General News — 27 January 2015

white-workspace_385-19322673ELEANOR HALL: Health specialists are raising questions about why Australia is a world leader in developing online mental health services but a laggard in using them. They say e-mental health programs, which are delivered through phones and computers, are cheap and effective, but that very few Australians use them. The Federal Government is now looking at reforms to mental health services.  The Black Dog Institute’s Professor Helen Christensen is a pioneer in the e-mental health field and she spoke to Lexi Metherell.

HELEN CHRISTENSEN: They have great advantage in terms of the cost. So if you imagine a DVD or something, it costs a lot to produce a DVD but once you actually punch them out to the community they cost very little per person, per DVD. So e-mental health services are the same, they have a scalability. So once you have a number of people using them they’re far less expensive that face to face services.

LEXI METHERELL: And at what stage in the onset of mental illness can e-health be used? I mean, can someone who presents with serious psychosis for example, can they be treated with an e-health system?

HELEN CHRISTENSEN: So they can be used in psychosis but they can be used just to increase your well being as well. So it goes everywhere from promoting positive mental health all the way through to treatment and recovery. To give you an example, people who have a small number of symptoms who would never meet diagnostic criteria could easily benefit from some of the automated e-health psychological techniques that are available, and somebody with psychosis, while not being cured at all of their psychosis by an e-mental health intervention, can learn to manage their condition better.

LEXI METHERELL: At the moment, what’s the situation in terms of e-mental health services? Is it just up to people to find them themselves?

HELEN CHRISTENSEN: We have a problem really in that there’s probably, we estimate around about 600,000 people in Australia would find e-mental health services useful, they might have mild to moderate levels of anxiety and depression, but our estimates around about 30,000 of people actually use them. So at the moment you can get a referral through your GP but it doesn’t tend to happen that frequently, so most people go online themselves and start looking for anything that’s going to help people manage how they’re feeling and kind of stumble over them.

LEXI METHERELL: Isn’t there a risk in terms of safety if a GP, say, does say refer a patient with depression to an e-mental health service that then you’re sort of letting this person go out on their own and they could be at risk of harming themselves or deteriorating further?

HELEN CHRISTENSEN: Well, there’s two issues there. First of all, there’s no evidence that these e-mental health systems lead to increased rates of harming, but on the other hand, it’s exactly right. We need to integrate these services directly into face to face care and that’s where there’ll be the cost savings and also the protection factors around people’s mental health.

LEXI METHERELL: And the Government is now considering its response to the review of the national mental health system, which was aimed at looking at more efficient and effective ways of funding mental health and providing mental health services. Could money be saved if e-mental health services were made more widely available?

HELEN CHRISTENSEN: Yes, I mean if you consider that these e-mental health services are as effective and 3.5 times less expensive per person, you can begin to see the cost savings that would follow. I think the sector, which consists of mostly organisations who provide this, would also like to see leadership in how we can all work together. We have lots of ideas about how to do that but at the moment Australia is a country where a lot of innovation stops once you’ve actually had the initial proof of concept and we don’t actually go the next step and we’d really like to see that happen now for e-mental health services.

ELEANOR HALL: That’s Professor Helen Christensen from the Black Dog Institute, speaking to Lexi Metherell.

This transcript first appeared The World Today ABC, 21 January 2015.


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