eMHPrac is funded by the Australian Government Integrating Online Resources into Mental Health Care in General Practice Dr Jan Orman MBBS MPsych Med BDI GP Services Consultant Black Dog Institute

eMHPrac is funded by the Australian Government

Do you need more help with mental health?  How common are mental health problems in your practice?  How many of your patients with mental health problems are adequately treated?

eMHPrac is funded by the Australian Government The stats: In 2014  >12% of general practice consultations are mental health consultations  Only 70% of people in Australia with mental health problems receive the professional treatment they need (compared with 47%in 2010 and 34% in 2007)

eMHPrac is funded by the Australian Government Conclusion:  Things are improving BUT  They are still not good enough.

eMHPrac is funded by the Australian Government eMH can help By:  Providing Free and accessible treatment  Overcoming stigma in treatment settings  Educating the community  Filling the gaps in services

eMHPrac is funded by the Australian Government Using the Internet in Mental Health Care  Websites for psychoeducation and support  Portals to guide us to online resources  Online treatment programs  All evidence based and Australian made

eMHPrac is funded by the Australian Government Websites There are a lot of unhealthy and counterproductive things in cyberspace.

eMHPrac is funded by the Australian Government Websites Beware!  There are toxic things out there in cyberspace.

eMHPrac is funded by the Australian Government

Recommending websites:  Make specific recommendations  Look at them yourself Australian sites of value: Rich sources of information and support

eMHPrac is funded by the Australian Government Portals These are interactive websites that provide guidance to online resources that can be trusted  Free access  Free of charge

eMHPrac is funded by the Australian Government

Online Therapy  Modular CBT (plus positive psychology, ACT, mindfulness)  Many studies and a good evidence base to support its use in mild to moderate common mental health problems esp anxiety and depression. As good as face to face therapy in a number of studies (see  Mostly free of charge, mostly open access (no referral required)  Range from interactive self-help to virtual clinic with therapist contact

eMHPrac is funded by the Australian Government This Way Up – Summary of Evidence Efficacy  GAD: 2 RCTs; iCBT is better than waitlist  Panic: RCT; iCBT is better than waitlist  PTSD: RCT; iCBT is better than waitlist  OCD: RCT; iCBT is better than waitlist  Trans-diagnostic anxiety and depression: 4RCTs; iCBT is better than waitlist  Depression: RCT; iCBT is better than waitlist. (Repetitive negative thinking declines, Distress tolerance improves with iCBT Suicidal thoughts halve with iCBT) (NB iCBT=internet based CBT/eMH)

eMHPrac is funded by the Australian Government 2 reasons not to leave it to your patients to find their own online therapy:  Some of it has no evidence base  There is evidence that patients will be more compliant and the therapy will have a better outcome if you are involved

eMHPrac is funded by the Australian Government Programs to consider:  MyCompass (Black Dog) – smart phone  MOODGym, eCouch, Blue board (ANU)  This Way Up (St Vincent’s & CRUfAD) - $ & R  On Track (Queensland University of Technology) – special programs  Anxiety online (Swinburne University) – therapist guidance $  Mindspot (Macquarie University) – therapist guidance, transdiagnostic programs

eMHPrac is funded by the Australian Government

When will eMH treatment programs be useful?: For people with mild to moderate depression anxiety and stress when  They are unwilling to seek face to face therapy – embarrassment, stigma, privacy  They are unable to access face to face therapy – money, distance, time, unavailability of suitable mhprofessioanls  There are long waits to access face to face therapy  They have complex problems and face to face therapy requires augmentation

eMHPrac is funded by the Australian Government Top Five tips for Successfully Using eMH in your Practice  Don’t make eMH an afterthought  Recommend specific programs  Demonstrate how to access the programs  Provide written details about access to programs – Healthshare handouts, s, SMS, referrals  Make clear arrangements for follow up

eMHPrac is funded by the Australian Government