Batterham Philip J, Sunderland Matthew, Calear Alison L, Davey Christopher G, Christensen Helen, Teesson Maree, Kay-Lambkin Frances, Andrews Gavin, Mitchell Philip B, Herrman Helen, Butow Phyllis N, Krouskos Demos
National Institute for Mental Health Research, The Australian National University, Acton, ACT, Australia
NHMRC Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney, NSW, Australia.
Aust N Z J Psychiatry. 2015 Sep;49(9):776-84. doi: 10.1177/0004867415582054. Epub 2015 Apr 23.
e-Mental health services have been shown to be effective and cost-effective for the treatment of depression. However, to have optimal impact in reducing the burden of depression, strategies for wider reach and uptake are needed.
A review was conducted to assess the evidence supporting use of e-mental health programmes for treating depression. From the review, models of dissemination and gaps in translation were identified, with a specific focus on characterising barriers and facilitators to uptake within the Australian healthcare context. Finally, recommendations for promoting the translation of e-mental health services in Australia were developed.
There are a number of effective and cost-effective e-health applications available for treating depression in community and clinical settings. Four primary models of dissemination were identified: unguided, health service-supported, private ownership and clinically guided. Barriers to translation include clinician reluctance, consumer awareness, structural barriers such as funding and gaps in the translational evidence base.
Key strategies for increasing use of e-mental health programmes include endorsement of e-mental health services by government entities, education for clinicians and consumers, adequate funding of e-mental health services, development of an accreditation system, development of translation-focused activities and support for further translational research. The impact of these implementation strategies is likely to include economic gains, reductions in disease burden and greater availability of more interventions for prevention and treatment of mental ill-health complementary to existing health and efficient evidence-based mental health services.
电子心理健康服务已被证明在治疗抑郁症方面有效且具有成本效益。然而，为了在减轻抑郁症负担方面产生最佳影响，需要制定扩大覆盖面和提高使用率的策略。
进行了一项综述，以评估支持使用电子心理健康项目治疗抑郁症的证据。通过该综述，确定了传播模式和转化方面的差距，特别关注在澳大利亚医疗环境中描述采用的障碍和促进因素。最后，制定了在澳大利亚促进电子心理健康服务转化的建议。
有许多有效且具有成本效益的电子健康应用程序可用于社区和临床环境中治疗抑郁症。确定了四种主要的传播模式：无指导、卫生服务支持、私人所有权和临床指导。转化的障碍包括临床医生的不情愿、消费者意识、资金等结构障碍以及转化证据基础方面的差距。
增加电子心理健康项目使用的关键策略包括政府实体对电子心理健康服务的认可、对临床医生和消费者的教育、电子心理健康服务的充足资金、认证系统的开发、以转化为重点的活动的开展以及对进一步转化研究的支持。这些实施策略的影响可能包括经济效益、疾病负担的减轻以及更多预防和治疗精神疾病的干预措施的更广泛可用性，以补充现有的健康和有效的循证心理健康服务。
