How E-Mental Health Services Benefit University Students with ADHD: A literature Review
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paper_title: Providing online support for young people with mental health difficulties: challenges and opportunities explored

paper_content:

Despite its growing popularity there is a paucity of information exploring the potential of the Internet to build a trusted community that helps reduce stigma, facilitates help-seeking and aids in the prevention or helps in the management of mental health difficulties for young people. Unsupervised online forums or chat rooms hold potential dangers for young people including the possibility of attracting adults who may take advantage of vulnerable adolescents. Contagion with members organizing suicide pacts, or describing suicidal or self-harming intentions and methods and young people ruminating about feeling depressed are also potential risks. This paper describes the development and conceptual underpinnings of the Reach Out! Online Community Forum, a moderated bulletin board, developed in consultation with, and facilitated by young people aged 16–25. The Forum, although facilitated by young people, is supported and monitored by trained moderators. Anecdotal evidence collected via unsolicited feedback from young people using the Forum suggests that it is a positive, unique and helpful online experience although little is known about the impact on stigma reduction and help seeking in the offline world. Given the proliferation of unsupervised forums and chat rooms there is a need for further research to determine the effectiveness or potential dangers of online forums in mental health prevention and early intervention work.
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paper_title: A Pilot Study of Working Memory and Academic Achievement in College Students With ADHD

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Objective: To investigate working memory (WM), academic achievement, and their relationship in university students with attention-deficit/hyperactivity disorder (ADHD). Method: Participants were university students with previously confirmed diagnoses of ADHD (n = 16) and normal control (NC) students (n = 30). Participants completed 3 auditory—verbal WM measures, 2 visual—spatial WM measures, and 1 control executive function task. Also, they self-reported grade point averages (GPAs) based on university courses. Results: The ADHD group displayed significant weaknesses on auditory—verbal WM tasks and 1 visual—spatial task. They also showed a nonsignificant trend for lower GPAs. Within the entire sample, there was a significant relationship between GPA and auditory—verbal WM. Conclusion: WM impairments are evident in a subgroup of the ADHD population attending university. WM abilities are linked with, and thus may compromise, academic attainment. Parents and physicians are advised to counsel university-bound ...
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paper_title: e-Mental health for mood and anxiety disorders in general practice.

paper_content:

BACKGROUND ::: Australia is a world leader in the development of internet-delivered programs for the prevention and management of mood and anxiety disorders. Despite a strong evidence base of time- and cost-effectiveness, as well as clinical efficacy, the uptake of these programs in general practice remains low. ::: ::: ::: OBJECTIVE ::: To familiarise general practitioners (GPs) with the range of online programs in Australia that have demonstrated efficacy and are currently available for use by patients with mental health problems. ::: ::: ::: DISCUSSION ::: E-mental health programs provide an efficacious and accessible form of mental healthcare and have the potential to fill the gap for those for whom such care is inaccessible, unaffordable or unacceptable. Clinicians can also use it in a stepped-care manner to augment existing healthcare services. There are a number of online resources currently available to Australians who have mood or anxiety disorders. These resources have strong evidence to support their effectiveness. Online portals facilitate access to these programs. Recently the Australian Federal Government has funded an education program (eMHPrac) for GPs and mental health professionals, to outline what is available, indicate situations where recommending such resources is appropriate, and suggest ways in which they can be incorporated into general practice.
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paper_title: E-Mental Health: A Rapid Review of the Literature

paper_content:

As e–mental health applications proliferate, the Internet is increasingly viewed as a potentially transformative tool that will broaden access to effective mental health services. This “rapid review” of the literature found an encouraging amount of rigorous research supporting the effectiveness of e–mental health applications, even therapist-assisted cognitive-behavioral therapy for anxiety and depression. Nevertheless, policy makers and health leaders must be sure to incorporate e–mental health applications into the existing service system so they complement—and not detract from—the provision of direct care, the authors said.
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paper_title: The internet as a setting for mental health service utilisation by young people

paper_content:

