Australians need quality digital treatments, not half-baked apps
Australia could lead the world in digital mental health if new platforms were paired with appropriate in-person clinical care, writes clinical psychologist Dr Peter Baldwin …
The rise of digital programs brought so much promise to the concept of mental health treatment. We were told it would revolutionise mental health care, making it faster, with more equitable access for consumers, and reaching more people at lower cost.
Today we have thousands of mental health smartphone applications (apps), numerous digital clinics, and dozens of government-funded mental health websites.
Yet, a recent Evaluation of Better Access report by the University of Melbourne shows waiting lines are longer than ever, co-payments are higher, and more than half of Australians who need care are having difficulty accessing it. If the digital revolution is here, why are more people not well?
The digital mental health market is stuck in a quality quagmire.
Of the more than 10 000 mental health apps on the market, only about 4% have any data behind them. A few self-help apps are effective on their own, but most people struggle to complete a full course of treatment using a mobile phone app.
Research shows that the best results occur when blending digital tools with human support — consumers get the immediacy and convenience of an app, with the expert care and human connection of a clinician. Sounds perfect, right?
In my experience, this type of care — called “blended care” — is easier to preach than to practise.
Different digital health systems do not share data between each other, let alone sharing data with digital health records. Even if a clinician were willing to adopt a blended approach and took the time to find the right tools, they would still end up with five or six digital platforms that they would have to manually input data into and pay for separately. Not exactly revolutionary.
A true digital mental health revolution will need more than a disjointed marketplace of apps and websites.
We will need integrated systems where clinicians can access science-based digital therapeutics, prescribe these with a click, and have artificial intelligence monitoring progress between sessions.
I envisage a system where patients, therapists, GPs and specialists can access the same data in the same place, placing everyone on the same page. Truly intelligent systems could even become part of a person’s mental health care plan.
Drawing on my years of digital mental health research at the Black Dog Institute, I believe this type of platform could revolutionise mental health care.
A person with anxiety could log on, be assessed, matched with a therapist, and access digital supports before their first appointment.
Therapy would then accelerate recovery, offering an expert guide through the higher intensity parts of treatment.
Round-the-clock access to digital guidance could be ongoing, preventing relapse. Real-time patient data could sharpen treatment planning. Perhaps most importantly, more efficient care will free practitioners to offer more consultations.
Based on current Australian Bureau of Statistics and Medicare data, if a clinical psychologist gave their patients with milder symptoms a 50/50 blend of therapy and digital support, rather than only using face-to-face therapy that practitioner would be able to see 16% more patients each month, at 18% less cost to the Medicare system, all without lowering clinical standards. And if we had 1000 clinicians move to this blended care model, Black Dog Institute modelling shows it would be able to save $28 million in Medicare costs per year.
This would free up clinician time to take on more severe and complex patients and save patients’ money out of pocket. From the clinician’s perspective, they would still be earning the same amount, just providing more care, to more patients, targeted to those who need it the most.
This need not be some imagined future. European countries, such as Germany, have piloted similar programs with encouraging results. We can do it here in Australia as well. We have the systems and technology to make it happen today. We also have the expertise — Australian researchers are global pioneers of digital mental health. Given more targeted investment, we could lead the world in translating this science to treatments that benefit all Australians.
Now that’s a digital mental health revolution I could get behind.
Health professionals wishing to access Black Dog resources can visit www.blackdog.org.au/cop
Dr Peter Baldwin is a clinical psychologist, Senior Research Fellow and Head of Clinical Research at Black Dog Institute.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
Subscribe to the free InSight+ weekly newsletter here. It is available to all readers, not just registered medical practitioners.
If you would like to submit an article for consideration, send a Word version to mjainsight-editor@ampco.com.au.
More from this week
Newsletters
Subscribe to the InSight+ newsletter
Immediate and free access to the latest articles
No spam, you can unsubscribe anytime you want.
By providing your information, you agree to our Access Terms and our Privacy Policy. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.