Research shows that cognitive behaviour therapy can be successfully delivered via the internet or telephone. Across the world, digital mental health services are now being implemented as part of routine care. One such digital mental health service is the Practitioner Online Referral and Treatment Service (PORTS).
PORTS was commissioned by the Western Australian Primary Health Alliance to provide free digital (telephone and online) psychological services to West Australian patients in primary care aged 16 years and over with symptoms of anxiety, depression, or substance use problems. PORTS aims to provide high quality and accessible care to people experiencing financial hardship or geographical disadvantage, and who might otherwise not have access to psychological treatment. Between July 2017 to December 2018 a total of 2,527 individuals were referred to PORTS by their General Practitioner (GP) or regional mental health service. Patient and referrer satisfaction with PORTS has been high, and treatment outcomes have been excellent.
In the first 18 months of operation, PORTS established itself as an innovative and effective digital mental health service. However, the deployment of PORTS was not without challenges, including the logistical challenge of implementing a new service model in a state which is one third the size of Australia, and the clinical challenge of patient engagement. One quarter of patients were unable to be contacted despite multiple attempts, although feedback from GPs indicated that this was not unexpected, given the target population of financially disadvantaged people who may lack reliable access to telephones or the internet and may have limited capacity to engage with any health services due to psychosocial stressors. Increasing patient engagement remains an important focus of PORTS service improvement.
Despite the challenges, PORTS has successfully provided services to people who typically experience barriers to treatment, either because of their remote location, or their inability to afford other services. PORTS continues to grow, and while it is not a panacea, it is a promising complement to face-to-face psychological services and a viable option for improving access to high quality care.
Read the full paper: Titov, N., Rock, D., Bezuidenhout, G., Webb, N., Kayrouz, R., Nielssen, O., Williams, L., Purtell, C., Dear, B. F., & Staples, L.G. (in press). Evaluation of The Practitioner Online Referral and Treatment Service (PORTS): The first 18 months of a state-wide digital service for adults with anxiety, depression, or substance use problems. Cognitive Behaviour Therapy. doi: 10.1080/16506073.2019.1666162
Pictured: Dr. Nickolai Titov
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