Can Sir John Kirwan's "The Journal" Reduuce Waiting Lists in Mental Health?
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Abstract
Background
"The Journal" (www.depression.org.nz) is a web based self help program for people with mild to moderate depression developed by the Ministry of Health in New Zealand. It uses social marketing techniques including the "celebrity" status of Sir John Kirwan to drive people to the website and guide them through a cognitive behavioral program. Approximately a quarter of the population of New Zealand have visited the website with nearly 30,000 people registering for The Journal 80% of whom show an improvement in PHQ-9 scores. The Journal was designed to be used without any professional input as a stand alone intervention for depression identified in the community. However it is also possible that it may be of value in secondary care. This is particulary the case where there are long waiting lists to see mental health professionals. Secondly the use of an e-therapy may generate the creation of new roles in mental health services such as an e-case manager. To test this idea we are doiing two randomised controlled trials one in New Zealand and one in Canada to assess the impact of using the The Journal in secondary mental health services.
Objective
The objectives of the two studies is to see if using The Journal and an e-case manager results in better, quicker outcomes than usual treatment. Specifically we hypothesise that users of The Journal will need fewer face to face appointments and will not wait as long to acheive remission than people who receive usual care.
Methods
The design of the studies is a randomised control trial with the intervention consisting of The Journal and an e-case manager to coach individuals through the e-therapy plus treatment as usual compared to written information about potential e-therapies plus treatment as usual. The main outcome is change in the PHQ-9 after 12 weeks. The setting for the New Zealand trial is three community mental health teams in Waitemata District Health Board in Auckland; the Canadian trial will be based at The Royal Ottawa Health Care Group central intake clinic in Ottawa.
Results
The New Zealand trial has just started recruiting and we plan to present the early results about acceptability, the experience of the e-case manager and baseline data at the conference. The Canadian trial is due to commence in June 2013.
Conclusions
The Journal and an E-case manager are potentially a useful intervention in secondary mental health services.
"The Journal" (www.depression.org.nz) is a web based self help program for people with mild to moderate depression developed by the Ministry of Health in New Zealand. It uses social marketing techniques including the "celebrity" status of Sir John Kirwan to drive people to the website and guide them through a cognitive behavioral program. Approximately a quarter of the population of New Zealand have visited the website with nearly 30,000 people registering for The Journal 80% of whom show an improvement in PHQ-9 scores. The Journal was designed to be used without any professional input as a stand alone intervention for depression identified in the community. However it is also possible that it may be of value in secondary care. This is particulary the case where there are long waiting lists to see mental health professionals. Secondly the use of an e-therapy may generate the creation of new roles in mental health services such as an e-case manager. To test this idea we are doiing two randomised controlled trials one in New Zealand and one in Canada to assess the impact of using the The Journal in secondary mental health services.
Objective
The objectives of the two studies is to see if using The Journal and an e-case manager results in better, quicker outcomes than usual treatment. Specifically we hypothesise that users of The Journal will need fewer face to face appointments and will not wait as long to acheive remission than people who receive usual care.
Methods
The design of the studies is a randomised control trial with the intervention consisting of The Journal and an e-case manager to coach individuals through the e-therapy plus treatment as usual compared to written information about potential e-therapies plus treatment as usual. The main outcome is change in the PHQ-9 after 12 weeks. The setting for the New Zealand trial is three community mental health teams in Waitemata District Health Board in Auckland; the Canadian trial will be based at The Royal Ottawa Health Care Group central intake clinic in Ottawa.
Results
The New Zealand trial has just started recruiting and we plan to present the early results about acceptability, the experience of the e-case manager and baseline data at the conference. The Canadian trial is due to commence in June 2013.
Conclusions
The Journal and an E-case manager are potentially a useful intervention in secondary mental health services.
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