General Practitioners’ Attitudes Toward a Web-Based Mental Health Service for Adolescents: Implications for Service Design and Delivery

Abstract

BackgroundAnxiety disorders and depression are prevalent among youth. General practitioners (GPs) are often the first point of professional contact for treating health problems in young people. A Web-based mental health service delivered in partnership with schools may facilitate increased access to psychological care among adolescents. However, for such a model to be implemented successfully, GPs’ views need to be measured.ObjectiveThis study aimed to examine the needs and attitudes of GPs toward a Web-based mental health service for adolescents, and to identify the factors that may affect the provision of this type of service and likelihood of integration. Findings will inform the content and overall service design.MethodsGPs were interviewed individually about the proposed Web-based service. Qualitative analysis of transcripts was performed using thematic coding. A short follow-up questionnaire was delivered to assess background characteristics, level of acceptability, and likelihood of integration of the Web-based mental health service.ResultsA total of 13 GPs participated in the interview and 11 completed a follow-up online questionnaire. Findings suggest strong support for the proposed Web-based mental health service. A wide range of factors were found to influence the likelihood of GPs integrating a Web-based service into their clinical practice. Coordinated collaboration with parents, students, school counselors, and other mental health care professionals were considered important by nearly all GPs. Confidence in Web-based care, noncompliance of adolescents and GPs, accessibility, privacy, and confidentiality were identified as potential barriers to adopting the proposed Web-based service.ConclusionsGPs were open to a proposed Web-based service for the monitoring and management of anxiety and depression in adolescents, provided that a collaborative approach to care is used, the feedback regarding the client is clear, and privacy and security provisions are assured.

Evaluating a Web-Based Mental Health Service for Secondary School Students in Australia: Protocol for a Cluster Randomized Controlled Trial

“…Both parents and school counsellors were concerned that students may not openly disclose their symptoms to a Web-based service [18]. Parents, counsellors, and GPs [19] were also concerned about teens’ adherence and engagement with self-directed Web-based CBT programs. This study will be able to determine these outcomes.…”

“…Codesigned with students, school counsellors [18], general practitioners [19], and parents [20], the Black Dog Institute has developed a Web-based mental health service called Smooth Sailing. On the basis of the principles of stepped care, Smooth Sailing uses a website to screen, assess, allocate, and deliver psychological interventions to improve help-seeking for mental health problems and reduce depressive and anxiety symptoms among secondary school youth.…”

Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.

“…Both screening services currently available for youth, Check Up GP and mobiletype, use an external website which require GPs to access and then review. This disruption to usual workflow can create barriers to the uptake and use (27)(28)(29)(30)(31). In addition, because GPs report lower levels of confidence treating youth patients and their complex presentations, the usefulness of screening services is likely to be enhanced when decisionmaking support is provided, as demonstrated in the mobiletype trial.…”

“…Using this familiar process reduces service complexity, assists with normalising routine review of patients' mental health as with any physical illness, and instils the sense that GPs "own" the service rather than researchers (23), which all help decrease the potential barriers to use and increase the likelihood of service engagement (28)(29)(30)(31)(36)(37)(38)(39)(40). On the other hand, practice staff reported a lower alignment with existing structures and processes rating, most likely reflecting that the tasks were added to their usual workflow and interactions with patients, namely, remembering to check youth eligibility, offer the mobile tablet, and explain the service to the patients and their parent.…”

Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.

“…As opposed to IMPARTS, which is embedded directly into the hospital software and patients' medical files, both Check Up GP and mobiletype sends the screener results to an external website which GPs are required to access and review. This complexity creates a potential barrier to use by disrupting their usual workflow (28,(34)(35)(36). Ultimately, screening solutions for youth mental health should enable detection of all symptom levels to provide prevention, early intervention, and treatment alongside decision-making support that is delivered within a setting that can offer immediate care.…”