Objective: To explore patterns of internet use by young people in Australia and assess the usefulness of online resources for mental health problems, exploring functionality that may be relevant in the development of online mental health services. Design and participants: Cross-sectional survey of a nationally representative sample of young people (2000 randomly selected participants aged 12―25 years), via telephone interview, conducted in January―March 2008. Main outcome measures: Patterns of internet use including type of use, social networking, sources of information about mental health, alcohol or other substance use problems and levels of satisfaction with the information, and type of information accessed via websites. Results: Young people reported using the internet to connect with other young people (76.9%; 1464/1905) and to seek information about a mental health problem, regardless of whether they had a problem themselves (38.8%; 735/1894). Twenty per cent of young people (398/1990) had personally experienced a mental health problem in the previous 5 years; when these people were asked about sources of information used for this problem, 30.8% (70/227) reported searching the internet. Patterns of internet use and types of resources used differed by age and sex. Conclusion: Our findings suggest that technology is important in the everyday lives of young people, and online mental health services that encompass promotion and prevention activities should include a variety of resources that appeal to all ages and both sexes, such as "question and answer" forums and email.
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paper_title: A framework for assessing e-health preparedness

paper_content:

Whilst healthcare is the biggest service industry on the globe, it has yet to realise the full potential of the e-business revolution in the form of e-health. This is due to many reasons including the fact that the healthcare industry is faced with many complex challenges in trying to deliver cost-effective, high-value, accessible healthcare and has traditionally been slow to embrace new business techniques and technologies. Given that e-health, to a great extent, is a macro level concern that has far reaching micro level implications, this paper firstly develops a framework to assess a country's preparedness with respect to embracing e-health (the application of e-commerce to healthcare) and from this an e-health preparedness grid to facilitate the assessment of any e-health initiative. Taken together, the integrative framework and preparedness grid provide useful and necessary tools to enable successful e-health initiatives to ensue by helping country and/or an organisation within a country to identify and thus address areas that require further attention in order for it to undertake a successful e-health initiative.
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paper_title: MEMO—A Mobile Phone Depression Prevention Intervention for Adolescents: Development Process and Postprogram Findings on Acceptability From a Randomized Controlled Trial

paper_content:

Background: Prevention of the onset of depression in adolescence may prevent social dysfunction, teenage pregnancy, substance abuse, suicide, and mental health conditions in adulthood. New technologies allow delivery of prevention programs scalable to large and disparate populations. Objective: To develop and test the novel mobile phone delivery of a depression prevention intervention for adolescents. We describe the development of the intervention and the results of participants’ self-reported satisfaction with the intervention. Methods: The intervention was developed from 15 key messages derived from cognitive behavioral therapy (CBT). The program was fully automated and delivered in 2 mobile phone messages/day for 9 weeks, with a mixture of text, video, and cartoon messages and a mobile website. Delivery modalities were guided by social cognitive theory and marketing principles. The intervention was compared with an attention control program of the same number and types of messages on different topics. A double-blind randomized controlled trial was undertaken in high schools in Auckland, New Zealand, from June 2009 to April 2011. Results: A total of 1348 students (13–17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups. Of these, 835 (97.7%) self-completed follow-up questionnaires at postprogram interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over three-quarters of participants viewed at least half of the messages and 90.7% (379/418) in the intervention group reported they would refer the program to a friend. Intervention group participants said the intervention helped them to be more positive (279/418, 66.7%) and to get rid of negative thoughts (210/418, 50.2%)—significantly higher than proportions in the control group. Conclusions: Key messages from CBT can be delivered by mobile phone, and young people report that these are helpful. Change in clinician-rated depression symptom scores from baseline to 12 months, yet to be completed, will provide evidence on the effectiveness of the intervention. If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage. ClinicalTrial: Australia New Zealand Clinical Trials Registry (ACTRN): 12609000405213; http://www.anzctr.org.au/trial_view.aspx?ID=83667 (Archived by WebCite at http://www.webcitation.org/64aueRqOb) [J Med Internet Res 2012;14(1):e13]
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paper_title: Systematic Reviews in the Social Sciences : A Practical Guide

paper_content:

