Introduction
Methods
Design
Search strategy
Criteria for including studies and documents for this review
Population of interest
eMental healthcare technology
Implementation findings, goals, and/or recommendations
Screening for eligibility
Data extraction
Quality assessment
Data analysis
Results
Literature search and selection
Research study and government/organizational document characteristics
Report (year, country) | Objectives | Target audience | Implementation focus | |
---|---|---|---|---|
General population | Children and adolescents | |||
A Way Forward: Equipping Australia’s Mental Health System for the Next Generation (2015, AUS) [37] | 1. To examine the current and future states of mental health and mental health service provision in Australia, specifically in terms of cost-effectiveness | - Mental Health Commission | ✓ | ✓ |
E-Mental Health Services in Australia 2014: Current and Future (2014, AUS) [43] | 1. To propose achievable and scalable solutions to unlock the even greater potential of eMental health for the community | - Government - Mental Health Commission | ✓ | |
Strategies for Adopting and Strengthening E-mental Health (2014, AUS) [38] | 1. To identify the benefits, issues and obstacles for the provision of online health services in the mental healthcare system 2. To determine what investment and development, including infrastructure and processes, is required for improved integration of evidence-based online mental health services | - Mental Health Commission | ✓ | ✓ |
E-therapies Systematic Review for Children and Young People with Mental Health Problems
(2014, UK) [39] | 1. To determine the availability of computer-based applications on the Internet for children and young people with mental health problems 2. To determine the acceptability of programs and to investigate aspects of concern and value to young people | - Government | ✓ | ✓ |
The Future’s Digital: Mental Health and Technology
(2014, UK) [42] | 1. To examine the case for digital transformation 2. To determine how digital technology is currently being used in the design and delivery of mental health services 3. To determine what actions national bodies and individual professionals, as well as commissioners, take to ensure digital technology is leveraged to its full potential | - Government - Decision-/policymakers - Healthcare professionals | ✓ | |
E-mental Health in Canada: Transforming the Mental Health System using Technology (2014, CAN) [17] | 1. To examine the spectrum of current eMental health technology/tools 2. To determine the key considerations examining the transformational potential of and barriers to the use of eMental health 3. To examine national and international eMental health approaches, including promising-practices 4. To provide recommendations for the future of eMental health | - Government - Decision-/policymakers - Healthcare professionals - Funders (i.e., insurers) - Academics - eMental healthcare technology developers | ✓ | ✓ |
E-mental Health in the Netherlands (2013, NED) [41] | 1. To showcase how eMental Health utilizes technological developments to respond to today’s challenges, while at the same time increasing the number of people in reach of mental healthcare, thus decreasing the treatment gap | - Individuals at all levels in the Netherlands | ✓ | |
Using Technology to Deliver Mental Health Services to Children and Youth in Ontario (2013, CAN) [40] | 1. To engage with policy- and decision-makers to identify their perspectives on eMental Health 2. To conduct a review of the literature on eMental Health 3. To provide recommendations | - Government - Decision-/policymakers - Healthcare professionals | ✓ | ✓ |
The eHealth Readiness of Australia’s Medical Specialists (2011, AUS) [44] | 1. To explore whether Australian medical specialists are ready to adopt and use eHealth technologies and solutions today and in a way consistent with policy direction in the future 2. To identify the barriers impacting eHealth readiness and adoption and explore how to minimize them 3. To identify eHealth enablers and explore how to apply them to drive adoption and effective usage | - Government - Healthcare professionals | ✓ |
Author (year, country) | Technology | Implementation of technology | Participants and setting | Individuals studied as part of implementation evaluation | ||||
---|---|---|---|---|---|---|---|---|
Children/adolescents | Parents | Healthcare professionals | Healthcare planners | Healthcare policymakers | ||||
Hetrick et al. (2015, AUS) [62] | Online monitoring tool of depressive symptoms, suicidality, and side effects (via iPad). | Adolescents completed the tool once a week for up to 3 months. They could fill in the tool at any location with Internet access at any time with the exception of suicidal ideation items; these items were completed at the beginning of their regular treatment session with their clinician on an iPad. Clinicians received a chart of scores after 4 weeks so that they could share with their patient and received an email regarding side effects that were endorsed for immediate action. | Adolescents, aged 14–24 years, receiving mental healthcare at the Youth Mood Clinic (YMC) Mental health clinic | ✓ | ✓ | |||
