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Feasibility of internet-delivered mental health treatments for rural populations

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Rural populations face numerous barriers to mental health care. Although internet-delivered mental health treatments may offer an accessible and cost-effective answer to these barriers, there has been little evaluation of the feasibility of this approach among rural communities.

Methods

Data were obtained from a random rural community sample through the third wave of the Australian Rural Mental Health Study. Attitudes towards internet-delivered mental health treatments and availability of internet access were explored. Data were analysed to identify sub-groups in whom internet-delivered treatments may be usefully targeted.

Results

Twelve hundred and forty-six participants completed the survey (mean age 59 years, 61 % females, 22 % from remote areas). Overall, 75 % had internet access and 20 % would consider using internet-based interventions, with 18 % meeting both of these feasibility criteria. Logistic regression revealed feasibility for internet-delivered mental health treatment was associated with younger age, male gender, being a carer, and a 12-month mental health problem. Participants who had used internet-delivered services in the past were significantly more likely to endorse these treatments as acceptable.

Conclusions

There is considerable potential for internet-delivered treatments to increase service accessibility to some sub-groups, particularly among people with mental health problems who are not currently seeking help. Resistance to internet treatments appears to be largely attitudinal, suggesting that enhancing community education and familiarity with such programs may be effective in improving perceptions and ultimately access.

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Acknowledgments

We wish to recognise the contribution of the ARMHS chief investigators: Prof David Lyle, A/Prof David Perkins, A/Prof Lyn Fragar, Prof John Beard, Prof Vaughan Carr, Prof Jeffrey Fuller, A/Prof Helen Stain, Prof Prasuna Reddy, and Senior Project Coordinator Dr Clare Coleman. The study was funded by the National Health and Medical Research Council (Project Grants #401241 and #631061), and also supported by a Research Capacity Building Grant to the Australian Rural Health Research Collaboration. We wish to acknowledge the support of Area Directors of Mental Health Services during the course of this phase of the study: Dr Russell Roberts, Richard Buss, Dinesh Arya and particularly acknowledge the research site coordinators in each site: Jan Sidford, John Ogle (Broken Hill), Trim Munro, Amy Strachan (Moree), Louise Holdsworth, Kath O’Driscoll (Lismore), Cheryl Bennett, Jannelle Bowler (Orange), along with Fleur Hourihan, Dr Gina Sartore, Denika Novello and the team of CIDI interviewers. Tonelle Handley would like to acknowledge Australian Rotary Health/Rotary Club of Parramatta City for their support through the provision of a PhD scholarship.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Centre for Translational Neuroscience and Mental Health, University of Newcastle, Level 5, McAuley Centre, Calvary Mater Hospital, Waratah, Callaghan, NSW, 2298, Australia

    Tonelle E. Handley, Frances J. Kay-Lambkin, Kerry J. Inder, Terry J. Lewin & Brian J. Kelly

  2. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia

    Frances J. Kay-Lambkin

  3. Hunter Medical Research Institute, Locked Bag 1, Hunter Region Mail Centre, Newcastle, Australia

    Kerry J. Inder, John R. Attia, Terry J. Lewin & Brian J. Kelly

  4. Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, Australia

    John R. Attia

Authors
  1. Tonelle E. Handley
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  2. Frances J. Kay-Lambkin
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  3. Kerry J. Inder
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  4. John R. Attia
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  5. Terry J. Lewin
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  6. Brian J. Kelly
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Corresponding author

Correspondence to Tonelle E. Handley.

Appendix: non-standardised survey items

Appendix: non-standardised survey items

Perceived financial prosperity Given your current needs and financial responsibilities, would you say that you and your family are…

  • Prosperous

  • Very comfortable

  • Reasonably comfortable

  • Just getting along

  • Poor

  • Very poor

Children in the house How many children live in your household more than 50 % of the time?

Caring Do you care for a disabled or ill family member/friend?

12-month mental health problems In the past 12 months have you experienced any mental health problems such as stress, anxiety or depression or worries about alcohol or drugs?

Have you sought any help or advice for any of these problems?

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Handley, T.E., Kay-Lambkin, F.J., Inder, K.J. et al. Feasibility of internet-delivered mental health treatments for rural populations. Soc Psychiatry Psychiatr Epidemiol 49, 275–282 (2014). https://doi.org/10.1007/s00127-013-0708-9

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  • DOI: https://doi.org/10.1007/s00127-013-0708-9

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