Such diverse thinkers as Lao-Tze, Confucius, and U.S. Defense Secretary Donald Rumsfeld have all pointed out that we need to be able to tell the difference between real and assumed knowledge. The systematic review is a scientific tool that can help with this difficult task. It can help, for example, with appraising, summarising, and communicating the results and implications of otherwise unmanageable quantities of data. This is important because quite often there are so many studies, and their results are often so conflicting, that no policymaker or practitioner could possibly carry out this task themselves.Systematic review methods have been widely used in health care, and are becoming increasingly common in the social sciences (fostered, for example, by the work of the Campbell Collaboration). ::: ::: This book outlines the rationale and methods of systematic reviews, giving worked examples from social science and other fields. It requires no previous knowledge, but takes the reader through the process stage by stage. It draws on examples from such diverse fields as psychology, criminology, education, transport, social welfare, public health, and housing and urban policy, among others.The book includes detailed sections on assessing the quality of both quantitative, and qualitative research; searching for evidence in the social sciences;meta-analytic and other methods of evidence synthesis; publication bias; heterogeneity; and approaches to dissemination.
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paper_title: Access to health care among Australian adolescents young people's perspectives and their sociodemographic distribution.

paper_content:

PURPOSE ::: To identify the health concerns for which adolescent residents in New South Wales, Australia, do not receive health care, and the associated factors, including their sociodemographic distribution. ::: ::: ::: METHODS ::: Purposive sampling was used to recruit school students who were stratified by gender and age (12-14, 14-16 and 16-17 years), from schools stratified by socioeconomic status and urban/rural location. Out-of-school young people were recruited through youth health services. Qualitative methods were used to collect and analyze data. ::: ::: ::: RESULTS ::: Eighty-one focus groups were conducted. Most young people defined health solely in terms of their physical well-being, but still identified a broad range of situations, conditions, or behaviors which they believed might affect their health. One-third of females and two-thirds of males said they would not seek help for their health concerns, and when they did, were most likely to seek help from family, friends, or others they trusted. When professional help was sought, young people again preferred someone they knew and trusted. The three groups of barriers to accessing health care were: concerns about confidentiality, knowledge of services and discomfort in disclosing health concerns, and accessibility and characteristics of services. Factors related to use of health care services were associated with age, gender, and location, but rarely with socioeconomic status. ::: ::: ::: CONCLUSIONS ::: The majority of these young people in New South Wales (particularly males) do not seek health care despite identifying a broad range of issues that affect their health.
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paper_title: E‐mental health: a new era in delivery of mental health services

paper_content:

range of factors have come together rapidly over the past decade to create a health services environment in which web-based technologies now offer one of the most promising opportunities for earlier and better management of common mental health problems. These factors include international recognition of the health burden attributable to anxiety, depression and substance misuse; 1 epidemiological evidence that mental disorders largely commence before the age of 25 years; 2,3 the development of highly interactive web-based technologies, and their widespread use in Australia (particularly among young people); and rapidly changing community attitudes towards help seeking for mental health problems. 4-6 Sadly, the proportion of Australian adults with current mental health problems using traditional health care services has not increased (38% in 1997 v 35% in 2007). 7 This is despite the apparent success of public awareness campaigns that have promoted help seeking 4-6 and some substantial changes in primary care-based approaches to the provision of medical and psychological treatments. 8,9 In reality, the structures, distribution and costs that currently underpin our primary and secondary care services make them relatively unavailable to many of those in need. 10 Despite the strong arguments in favour of early intervention in youth mental health, it is this group who are most neglected by the current arrangements. 11,12 By contrast, young people with difficulties are increasingly seeking informal and formal help online (see
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paper_title: e-Mental health for mood and anxiety disorders in general practice.

paper_content:

