From AI picking up on social media cues to prevent suicide to video conferencing with a psychologist, experts say telehealth has a big role to play in tackling the leading cause of death for Australians aged 15-44.
The federal government gave the sector a $9.1 million vote of confidence when it announced in the recent budget a Medicare rebate for online video consultations with psychologists.
The initiative will be rolled out first in rural and regional Australia and has been broadly welcomed by those in the mental health sector, including William Stubbs, co-founder of award-winning non-profit Spur Projects.
“In much the same way that Angel Flights is a great resource to transport the sick from remote areas to where there are services, telehealth provides the equivalent resources for mental illness,” said Stubbs, who helped develop the world's largest real-time mental health survey How is the World Feeling?
The budget also showed the government is forging ahead with establishing “Head to Health” – a new digital mental health gateway aiming to provide easy access to resources via multiple channels, including social media.
The Health Department's project team stated: “We will be testing a prototype of the website and seeking feedback from a closed target audience prior to its public launch in September 2017.”
While these government initiatives are welcome, they do not preclude IT professionals and clinicians from entering what is a large, and underserved, market.
Statistics show at least 690,000 Australians live with complex mental illness and 7.3 million people aged 16-85 will experience a common mental health-related condition in their lifetime. Around $8.5 million is spent on mental health-related services annually.
There's already a good range of evidence-based digital programs for anxiety and depression in Australia, including This Way Up, the Black Dog Institute's myCompass and Snapshot, and the Australian National University's ehub Health.
But the Black Dog Institute's Director of Clinical Services, Associate Professor Josephine Anderson, said there were not yet many good programs for other common disorders.
“A capacity to access help for alcohol and other drug problems online would be a really big advantage,” she said.
“It's also fairly early days for work around digital programs for managing bipolar disorder.”
Stubbs noted that mobile apps could also be particularly helpful for preventing suicide, which research shows is often an impulsive decision.
“In a lot of cases when somebody tries to take their life, it was a decision made within the past hour,” Stubbs said.
“If you can have a tool that immediately connects people to help when they need it, that's going to make a huge difference.”
He pointed to Facebook's introduction earlier this year of suicide prevention tools within Messenger, and researchers who have trained a machine to spot depression on Intagram.
“You'll see AI in messaging become more intelligent and complex so that counsellor bots can talk with individuals on social media,” he said.
Stubbs also predicted that within five to ten years we'll be logging our mental health in the same way we now use Fitbits.
“There's also research around using Wifi signals to read your heart rate and various biometrics from afar – you might have sensors in a city detecting whether the population is feeling a-ok,” he said.
But, as Stubbs admits, that's all “a bit sci-fi”.
In the here and now, there are well-founded concerns about using telehealth to treat or support people with mental illness.
University of Sydney Research Fellow of Rural Health Dr Emily Saurman warned that while telehealth services improved access to care, they should not replace face-to-face care.
“It's a slippery slope but that's where it could go. And that's where it should not go. Because there's an importance for physical, hands-on care and assessment,” she said.
“Telehealth is often touted for improving access but access isn't just about not having to travel.
“It's about so much more: is the service responding to supply and demand? Is it available 24/7 or only during business hours? Do I, or the hospital, need to buy things to use this service? What's the cost of upkeep?”
Saurman added that it was also important to ensure that telehealth programs were backed up with resources.
“While the immediacy of telehealth is quite useful, you have to have a workforce that can be responsive immediately in community,” she said.
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