A Comparison of Self-Referral and Referral via Primary Care Providers, through Two Similar Digital Mental Health Services in Western Australia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.1.1. PORTS Patients
2.1.2. MindSpot Patients
2.2. Clinical Models
2.2.1. PORTS Clinical Model
2.2.2. MindSpot Clinical Model
2.3. The Wellbeing Course
2.4. Questionnaires and Measures
2.5. Statistical Analyses
3. Results
3.1. Patient Flow
3.2. Comparison of Patient Characteristics
3.3. Wellbeing Course Treatment Outcomes
3.4. Treatment Satisfaction
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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MindSpot | PORTS | Sig. | |
---|---|---|---|
Age | |||
Mean age (SD) | 34.9 (13.6) | 39.4 (15.8) | F = 211.3; p < 0.001 *** |
Age range | 18–93 years | 16–95 years | |
Gender | |||
Female | 74.7% (3103/4154) a | 62.6% (3034/4848) b | χ2 = 158.9, p < 0.001 *** |
Male | 24.6% (1021/4154) a | 35.5% (1722/4848) b | |
Other | 0.7% (30/4154) a | 1.9% (92/4848) b | |
Cultural identity | |||
Aboriginal or Torres Strait Islander | 3.1% (118/3832) | 3.6% (95/2644) | χ2 = 3.2, p = 0.199 |
Born in Australia: non-Indigenous | 67.8% (2589/3832) | 65.8% (1741/2644) | |
Born in country other than Australia | 29.1% (1116/3832) | 30.6% (808/2644) | |
Education | |||
Postgraduate degree | 15.6% (602/3871) a | 5.9% (156/2644) b | χ2 = 321.8, p < 0.001 *** |
Undergraduate degree | 21.6% (837/3871) a | 11.7% (310/2644) b | |
Other tertiary qualification | 29.9% (1157/3871) a | 33.4% (883/2644) b | |
No tertiary qualification | 32.9% (1275/3871) a | 49.0% (1295/2644) b | |
Employment | |||
Employed full or part-time | 57.4% (2226/3877) a | 42.2% (1116/2644) b | χ2 = 145.6, p < 0.001 *** |
Unemployed | 12.0% (465/3877) a | 16.0% (423/2644) b | |
Other | 30.6% (1186/3877) a | 41.8% (1105/2644) b | |
Marital status | |||
Married (registered or de facto) | 37.5% (1453/3871) a | 34.1% (902/2644) b | χ2 = 90.9, p < 0.001 *** |
Separated | 5.8% (225/3871) a | 10.1% (266/2644) b | |
Divorced | 5.8% (225/3871) a | 7.6% (201/2644) b | |
Widowed | 0.7% (28/3871) a | 2.5% (66/2644) b | |
Other | 50.1% (1940/3871) a | 45.7% (1209/2644) a | |
Self-described location | |||
Capital city or surrounding suburbs | 71.3% (2757/3869) a | 74.8% (1977/2644) b | χ2 = 37.8, p < 0.001 *** |
Other urban area | 11.2% (435/3869) a | 13.2% (348/2644) b | |
Rural or remote region | 17.5% (677/3869) a | 12.1% (319/2644) b | |
IRSD | |||
First quintile (most disadvantaged) | 10.0% (402/4031) a | 16.1% (777/4826) b | χ2 = 173.2, p < 0.001 *** |
Second quintile | 23.0% (926/4031) a | 26.6% (1286/4826) b | |
Third quintile | 20.2% (814/4031) a | 23.0% (1109/4826) b | |
Fourth quintile | 20.9% (844/4031) a | 16.5% (798/4826) b | |
Fifth quintile (least disadvantaged) | 25.9% (1045/4031) a | 17.7% (856/4826) b | |
Symptoms and impairment | |||