Reuland et al. (2014, USA) [48] | CBM-I (Cognitive Bias Modification for Interpretation) | Online intervention where adolescents were instructed to read and imagine themselves in 50 scenarios per session that were ambiguous in meaning until a word fragment near the end of the scenario resolved the ambiguity in a positive way (e.g., in a way inconsistent with socially anxious beliefs) | Socially anxious adolescents, aged 10-15 years, and their mothers No specific setting | ✓ | ✓ | |||
Gonzales et al. (2014, USA) [45] | Text messagea
| Young people, aged 12–24 years, receiving outpatient or residential substance abuse treatment Outpatient and residential substance abuse treatment programs | ✓ | |||||
Gladstone et al. (2014, USA) [49] | CATCH-IT: Competent Adulthood Transition with Cognitive-behavioural Humanistic and Interpersonal Training | 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase depressive disorders. Modules use CBT, behavioral activation, interpersonal psychotherapy, and community resiliency concept model. | Young people, aged 14–21 years, with a general primary care concern Primary care settings | ✓ | ||||
Eisen et al. (2013, USA) [50] | Primary care professionals and young people, aged 14–21 years, with a general primary care concern Primary care settings | ✓ | ✓ | |||||
Iloabachie et al. (2011, USA) [51] | Young people, aged 14–21 years, with a general primary care concern who had positive screens for sub-threshold depressive symptoms, and parents of those who were <18 years Primary care settings | ✓ | ✓ | |||||
Fothergill et al. (2013, USA) [52] | Online screener (via computer or tablet) | 25 questions, that can branch into as many as 57 questions based on responses, regarding somatic and mental health concerns, general health risk, anxiety, and parental depression. The screener calculates scores for the validated scales it contains. A summary screen tallies the positive responses within broad categories and highlights scores for the validated assessments above the standard cut-offs | Primary care professionals and parents presenting for a well child visit Primary care settings | ✓ | ✓ | |||
Branson et al. (2013, USA) [46] | Text message | Reminders sent the evening before each scheduled therapy session (e.g., “C u Wed @8”) | Adolescents, aged 13–17 years Hospital-based outpatient mental health clinic | ✓ | ||||
Han et al. (2013, USA) [53] | Toolkit on the MDPC Website | Health questionnaire (PHQ-9), education material for patients, guides to diagnostic and treatment approaches, specialty care referral forms, slide presentation, training manuals, publications, cost calculator (investment savings for employers) | Healthcare professionals using the MDPC website | ✓ | ||||
Salloum et al. (2013, USA) [56] | Camp Cope-A-Lot: cCBT program for childhood anxiety within community mental health centers | Therapist provides monitoring and coaching as the child completes the program. The therapist is present during program completion to answer any questions and build therapeutic alliance. 12 weekly sessions: sessions 1 to 6 focus on skill-building and sessions 6 to 12 are exposure-based sessions where the therapist provides direct coaching | Children aged 7–13 years, with an anxiety disorder, their parents, administrators, study therapists Community-based mental healthcare settings | ✓ | ✓ | ✓ | ✓ | |
Merry et al. (2012, NZ) [64] | SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) | Interactive fantasy game designed to deliver cognitive behavioural therapy for the treatment of clinical depression. 7 modules delivered over a period of 4 to 7 weeks. A “guide” puts the game into context, provides education, gauges mood, and sets and monitors real-life challenges | Adolescents, aged 12–19 years, seeking help for mild to moderate depressive symptoms that were assessed by a clinician as being fit for self-help and not being a high risk for suicide or self-harm Primary care settings | ✓ | ||||
Ahmad et al. (2012, CAN) [63] | Computer-assisted interactive health risk assessment tool | A health risk assessment tool that provides feedback to both the patient and the physician on psychosocial health. The tool considers the contextual details of the patient (e.g., violence, drug or alcohol abuse) | Healthcare professionals (nurses, physicians, social workers, etc.) Primary and acute care settings | ✓ | ||||
