Feasibility of a video-delivered mental health course for primary care patients: a single-group prospective cohort study

Abstract

Background In many health care systems, primary care is tasked with offering psychological treatment for common mental disorders. Resources are often limited, which complicates widespread dissemination of traditional psychological treatments. Stepped care models where the less resource-intensive interventions are delivered first, can be employed, but often do not eliminate the need for a thorough diagnostic assessment, which can be time-consuming, has the potential to bottleneck patient intake, and can add to waiting times. Novel low-threshold formats are needed to improve access to mental health care in the primary care setting. Methods This was a single-group prospective cohort study (N = 91). We assessed the feasibility of a video-delivered course as a first-line intervention for patients seeking help for mental health problems at a primary care center. The course had a transdiagnostic approach, suitable for both depression and anxiety disorders, and was based on cognitive behavioral techniques. Patients in need of psychosocial assessment, which usually entailed a four- to six-week wait, were referred by physicians or triage nurses. Study participants could start within a week, without the need for conventional diagnostic assessment, and were informed that they would be offered assessment after the course if needed. Key feasibility outcomes included participant satisfaction, attendance rates, the proportion of participants in need of additional clinical intervention after the course, and the rate of clinically significant improvement in anxiety and depression symptoms. Results Participants scored a mean of 21.8 (SD = 4.0, 9–32, n = 86) on the Client Satisfaction Questionnaire-8; just below our target of 22. The mean attendance rate was 5.0/6 lectures (SD = 1.6, range: 0–6, n = 91). Forty-six percent (37/81) reported experiencing no need of further clinical intervention after the course. The rate of clinically significant improvement was 59% (27/46) for anxiety and 48% (22/46) for depression. No serious adverse event was reported. Conclusions Delivering a low-threshold online video-delivered mental health course in primary care appears to be feasible. Adjustments to further improve patient satisfaction are warranted, such as offering the choice of participating online or face-to-face. Trial Registration (ClinicalTrials.gov NCT04522713) August 21, 2020.

Internet-delivered transdiagnostic psychological treatments for individuals with depression, anxiety or both: a systematic review with meta-analysis of randomised controlled trials

“…In addition to beneficial effects for the patient, transdiagnostic treatments can also have organisational advantages, such as streamlined procedures and less time needed for diagnostic assessment. 14 In early meta-analysis, transdiagnostic psychological treatments have been found to have moderate pooled effects on depression and anxiety compared with mostly rudimentary treatment-as-usual and waitlist control groups. 15 Another method of improving access to psychological treatments can be to deliver these online-for example via websites, mobile apps or videoconferencing-which saves time and costs for both clinicians and patients.…”

“…That is, transdiagnostic treatments are characterised by focusing on components relevant for both depression and anxiety, in contrast to diagnosis-specific treatments targeting one specific mental health condition. In addition to beneficial effects for the patient, transdiagnostic treatments can also have organisational advantages, such as streamlined procedures and less time needed for diagnostic assessment 14. In early meta-analysis, transdiagnostic psychological treatments have been found to have moderate pooled effects on depression and anxiety compared with mostly rudimentary treatment-as-usual and waitlist control groups 15…”