As GPs, we are often short of both time and resources, and when it comes to providing mental health care, many of us feel inadequately prepared for the task. We are also often isolated and under-supported.
However, there is a wide range of evidence-based resources available to support us in caring for patients experiencing mental health issues, so why don’t we make use of them?
The trouble is, using online resources is not as simple as prescribing a medication or making a referral. To have our patients get the best out of digital mental health resources we need to get to know these resources and learn to use them appropriately. On top of that initial investment, we also need to convince our patients that using an app or working through an online treatment program is likely to help. Then we need to support them while they do the work.
Perhaps it sounds like too much effort but, given the lengthy wait times for specialist mental health services, isn’t it worth a try?
I am talking specifically here about online mental health treatment programs such as THISWAYUP, MindSpot. MoodGYM and myCompass (mycompass.org.au). All of these are Australian-made programs with a solid evidence base behind them.
These online treatment programs are largely based on Cognitive Behavioural Therapy and are designed to give users skills to monitor mood, thoughts and behaviours, and to reduce mild to moderate symptoms of depression, anxiety and stress. The programs can be used as a standalone resource but are likely to have greater adherence and better results if you introduce them yourself with enthusiasm and see your patients regularly to enhance their commitment to the program and their understanding of its content.
Integrating the content of online treatment programs into your therapeutic conversations is known as ‘blended care’.
Case example
Edward is 54 and has been troubled by low mood and anxiety for some years. He is taking some medications but their value to him is dubious. Despite the impact on his life, work and relationships, he has refused to accept there is anything anyone can do to help him and he is unwilling to talk to anyone but me.
Ed feels very strongly that seeking help for his mental health is a sign of weakness. Ed is very inflexible in his thinking and it is hard to make a difference beyond that which comes with listening with an empathic ear.
Recently, I talked to Ed about possibly doing some work on his mental health online. I used my laptop in session to show Ed the Men’s module in myCompass, a modular CBT program from Black Dog Institute. myCompass is structured so that users do not need to work linearly through the program as they do with many others, they simply register then choose the modules they think might suit them best.
Ed agreed to look at a module designed especially for men and to check back with me in a week, when he could reasonably be expected to have finished the first set of activities.
On review, Ed told me excitedly about what he had learned. He was also keen to tell me there were other modules in the program that he might benefit from and he would like to get on with them.
Ed is now working through the modules and learning about skills he can use to improve his mental health. He likes the online environment (rather than in-person therapy), but he still has me there as his GP to discuss any difficulties he is having or gains he has made.
You can help make blended care in mental health work by:
- learning about what online resources are available (check out the Guide to Digital Mental Health Resources and other resources available through the e-Mental Health in Practice program and on Black Dog Institute’s website).
- recommending digital resources enthusiastically and appropriately.
- showing them to people so they are familiar with them before leaving your consulting room.
- helping your patient download the resource or program you recommend so it is ready to use on their own device when they get home.
- continuing to see them regularly while they are using the online resource or program and discussing their progress.
Key messages
- GPs are often short of mental health resources
- Digital tools are easily accessed and generally free
- Blended care is use of in person and online/therapies/tools.
Author competing interests – nil