Management of patients who are using e-mental health

Last revised: 03 Sep 2018

While it is not a requirement that an e-mental health recommendation be documented in a GP Mental Health Treatment Plan, this can be a useful way to articulate the plan for the patient’s care. Such a document would include the plan for follow-up and alternative referral options in the event that e-mental health is not suitable or effective.

The General Practice Mental Health Standards Collaboration (GPMHSC) has developed a series of GP Mental Health Treatment Plan templates to support GPs in the management of patients with a mental health issue. These templates include prompts to consider e-mental health interventions and can be adapted to suit your needs and those of your patients and practice.

As with any individual who has a mental health issue, patients who have started an e-mental health treatment program should be followed up in a timely manner. Checking in with patients two weeks after recommending an e-mental health intervention, for example, allows you to determine whether they are engaged and responding to treatment. Decisions can then be made about patients’ ongoing management.54

Monitoring self-harm and suicidal ideation is crucial. If the patient appears to have an elevated risk at follow-up, take action in line with your existing practice protocols and revise the treatment plan.53

Practice tip

Many patients, particularly those experiencing depression, might have difficulties with motivation or concentration during their use of the recommended intervention. To counter these issues, set realistic goals for treatment and encourage patients to print material to use as a memory aide.

Figure 1. A model for follow-up of patients using e-mental health interventions

Figure 1

A model for follow-up of patients using e-mental health interventions54

Adapted with permission from Orman J, O’Dea B, Shand F, Berk M, Proudfoot J, Christensen H. e-Mental health for mood and anxiety disorders in general practice. Aust Fam Physician 2014;43(12):832–37. 

The exact reasons users drop out of e-mental health interventions remain unclear.

People may drop out of e-mental health for the same reasons they drop out of face-to-face therapy. They might lack time to engage in the treatment, experience a change in circumstances, or have problems in accessing the service. Some might make early treatment gains and decide they no longer need to use the program, while others might quit because they are not experiencing any benefit.55 However, the lack of face-to-face contact with a therapist might also present a barrier for some patients.55,56

Research shows that e-mental health treatment is most likely to be successful when the patient has some level of additional support from a clinician,11 although the optimal amount of therapist contact is uncertain.57

Simply reminding patients to use the service periodically might improve the individual’s chances of following the treatment through to completion.58–60 Reminders might take the form of a brief phone call, postcard, SMS or email. GPs might arrange for the practice nurse to make contact with the patient shortly after engagement to check progress and address any technical problems in accessing the service.

GPs considering the use of an automated reminder system should refer to the following RACGP resources:

 

Practice tip

In addition to reminding patients to log in, GPs might also provide prompts to complete ‘homework’ activities, make an appointment at the clinic to review progress, or print out material from the program to discuss at the next appointment.

This event attracts CPD points and can be self recorded

Did you know you can now log your CPD with a click of a button?

Create Quick log

Related documents