Factors Influencing Uptake of Digital Mental Health Services (DMHS)


“Digital mental health services (DMHS) have proven effectiveness and play an important role within the broader mental health system by reducing barriers to evidence-based care. However, improved understanding of the factors associated with successful treatment uptake, treatment completion and positive clinical outcomes will facilitate efforts to maximise outcomes.”

“The aim of the current study was to perform a detailed examination of patient factors associated with service pathway engagement and outcomes using a large sample of patients who accessed a national DMHS. In addition to examining the effect of demographic and clinical characteristics on treatment uptake, treatment completion and subsequent clinical improvement, we further aimed to examine the effect of a range of self-reported psychosocial stressors, and whether these factors were similar, or independent in these groups.”

Methods and Results


“Using a prospective uncontrolled observational cohort study design, we collected self-reported demographic, psychosocial and clinical data from 15,882 patients who accessed the MindSpot Clinic, Australia, between 1 January and 31 December 2019. Using a series of univariate regression models and multivariate classification algorithms we found that older age, higher educational attainment, and being in a relationship were all positively associated with uptake, completion and significant symptom improvement, while higher initial symptom severity was negatively associated with those outcomes.”



“While some of the factors identified in the current study such as age, initial symptom severity, relationship status, educational attainment have been identified in previous studies, the effect of multiple self-reported psychosocial difficulties has not been studied. Those difficulties were found to be strongly associated with uptake, completion and subsequent improvement. As with previous findings, psychosocial difficulties on their own have limited impact on each of these variables. However, the presence of multiple co-existing difficulties was negatively associated with all three outcomes.”

“In our large community sample, just under half reported more than two concurrent psychosocial difficulties, suggesting a large proportion of prospective patients who might benefit from treatment, but may find it challenging progress.”


Future Directions


“While many behavioural and mental health apps are designed to simplify treatment and minimise treatment burden, none have yet proven to be able to reduce that burden while maintaining treatment outcome… Future research should further explore the effect of interventions and treatment modifications that improve uptake and treatment completion particularly targeting those affected by treatment burden and related challenges.”

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