A Comparison of Self-Referral and Referral via Primary Care Providers, through Two Similar Digital Mental Health Services in Western Australia

Abstract

Digital mental health services (DMHSs) deliver mental health information, assessment, and treatment, via the internet, telephone, or other digital channels. The current study compares two DMHSs operating in Western Australia (WA)—The Practitioner Online Referral System (PORTS) and MindSpot. Both provide telephone and online psychological services at no cost to patients or referrers. However, PORTS is accessed by patients via referral from health practitioners, and is designed to reach those who are financially, geographically, or otherwise disadvantaged. In contrast, MindSpot services are available to all Australian residents and patients can self-refer. This observational study compares characteristics and treatment outcomes for patients of PORTS and MindSpot in WA. Eligible patients were people who resided in WA and registered with either clinic from January 2019 to December 2020. Results showed that PORTS patients were more likely to be older, male, and unemployed. They were less likely to report a tertiary education and were more likely to live in areas with higher levels of socioeconomic disadvantage. Despite these differences, treatment outcomes were excellent for patients from both clinics. Results provide further evidence for the accessibility, acceptability, and effectiveness of DMHSs regardless of referral pathway or patient characteristics.

Effectiveness of internet delivered cognitive behaviour therapy provided as routine care for people in the depressed phase of bipolar disorder treated with Lithium

“…Additional confounders included the potential effect of socioeconomic status on outcome, [ 48 ] as the BD group had a higher level of education, and remote location on the likelihood of being prescribed Lithium, because of the reduced availability of psychiatrists and the monitoring required for that treatment. However, iCBT has the potential to overcome inequalities in the provision of evidence based psychological care, as demonstrated by the good results from a related service for disadvantaged patients, which included more male subjects [ 49 ]. A further limitation is the probability that there were many patients in the total clinic sample with BD who were receiving treatment with other forms of mood stabilising medication, or no medication at all.…”

Prevalence and Predictors of Long COVID in Patients Accessing a National Digital Mental Health Service

“…The MindSpot Clinic routinely collects sociodemographic and clinical data to ensure that services are effective, acceptable, and relevant to patients [ 14 , 15 ]. This means that MindSpot is in the unique position of having access to large volumes of quantitative data from patients located in all the states and territories of Australia.…”

Circumstances of suicide after registration with a national digital mental health service: an analysis of coroners’ reports

“… 4 , 7 , 8 Most clinic patients self-refer, with only a minority referred by clinicians who have seen the patients in person. In contrast, other Australian DMHS either only take referrals from general practitioners and other clinicians 9 , 10 or encourage referrers to use the DMHS alongside face-to-face treatment. 11 It had been assumed that the treatment programmes offered by DMHS would be suited to people with mild to moderate symptoms, but three-quarters of MindSpot's patients report clinically significant symptoms of depression, often in the severe range, more than one-quarter report suicidal thoughts, nearly 4% report a current suicide plan 4 and around 0.5% are referred for urgent face-to-face care.…”