Delivering Psychiatric Care Through Broadband

Depressed people can have a hard-enough time getting out of the house to get treatment. Its even worse for those who live far away from treatment centers.

Now, researchers at The Australian National University have found that brief Internet-based interventions can have long-term benefits that may be as effective as visiting psychotherapists.

Researchers at ANU, in Canberra, have developed a cognitive behavioral therapy Web site, called MoodGym, and an educational Web site, called BluePages, that provide information on a range of standard and alternative psychological treatments.

Cognitive behavioral therapy seeks to train depressed patients into healthier thinking habits.

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ANU researchers evaluated the effectiveness of the two sites for 12 months after users had made initial contact. According to ANU, other studies have evaluated the Internets usefulness for treating depression, but this study is the first to examine such long-term effects.

The ANU study found that users of both Web sites reported improvements 12 months after first contact but that BluePages was particularly effective for those reporting higher levels of depression.

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Helen Christensen, one of the researchers leading the study, said her team collected data on what patients did after viewing the BluePages site. "They were less likely to use actions that did not have an evidence base," Christensen said. "So control participants were likely to use music or take alcohol, while BluePages participants were less likely to do so."

"We dont know exactly why the Internet interventions are so effective in the longer term, but it may be that there is a reduction in use of ineffective and potentially damaging treatments," Christensen said.

Because the results have not been published yet, more details are not available. However, an earlier study evaluating these Web pages used more than 500 people who responded to a mail solicitation and manifested depressive systems according to standard questionnaires used by psychologists.

That study divided participants into three groups. One group visited MoodGym, another visited BluePages and another was not directed to Web sites. All participants were called weekly; those assigned to Web sites were instructed to access them. Those not assigned to Web sites received information about habits, such as artistic activity, strategies for coping with stress and so forth, that might influence depression. The study found that both Web sites helped to lower depressive symptoms more than the control intervention but that participants were more likely to stick with the BluePages site than with MoodGym.

Christensen speculated that these resources could be particularly effective for people unwilling to seek professional help.

"The findings also suggest that brief interventions may have a lasting positive effect on people struggling with depression—an outcome that may seem counterintuitive given the lack of human support and low level of human interaction," she said.

Christensen said she would like sites such as these to be able to provide a bridge for professional services, including Web counseling, telephone support and telepsychiatry.

Telemedicine can connect counselors and patients without either having to travel far, and its use is growing. A spokesperson for the American Telemedicine Association said group members in 12 states are practicing mental health or psychiatry remotely. For health networks, the number is 21 states.

Blue Cross and Blue Shield surveyed patients in rural Georgia and found that psychiatrists were the most-needed specialists, according to Associated Press reports. BCBS is building a telemedicine network to link university teaching hospitals with rural clinics and hospitals.

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