General distress (K-10) | 31.1 (7.4) | 31.5 (8.0) | F = 2.8, p = 0.093 |
Self-reported current depression | 69.7% (2662/3820) | 78.3% (2071/2645) | χ2 = 0.59.1, p < 0.001 *** |
Self-reported current anxiety | 87.3% (3333/3820) | 89.7% (2373/2645) | χ2 = 0.9.2, p = 0.002 ** |
Thoughts of suicide in last week | 29.1% (1051/3615) | 27.2% (720/2644) | χ2 = 2.6, p = 0.110 |
Current plan for self-harm | 3.3% (118/3615) | 1.9% (50/2644) | χ2 = 11.0, p < 0.001 *** |
Whole days out of role in last month | 5.5 (7.5) | 7.7 (8.9) | F = 94.1, p < 0.001 *** |
Estimated Marginal Means | Effect Size from Assessment | Percentage Change from Assessment | ||||||
---|---|---|---|---|---|---|---|---|
n | Assessment | Post-Treatment | 3-Month Follow-Up | To Post-Treatment | To 3-Month Follow-Up | To Post-Treatment | To 3-Month Follow-Up | |
K-10 | ||||||||
MindSpot | 425 | 29.8 (6.7) | 20.8 (6.9) *** | 19.5 (5.4) *** | 1.32 [1.17–1.47] | 1.69 [1.53–1.85] | 45.2% [41.8%–48.4%] | 52.4% [49.8%–55.0%] |
PORTS | 780 | 30.6 (7.4) | 22.2 (7.5) *** | 22.0 (6.4) *** | 1.13 [1.02–1.23] | 1.24 [1.13–1.35] | 40.9% [38.3%–43.5%] | 41.8% [39.6%–44.0%] |
PHQ-2 | ||||||||
MindSpot | 425 | 3.2 (1.6) | 1.7 (1.4) *** | 1.4 (1.2) *** | 1.00 [0.85–1.14] | 1.27 [1.12–1.42] | 47.9% [43.6%–52.0%] | 56.1% [52.5%–59.4%] |
PORTS | 780 | 3.4 (1.8) | 2.0 (1.5) *** | 1.8 (1.5) *** | 0.85 [0.74–0.95] | 0.97 [0.86–1.07] | 41.4% [38.2%–44.5%] | 46.5% [43.3%–49.4%] |
GAD-2 | ||||||||
MindSpot | 425 | 3.8 (1.6) | 1.9 (1.4) *** | 1.7 (1.1) *** | 1.26 [1.12–1.41] | 1.53 [1.38–1.68] | 50.1% [46.6%–53.5%] | 54.6% [51.6%–57.3%] |
PORTS | 780 | 3.7 (1.7) | 2.2 (1.5) *** | 1.9 (1.2) *** | 0.94 [0.83–1.04] | 1.22 [1.11–1.33] | 40.5% [37.6%–43.3%] | 48.8% [46.5%–51.1%] |
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Staples, L.G.; Webb, N.; Asrianti, L.; Cross, S.; Rock, D.; Kayrouz, R.; Karin, E.; Dear, B.F.; Nielssen, O.; Titov, N. A Comparison of Self-Referral and Referral via Primary Care Providers, through Two Similar Digital Mental Health Services in Western Australia. Int. J. Environ. Res. Public Health 2022, 19, 905. https://doi.org/10.3390/ijerph19020905
Staples LG, Webb N, Asrianti L, Cross S, Rock D, Kayrouz R, Karin E, Dear BF, Nielssen O, Titov N. A Comparison of Self-Referral and Referral via Primary Care Providers, through Two Similar Digital Mental Health Services in Western Australia. International Journal of Environmental Research and Public Health. 2022; 19(2):905. https://doi.org/10.3390/ijerph19020905
Chicago/Turabian StyleStaples, Lauren G., Nick Webb, Lia Asrianti, Shane Cross, Daniel Rock, Rony Kayrouz, Eyal Karin, Blake F. Dear, Olav Nielssen, and Nickolai Titov. 2022. "A Comparison of Self-Referral and Referral via Primary Care Providers, through Two Similar Digital Mental Health Services in Western Australia" International Journal of Environmental Research and Public Health 19, no. 2: 905. https://doi.org/10.3390/ijerph19020905