Murphy et al. (2011, USA) [57] | Electronic Outcomes Rating Form (e-ORF) in conjunction with a web-based patient tracking system | The e-ORF is an electronic form filled out by parents of all intake patients using a digital pen. The form includes assessment tools (BPRS-C, CGAS). The e-ORF automatically prints outcome forms of routine paperwork for intake visit and follow-up forms every 90 days to reduce burden on the administrative and clinical staff. The digital pens have the ability to enter the assessment data directly into the hospital’s database | Children and adolescents ≤18 years undergoing outpatient mental health evaluation Outpatient child psychiatric clinic | ✓ | ||||
Diamond et al. (2010, USA) [54] | BHS (Behavioural Health Screen) | Screening tool assesses risk behaviors and psychiatric symptoms in 13 modules. Patient completes the BHS in a waiting room, the report printed at primary care office, and the summary of assessment given to physician | Adolescents with a general primary care concern Primary care settings | ✓ | ||||
Fein et al. (2010, USA) [55] | BHS-ED (Behavioural Health Screen–Emergency Department) | Psychosocial assessment tool designed for adolescents in non-psychiatric medical settings. Nurses or medical technicians logged the patient onto the website and registered them with a password and medical record number. The BHS-ED began with a slide and audio show that explained the rationale for the screening and the standard limits of confidentiality | Adolescents, aged 14–18 years, without acute or critical injuries or illness, presenting with non-psychiatric symptoms Emergency department of an urban tertiary care children’s hospital | ✓ | ||||
Stallard et al. (2010, UK) [61] | cCBT | Focus was whether mental health professionals would consider the delivery of CBT via computer technology | Mental health professionals National conference, British Association of Behavioral and Cognitive Psychotherapy | ✓ | ||||
Pretorious et al. (2010, UK) [59] | Web-based CBT for bulimic disorders | 8 interactive, multimedia sessions, electronic message board for participants and parents, and email support provided by therapist (flexible weekly support and advice via email) | Young women, aged 16–20 years, with bulimia nervosa or atypical bulimia nervosa Clinic | ✓ | ||||
Horwitz et al. (2008, USA) [58] | CHADIS (Child Health and Development Interactive System) | CHADIS provides access to 23 different questionnaires and asks parents prioritize their concerns so clinicians can plan agenda for the upcoming appointment | Parents of children <8 years presenting for a well-child visit and pediatricians Primary care and community-based mental healthcare settings | ✓ | ✓ | |||
John et al. (2007, USA) [47] | Personal digital assistant (PDA) decision support system (DSS) | Screening questions supporting the PDA application: Short Mood and Feeling Questionnaire (SMFQ) and four additional questions, two related to family history of depression and two related to suicide | Pediatric Advanced Practice Nursing students treating children aged 8 to 18 years University-based medical centre | ✓ | ||||
Hanley et al. (2006, UK) [60] | Online counseling services for youtha
| Counselors Online forum | ✓ |
Implementation outcomes
Author (year, country) | Implementation outcome investigated | |||||||
---|---|---|---|---|---|---|---|---|
Acceptability | Adoption | Appropriateness | Cost | Feasibility | Fidelity | Penetration | Sustainability | |
Research studies | ||||||||
Hetrick et al. (2015, AUS) [62] | ✓ | ✓ | ||||||
Gonzales et al. (2014, USA) [45] | ✓ | |||||||
Reuland et al. (2014, USA) [48] | ✓ | ✓ | ✓ | |||||
Gladstone et al. (2014, USA) [49] | ✓ | |||||||
Eisen et al. (2013, USA) [50] | ✓ | ✓ | ||||||
Fothergill et al. (2013, USA) [52] | ✓ | ✓ | ||||||
Han et al. (2013, USA) [53] | ✓ | ✓ | ||||||
Salloum et al. (2013, USA) [56] | ✓ | ✓ | ||||||
Branson et al. (2013, USA) [46] | ✓ | ✓ | ✓ | |||||
Ahmad et al. (2012, CAN) [63] | ✓ | ✓ | ||||||
Merry et al. (2012, NZ) [64] | ✓ | ✓ | ✓ | |||||
Murphy et al. (2011, USA) [57] | ✓ | ✓ | ||||||
Iloabachie et al. (2011, USA) [51] | ✓ | |||||||
Diamond et al. (2010, USA) [54] | ✓ | |||||||
Fein et al. (2010, USA) [55] | ✓ | |||||||
Pretorious et al. (2010, UK) [59] | ✓ | ✓ | ||||||
Stallard et al. (2010, UK) [61] | ✓ | |||||||
Horwitz et al. (2008, USA) [58] | ✓ | |||||||
John et al. (2007, USA) [47] | ✓ | ✓ | ||||||
Hanley et al. (2006, UK) [60] | ✓ | |||||||
Implementation outcome addressed/recommended | ||||||||
Government and organizational documents | ||||||||
Reach Out (2015, AUS) [37] | ✓ | ✓ | ✓ | ✓ | ||||
eMHA (2014, AUS) [43] | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
NCCMH (2014, UK) [39] | ✓ | ✓ | ✓ | ✓ | ||||
MHCC (2014, CAN) [17] | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
Sax (2014, AUS) [38] | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
MHN (2014, UK) [42] | ✓ | ✓ | ✓ | ✓ | ✓ | |||
OCE (2013, CAN) [40] | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
GGZ (2013, AUS) [41] | ✓ | ✓ | ||||||
DHA (2011, AUS) [44] | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |