rs-269174/v1
Efficacy of Internet Delivered Cognitive Behaviour Therapy for Anxiety and Depression in People with Bipolar DisorderPreprint
Nielssen, O. B., Staples, L., Karin, E., Kayrouz, R., Dear, B. F., & Titov, N. (2020) · Research Square · doi:10.21203/rs.3.rs-80609/v1
Self-citation
Charting the course: a scoping review on telehealth research trends in Australia
Leslie, A., Majmudar, A., Semaan, I., Spajic, D., Mountain, O., Stretton, B., Kovoor, J. G., Gupta, A. K., & Bacchi, S. (2024) · Internal Medicine Journal · doi:10.1111/imj.16601
Effectiveness, facilitators and barriers of digital mental health services for First Nations Peoples in Australia: A systematic reviewPreprint
Zhai, S., Goodman, A., Smith, A. C., Diminic, S., & Zhou, X. (2025) · medRxiv · doi:10.1101/2025.04.27.25326251
From Challenges to Change: Reflections on Integrated Care and Australian Rural Mental Health
Dalton, H. E., & Perkins, D. A. (2025) · Springer eBooks · doi:10.1007/978-3-031-25376-8_110-1
Effectiveness, facilitators and barriers of digital mental health services for First Nations Peoples in Australia: A systematic review (Preprint)Preprint
Zhai, S., Goodman, A., Smith, A. C., Diminic, S., & Zhou, X. (2025) · doi:10.2196/preprints.80386
Cautious Interest: Stakeholder Perspectives on the Value of a Digital Mental Health Clinic in Aotearoa
Ritchie, C. (2025) · doi:10.26686/wgtn.29936771
From Challenges to Change: Reflections on Integrated Care and Australian Rural Mental Health
Dalton, H. E., & Perkins, D. A. (2025) · Springer eBooks · doi:10.1007/978-3-031-96286-8_110
Additional file 5 of A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O., Dear, B. F., & Titov, N. (2020) · Figshare · doi:10.6084/m9.figshare.11972712
Self-citation
Additional file 2 of A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O., Dear, B. F., & Titov, N. (2020) · Figshare · doi:10.6084/m9.figshare.11972697
Self-citation
Additional file 4 of A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O., Dear, B. F., & Titov, N. (2020) · Figshare · doi:10.6084/m9.figshare.11972709
Self-citation
Additional file 1 of A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O., Dear, B. F., & Titov, N. (2020) · Figshare · doi:10.6084/m9.figshare.11972691
Self-citation
Additional file 6 of A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O., Dear, B. F., & Titov, N. (2020) · Figshare · doi:10.6084/m9.figshare.11972721
Self-citation
Additional file 3 of A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O., Dear, B. F., & Titov, N. (2020) · Figshare · doi:10.6084/m9.figshare.11972700
Self-citation
Effectiveness of three key Australian digital mental health services (Preprint)Preprint
Bassilios, B., Scurrah, K. J., Roberts, L. J., Ftanou, M., & Spittal, M. J. (2025) · doi:10.2196/preprints.90121
Extending the Reach of Interventions to Treat Mental Disorders
Kazdin, A. E. (2026) · Psychiatry International · doi:10.3390/psychiatryint7020078
Australian Digital Mental Health Services for Anxiety and Depression: Meta-Analysis and Comparison Study
Bassilios, B., Scurrah, K. J., Morgan, A. J., Roberts, L. J., Ftanou, M., & Spittal, M. J. (2026) · JMIR Formative Research · doi:10.2196/90121

The first 30 months of the MindSpot Clinic: Evaluation of a national e-mental health service against project objectives
Titov, N., Dear, B. F., Staples, L. G., Bennett-Levy, J., Klein, B., Rapee, R. M., Andersson, G., Purtell, C., Bezuidenhout, G., & Nielssen, O. B. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416671598 · Cited by 183 · see citing works
Self-citation
User characteristics and outcomes from a national digital mental health service: an observational study of registrants of the Australian MindSpot Clinic
Titov, N., Dear, B. F., Nielssen, O., Wootton, B., Kayrouz, R., Karin, E., Genest, B., Bennett-Levy, J., Purtell, C., Bezuidenhout, G., et al. (2020) · The Lancet Digital Health · doi:10.1016/s2589-7500(20)30224-7 · Cited by 108 · see citing works
Self-citation
Characteristics and Treatment Outcomes for Patients of a Digital Psychology Service in Regional and Remote Parts of Australia
Staples, L., Dear, B. F., Nielssen, O. B., & Titov, N. (2025) · Australian Journal of Rural Health · doi:10.1111/ajr.70032 · Cited by 7 · see citing works
Self-citation
A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service
Kayrouz, R., Karin, E., Staples, L., Nielssen, O. B., Dear, B. F., & Titov, N. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02486-3 · Cited by 22 · see citing works
Self-citation
MindSpot: a valuable service that raises questions
Battersby, M., Baigent, M. F., & Redpath, P. (2020) · The Lancet Digital Health · doi:10.1016/s2589-7500(20)30248-x · Cited by 4 · see citing works

Authors: Titov, N., Schofield, C., Staples, L., Dear, B. F., & Nielssen, O.
Affiliations: Macquarie University (AU)
Aboriginal Mental Health Consultant, Illawarra Aboriginal Medical Service, Wollongong, NSW, Australia
National Health and Medical Research Council (AU)
Corresponding author: Nielssen, Olav
ORCID: Titov, Nickolai
Staples, Lauren
Dear, Blake F
Nielssen, Olav
Venue: Australasian Psychiatry
Publisher: SAGE Publications
Published: 2018-07-30
Volume: 27
Issue: 4
Pages: 352-357
ISSN: 1039-8562 (ISSN-L)
1440-1665
DOI: 10.1177/1039856218789784
OpenAlex: W2887903306
Cited by: 43
References: 10
Citations by year: 2026: 2 · 2025: 10 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 10 · 2019: 2
FWCI: 6.00
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
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Social Sciences › Health › Indigenous Health, Education, and Rights
Keywords: Aboriginal and Torres Strait Islander peoples, Indigenous Australians, digital mental health services, anxiety, depression, psychological distress, remote mental health care, barriers to mental health care, treatment outcomes, Indigenous mental health
MeSH terms: Adult, Anxiety, Australia, Depression, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Middle Aged, Outcome and Process Assessment, Health Care, Patient Acceptance of Health Care, Telemedicine, Native Hawaiian or Other Pacific Islander, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

A comparison of Indigenous and non-Indigenous users of MindSpot: an Australian digital mental health service

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks