Mental Health Screening in General Practices as a Means for Enhancing Uptake of Digital Mental Health Interventions: An Observational Cohort Study (Preprint)
BACKGROUND Digital mental health interventions will play a critical role in managing the mental health impacts of the COVID-19 pandemic. Thus, enhancing their uptake is a key priority. General Practitioners (GPs) are well-positioned to facilitate access to digital interventions, but tools that assist GPs in identifying suitable patients are lacking. OBJECTIVE This study evaluated the effectiveness of a web-based mental health screening and treatment-recommendation tool (‘StepCare’) for improving the detection of anxiety and depression in general practice, and subsequently, uptake of digital mental health interventions. METHODS StepCare screens patients for symptoms of depression (PHQ-9) and anxiety (GAD-7) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for mild-to-moderate symptoms. Patients (n=5,138) from 85 general practices across Australia were invited to take part in screening. RESULTS Depression and/or anxiety was detected in 43.1% of patients screened (one quarter were previously undiagnosed/untreated). The majority (89.5%) of previously undiagnosed/untreated patients had mild-to-moderate symptoms and were candidates for digital mental health interventions. Although less than half were prescribed a digital intervention by their GP, when a digital intervention was prescribed, over two thirds of patients used it. CONCLUSIONS Implementing mental health screening in general practices can increase patient access to digital mental health interventions. Although GPs prescribed digital interventions less frequently than in-person psychotherapy or medication, the promising rates of uptake by GP-referred patients suggests that GPs can play a critical role in championing digital interventions and maximising the associated benefits.