Impact of a Web-Based Psychiatric Assessment on the Mental Health and Well-Being of Individuals Presenting With Depressive Symptoms: Longitudinal Observational Study

Abstract

Background Web-based assessments of mental health concerns hold great potential for earlier, more cost-effective, and more accurate diagnoses of psychiatric conditions than that achieved with traditional interview-based methods. Objective The aim of this study was to assess the impact of a comprehensive web-based mental health assessment on the mental health and well-being of over 2000 individuals presenting with symptoms of depression. Methods Individuals presenting with depressive symptoms completed a web-based assessment that screened for mood and other psychiatric conditions. After completing the assessment, the study participants received a report containing their assessment results along with personalized psychoeducation. After 6 and 12 months, participants were asked to rate the usefulness of the web-based assessment on different mental health–related outcomes and to self-report on their recent help-seeking behavior, diagnoses, medication, and lifestyle changes. In addition, general mental well-being was assessed at baseline and both follow-ups using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Results Data from all participants who completed either the 6-month or the 12-month follow-up (N=2064) were analyzed. The majority of study participants rated the study as useful for their subjective mental well-being. This included talking more openly (1314/1939, 67.77%) and understanding one’s mental health problems better (1083/1939, 55.85%). Although most participants (1477/1939, 76.17%) found their assessment results useful, only a small proportion (302/2064, 14.63%) subsequently discussed them with a mental health professional, leading to only a small number of study participants receiving a new diagnosis (110/2064, 5.33%). Among those who were reviewed, new mood disorder diagnoses were predicted by the digital algorithm with high sensitivity (above 70%), and nearly half of the participants with new diagnoses also had a corresponding change in medication. Furthermore, participants’ subjective well-being significantly improved over 12 months (baseline WEMWBS score: mean 35.24, SD 8.11; 12-month WEMWBS score: mean 41.19, SD 10.59). Significant positive predictors of follow-up subjective well-being included talking more openly, exercising more, and having been reviewed by a psychiatrist. Conclusions Our results suggest that completing a web-based mental health assessment and receiving personalized psychoeducation are associated with subjective mental health improvements, facilitated by increased self-awareness and subsequent use of self-help interventions. Integrating web-based mental health assessments within primary and/or secondary care services could benefit patients further and expedite earlier diagnosis and effective treatment. International Registered Report Identifier (IRRID) RR2-10.2196/18453

Learnings from user feedback of a novel digital mental health assessment

“…Feedback indicates that the majority of participants who completed the digital mental health assessment considered it to be worthwhile, with over a third categorizing it as very worthwhile. This finding corroborates previous evidence demonstrating that users find engaging with DMHI to be helpful ( 81 , 82 ). It also supports research that found, via varied measures, high satisfaction is reported by individuals using mental health apps.…”

“…In terms of positive wellbeing outcomes, the major dimension was related to the receipt of a results report encouraging help-seeking, or facilitating more health conscious behavior to improve their mental health. This finding reflects insights from previous reports demonstrating that engaging in online screening tools increases one’s likelihood in seeking mental healthcare or support ( 82 , 100 – 102 ). Additionally, some users stated that they considered their results report to be of interest or of non-specified usefulness.…”

mHealth Solutions for Mental Health Screening and Diagnosis: A Review of App User Perspectives Using Sentiment and Thematic Analysis

“…A commonly reported facet of the performance theme was a self-reported increase in the user's understanding of or responsibility for their mental health following completion of the mental health assessment. This finding builds on previous reports demonstrating how mhealth tools designed for mental health can be employed in order to empower individuals to self-manage their mental health ( 28 – 30 , 74 ) or encourage a user to seek help from a healthcare professional ( 38 ). In addition to increasing the user's understanding and/or responsibility for their mental health, another facet of the performance theme was the quality of the diagnostic and/or screening assessment and the accuracy as perceived by the user.…”

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“…A commonly reported facet of the performance theme was a self-reported increase in the user's understanding of or responsibility for their mental health following completion of the mental health assessment. This finding builds on previous reports demonstrating how mhealth tools designed for mental health can be employed in order to empower individuals to selfmanage their mental health (28)(29)(30)74) or encourage a user to seek help from a healthcare professional (38). In addition to increasing the user's understanding and/or responsibility for their mental health, another facet of the performance theme was the quality of the diagnostic and/or screening assessment and the accuracy as perceived by the user.…”