Online Mental Health Resources in Rural Australia: Clinician Perceptions of Acceptability

Abstract

BackgroundOnline mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients.ObjectiveTo understand rural clinicians’ attitudes towards the acceptability of online mental health resources as a treatment option in the rural context.MethodsIn-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method.ResultsClinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources.ConclusionsSuccessful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing services, and provide opportunities for renegotiating the socially defined role of the clinician in the eHealth era.

Review of key telepsychiatry outcomes

“…Provider satisfaction: Based on 11 studies that use qualitative self-report methods, providers tend to have mixed reactions to telepsychiatry [25,33,34,[44][45][46][47][48][49][50][51][52] . Some studies have shown that adult and child psychiatrists reported adequate to high satisfaction with telepsychiatry [53] and one study demonstrated that mental health providers prefer telepsychiatry over telephone-based consultation [51] .…”

“…Finally, some investigators have documented negative reactions to telepsychiatry as providers are resistant to use telepsychiatry [55] and concern that perceived technological challenges associated with telepsychiatry may hinder doctor-patient interactions [56] . Qualitative interviews yield similarly mixed results as some allied health providers report satisfaction with telepsychiatry services [44] , while others [45,46] express concerns about the potential adverse impacts of telepsychiatry on the therapeutic alliance and cited barriers …”

Current Views and Perspectives on E-Mental Health: An Exploratory Survey Study for Understanding Public Attitudes Toward Internet-Based Psychotherapy in Germany

“…In addition, stigmatized beliefs about mental illnesses have been identified as global problem for both help-seeking persons as well as for the diffusion of mental health services [4-6]. With respect to limited capacities of health care, the dissemination of Internet-delivered psychological services is suggested as an efficient strategy to improve the access to professional help by overcoming structural or regional barriers [2,3,7,8] and the stigma of seeking help for mental health problems [9,10]. Internet-delivered computerized, electronic mental health (e-mental health) services include the usage of modern digital technologies and new media in, for instance, monitoring, screening, psychoeducation, prevention, health promotion, self-help, counseling, aftercare, and psychotherapy [11].…”

Perceived Drivers and Barriers to the Adoption of eMental Health by Psychologists: The Construction of the Levels of Adoption of eMental Health Model (Preprint)

“…In addition, some studies emphasize the importance of contextual factors of daily clinical practice, such as the level of knowledge and training, available time and resources, perceived social norms, forces within the current care system, and the design and usability of the technological tools [14,16,[19][20][21][22][23][24][25].…”

“…[14,20,22]), whereas other studies took a more exploratory approach (e.g. [21,23,24,33,34]. However, this research has mainly resulted in lists of factors that impact the adoption of online treatment without structuring their relative weights or considering the influence of individual differences in practitioners' willingness and experience to explore and use online therapeutic tools.…”