The Centre for Mental Health at the University of Melbourne was commissioned by the Australian Department of Health to undertake the independent evaluation of three Australian government funded supported digital mental health services DMHSs. The evaluation aims to inform Australian Government decisions related to future funding for supported DMHSs and activities to increase awareness and utilisation of these services by people with lived experience of mental illness and health professionals.

The data shows that treatments delivered by DMHSs produce significant clinical improvement for consumers. The magnitude of improvement produced, especially by therapist-supported treatment, is comparable with more resource intensive face-to-face treatment options. Services have the potential to be scalable and good value for money.

DMHSs refer to mental health organisations or programs that remotely deliver a range of psychological strategies and interventions via online (desktops, mobile devices and apps) and/or mobile platforms. Online DMHSs, which are the focus of this evaluation, differ in the type and level of therapist support provided. Some online DMHSs do not offer any therapist support and are considered to be fully automated self-directed (or unguided) programs, and others involve support (or guidance) from clinicians, volunteer crisis supporters, teachers, administrators or peers. 

The services offered by these DMHSs are largely intended to target consumers with depression and anxiety disorders who choose to use digital mental health treatment or who, for a range of reasons, may have limited, or no, access to alternative treatment options.

The evaluation uses a mixed-methods approach and was guided by the five key evaluation questions. It provides key recommendations for consideration in future policy making.

Recommendations

1. A long-term strategy and approach to resourcing are required to build confidence across the sector, support a responsive continuous improvement approach to service development and implementation, and enable and embed system-wide changes.
2. Resources and mechanisms are required to build capacity across the system. National or service-based resources may be an appropriate mechanism.
3. Innovative approaches are required to achieve to system integration.
4. Increase capacity to collect and provide timely accessible data and explore opportunities to optimise currently collected data.
5. Continuing investment to develop the evidence base for DMHSs is crucial.
6. Service development initiatives involving people with lived experience are needed to address the diversity within focus populations and scale services.
7. Service development needs to keep pace with technological advances.
8. Commission evidence-based services.