BACKGROUND ::: Australia is a world leader in the development of internet-delivered programs for the prevention and management of mood and anxiety disorders. Despite a strong evidence base of time- and cost-effectiveness, as well as clinical efficacy, the uptake of these programs in general practice remains low. ::: ::: ::: OBJECTIVE ::: To familiarise general practitioners (GPs) with the range of online programs in Australia that have demonstrated efficacy and are currently available for use by patients with mental health problems. ::: ::: ::: DISCUSSION ::: E-mental health programs provide an efficacious and accessible form of mental healthcare and have the potential to fill the gap for those for whom such care is inaccessible, unaffordable or unacceptable. Clinicians can also use it in a stepped-care manner to augment existing healthcare services. There are a number of online resources currently available to Australians who have mood or anxiety disorders. These resources have strong evidence to support their effectiveness. Online portals facilitate access to these programs. Recently the Australian Federal Government has funded an education program (eMHPrac) for GPs and mental health professionals, to outline what is available, indicate situations where recommending such resources is appropriate, and suggest ways in which they can be incorporated into general practice.
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paper_title: E-Mental Health: A Rapid Review of the Literature

paper_content:

As e–mental health applications proliferate, the Internet is increasingly viewed as a potentially transformative tool that will broaden access to effective mental health services. This “rapid review” of the literature found an encouraging amount of rigorous research supporting the effectiveness of e–mental health applications, even therapist-assisted cognitive-behavioral therapy for anxiety and depression. Nevertheless, policy makers and health leaders must be sure to incorporate e–mental health applications into the existing service system so they complement—and not detract from—the provision of direct care, the authors said.
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paper_title: The internet as a setting for mental health service utilisation by young people

paper_content:

Objective: To explore patterns of internet use by young people in Australia and assess the usefulness of online resources for mental health problems, exploring functionality that may be relevant in the development of online mental health services. Design and participants: Cross-sectional survey of a nationally representative sample of young people (2000 randomly selected participants aged 12―25 years), via telephone interview, conducted in January―March 2008. Main outcome measures: Patterns of internet use including type of use, social networking, sources of information about mental health, alcohol or other substance use problems and levels of satisfaction with the information, and type of information accessed via websites. Results: Young people reported using the internet to connect with other young people (76.9%; 1464/1905) and to seek information about a mental health problem, regardless of whether they had a problem themselves (38.8%; 735/1894). Twenty per cent of young people (398/1990) had personally experienced a mental health problem in the previous 5 years; when these people were asked about sources of information used for this problem, 30.8% (70/227) reported searching the internet. Patterns of internet use and types of resources used differed by age and sex. Conclusion: Our findings suggest that technology is important in the everyday lives of young people, and online mental health services that encompass promotion and prevention activities should include a variety of resources that appeal to all ages and both sexes, such as "question and answer" forums and email.
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paper_title: State of the e-mental health field in Australia: Where are we now?

paper_content:

Objective:E-mental health technologies are increasing rapidly, both in number and in utilisation by consumers, health systems and researchers. This review aimed to: (i) examine the features and scientific evidence for e-mental health programs; (ii) describe the growth in these programs in the past decade, and track the extent and quality of scientific research over time; and (iii) examine Australian and international contribution to the field.Method:Two types of e-mental health programs; ‘web interventions’ and mobile applications’; targeting depression, bipolar disorder, generalised anxiety disorder, social anxiety, panic disorder and general stress were included. Data were collected from the Beacon website (www.beacon.anu.edu.au; last updated July 2011). Features of each program and their supporting scientific evidence were coded.Results:In total, 62 web interventions and 11 mobile applications were identified. Half of these were developed in Australia. The majority of programs were aimed towards adults...
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paper_title: Attention Deficit Hyperactivity Disorder in Australian Adults: Prevalence, Persistence, Conduct Problems and Disadvantage

paper_content:

BACKGROUND ::: The Prevalence and persistence of ADHD have not been described in young Australian adults and few studies have examined how conduct problems (CP) are associated with ADHD for this age group. We estimate lifetime and adult prevalence and persistence rates for three categories of ADHD for 3795 Australian adults, and indicate how career, health and childhood risk factors differ for people with ADHD symptoms and ADHD symptoms plus CP. ::: ::: ::: METHODOLOGY ::: Trained interviewers collected participant experience of ADHD, CP, education, employment, childhood experience, relationship and health variables. Three diagnostic definitions of ADHD used were (i) full DSM-IV criteria; (ii) excluding the age 7 onset criterion (no age criterion); (iii) participant experienced difficulties due to ADHD symptoms (problem symptoms). ::: ::: ::: RESULTS ::: Prevalence rates in adulthood were 1.1%, 2.3% and 2.7% for each categorization respectively. Persistence of ADHD from childhood averaged across gender was 55.3% for full criteria, 50.3% with no age criterion and 40.2% for problem symptoms. ADHD symptoms were associated with parental conflict, poor health, being sexually assaulted during childhood, lower education, income loss and higher unemployment. The lifetime prevalence of conduct problems for adults with ADHD was 57.8% and 6.9% for adults without ADHD. The greatest disadvantage was experienced by participants with ADHD plus CP. ::: ::: ::: CONCLUSION ::: The persistence of ADHD into adulthood was greatest for participants meeting full diagnostic criteria and inattention was associated with the greatest loss of income and disadvantage. The disadvantage associated with conduct problems differed in severity and was relevant for a high proportion of adults with ADHD. Women but not men with ADHD reported more childhood adversity, possibly indicating varied etiology and treatment needs. The impact and treatment needs of adults with ADHD and CP and the report of sexual assault during childhood by women and men with ADHD also deserve further study.
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paper_title: ADHD in College Students

paper_content:

Objective: According to the American Psychiatric Association, 3% to 7% of the school-age population has ADHD and many children continue to display significant symptoms throughout adolescences and adulthood. Relative to the childhood literature, less is known about ADHD in adults, especially college students with ADHD. The principle purpose of this review articles is to summarize the major research findings concerning ADHD in the college student population with regard to prevalence of symptoms, neuropsychological and psychological functioning. Overall, findings suggest that college students with ADHD are at greater risk for academic and psychological difficulties, and they perform similar to non-ADHD controls on many neuropsychological tasks. These findings are preliminary, however, and are tempered by the small number of studies that have been conducted as well as the methodological limitations of these studies. Conclusion: Future research using larger sample sizes, rigorous assessment criteria, and a lon...
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paper_title: Internet-Based Cognitive Behavioral Therapy for Adults With ADHD in Outpatient Psychiatric Care: A Randomized Trial.

paper_content:

Objective: The purpose of the study was to evaluate an Internet-based cognitive behavioral therapy (iCBT) program targeting difficulties and impairments associated with adult ADHD. Method: Forty-five adults diagnosed with ADHD were randomized to either self-help (iCBT self-help format [iCBT-S]), self-help with weekly group sessions (iCBT group-therapy format [iCBT-G]), or a waiting-list control group. Treatment efficacy was measured at pre- and posttreatment and at 6-month follow-up. Results: Intention-to-treat (ITT) analysis showed a significant reduction in ADHD symptoms for the iCBT-S group in comparison with the waiting-list controls at posttreatment, with a between-group effect size of d = 1.07. The result was maintained at 6-month follow-up. No significant difference was found at posttreatment or 6-month follow-up between the iCBT-S and iCBT-G groups. Conclusion: The findings show that a CBT treatment program administered through the Internet can be a promising treatment for adult ADHD. Limitations ...
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paper_title: Cognitive assistive technology and professional support in everyday life for adults with ADHD

paper_content:

AbstractPurpose: An evaluation of a model of intervention in everyday settings, consisting of cognitive assistive technology (CAT) and support provided by occupational therapists to adults with attention deficit hyperactivity disorder (ADHD). The purpose was to study how professional support and CAT facilitate everyday life and promote community participation of adults with ADHD. Method: The intervention was implemented in five steps and evaluated in a 15-month study (March 2006 = T1 to June 2007 = T2). One questionnaire and one protocol describe the CATs and provided support. Two questionnaires were employed at T1 and T2 for evaluation of the intervention in everyday settings. Results: The participants tried 74 CATs, with weekly schedules, watches and weighted blankets being most highly valued. Carrying out a daily routine was the most frequent support. More participants were working at T2 than at T1. Frequency of performing and satisfaction with daily occupations as well as life satisfaction were stable...
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paper_title: Computer-Aided Cognitive Behaviour Therapy

paper_content:

Dropout rates soar, however, if Internet access to CCBT is open and unmonitored [1] . The coming of age of CCBT as a way of delivering mental health care was recently recognized by its first approval by a government agency. That approval came from the National Institute for Clinical Excellence (NICE), the English regulatory body. NICE [3] now recommends 2 CCBT systems for the National Health Service – Beating the Blues for depression and FearFighter for panic and phobic disorders. Few CCBT systems have dealt with obsessive-compulsive disorder (OCD). There have been case reports of CCBT with OCD [4, 5] and a pilot study of vicarious exposure by CCBT [6, 7] . Most CCBT research on OCD so far has concerned the BTSteps (Behavior Therapy Steps) system [8] , which Tumur et al. [9] and McCrone et al. [10] refer to in this issue. The BTSteps system delivers its CCBT by telephone via a computer-driven interactive voice response (IVR) system which helps the user plan and carry out the selfdirected exposure and ritual prevention that are core features of effective CBT for OCD. The patient directs the computer IVR interview by key presses on the phone, usually at home and mostly outside usual working hours. (In Britain BTSteps has been adapted for use at home on the Internet and is available under the name OCFighter to avoid confusion with a well-known telephone company). Worldwide the demand for cognitive behaviour therapy (CBT) exceeds the availability of therapists. This gap and advances in information technology have catalyzed a rich ferment of research into computer-aided CBT (CCBT). Certain CCBT systems can save much therapist time by allowing most treatment tasks to be delegated to patient-computer interactions. In contrast, therapist time is not saved either by conducting CBT via email, telephone or videoconference exchanges between patient and therapist in real time, or via most virtual reality systems. CCBT also provides guidance personalized to each patient yet perfectly standardized given the same series of patient responses. Fully 175 CCBT studies including 87 randomized controlled trials (RCTs) have just been reviewed in a Maudsley Monograph [1] , and in this journal Emmelkamp [2] discussed technological innovations in psychotherapy including CCBT. The 97 CCBT systems reviewed in the Monograph concerned a wide spectrum of mental health problems. A growing number of CCBT systems are becoming available on the Internet. Users of CCBT on the Internet are more likely to complete it if they are first screened, are then given access by a password, and are then supported briefly by phone, email or face to face.
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paper_title: E-Mental Health: A Rapid Review of the Literature

paper_content:

As e–mental health applications proliferate, the Internet is increasingly viewed as a potentially transformative tool that will broaden access to effective mental health services. This “rapid review” of the literature found an encouraging amount of rigorous research supporting the effectiveness of e–mental health applications, even therapist-assisted cognitive-behavioral therapy for anxiety and depression. Nevertheless, policy makers and health leaders must be sure to incorporate e–mental health applications into the existing service system so they complement—and not detract from—the provision of direct care, the authors said.
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paper_title: Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms

paper_content:

Abstract The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms ( p . 01 ) and global severity ( p . 002 ), as well as self-reported ADHD symptoms ( p . 0001 ) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety ( p 's p . 01 ), and a trend to have lower self-reported depression ( p = . 06 ). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) ( p . 02 ). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing.
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paper_title: State of the e-mental health field in Australia: Where are we now?

paper_content:

Objective:E-mental health technologies are increasing rapidly, both in number and in utilisation by consumers, health systems and researchers. This review aimed to: (i) examine the features and scientific evidence for e-mental health programs; (ii) describe the growth in these programs in the past decade, and track the extent and quality of scientific research over time; and (iii) examine Australian and international contribution to the field.Method:Two types of e-mental health programs; ‘web interventions’ and mobile applications’; targeting depression, bipolar disorder, generalised anxiety disorder, social anxiety, panic disorder and general stress were included. Data were collected from the Beacon website (www.beacon.anu.edu.au; last updated July 2011). Features of each program and their supporting scientific evidence were coded.Results:In total, 62 web interventions and 11 mobile applications were identified. Half of these were developed in Australia. The majority of programs were aimed towards adults...
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paper_title: e-Mental health for mood and anxiety disorders in general practice.

paper_content:

BACKGROUND ::: Australia is a world leader in the development of internet-delivered programs for the prevention and management of mood and anxiety disorders. Despite a strong evidence base of time- and cost-effectiveness, as well as clinical efficacy, the uptake of these programs in general practice remains low. ::: ::: ::: OBJECTIVE ::: To familiarise general practitioners (GPs) with the range of online programs in Australia that have demonstrated efficacy and are currently available for use by patients with mental health problems. ::: ::: ::: DISCUSSION ::: E-mental health programs provide an efficacious and accessible form of mental healthcare and have the potential to fill the gap for those for whom such care is inaccessible, unaffordable or unacceptable. Clinicians can also use it in a stepped-care manner to augment existing healthcare services. There are a number of online resources currently available to Australians who have mood or anxiety disorders. These resources have strong evidence to support their effectiveness. Online portals facilitate access to these programs. Recently the Australian Federal Government has funded an education program (eMHPrac) for GPs and mental health professionals, to outline what is available, indicate situations where recommending such resources is appropriate, and suggest ways in which they can be incorporated into general practice.
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paper_title: E-Mental Health: A Rapid Review of the Literature

paper_content:

As e–mental health applications proliferate, the Internet is increasingly viewed as a potentially transformative tool that will broaden access to effective mental health services. This “rapid review” of the literature found an encouraging amount of rigorous research supporting the effectiveness of e–mental health applications, even therapist-assisted cognitive-behavioral therapy for anxiety and depression. Nevertheless, policy makers and health leaders must be sure to incorporate e–mental health applications into the existing service system so they complement—and not detract from—the provision of direct care, the authors said.
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paper_title: Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms

paper_content:

Abstract The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms ( p . 01 ) and global severity ( p . 002 ), as well as self-reported ADHD symptoms ( p . 0001 ) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety ( p 's p . 01 ), and a trend to have lower self-reported depression ( p = . 06 ). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) ( p . 02 ). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing.
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paper_title: The internet as a setting for mental health service utilisation by young people

paper_content:

Objective: To explore patterns of internet use by young people in Australia and assess the usefulness of online resources for mental health problems, exploring functionality that may be relevant in the development of online mental health services. Design and participants: Cross-sectional survey of a nationally representative sample of young people (2000 randomly selected participants aged 12―25 years), via telephone interview, conducted in January―March 2008. Main outcome measures: Patterns of internet use including type of use, social networking, sources of information about mental health, alcohol or other substance use problems and levels of satisfaction with the information, and type of information accessed via websites. Results: Young people reported using the internet to connect with other young people (76.9%; 1464/1905) and to seek information about a mental health problem, regardless of whether they had a problem themselves (38.8%; 735/1894). Twenty per cent of young people (398/1990) had personally experienced a mental health problem in the previous 5 years; when these people were asked about sources of information used for this problem, 30.8% (70/227) reported searching the internet. Patterns of internet use and types of resources used differed by age and sex. Conclusion: Our findings suggest that technology is important in the everyday lives of young people, and online mental health services that encompass promotion and prevention activities should include a variety of resources that appeal to all ages and both sexes, such as "question and answer" forums and email.
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paper_title: Implementation quality of whole-school mental health promotion and students’ academic performance

paper_content:

Background: This paper argues for giving explicit attention to the quality of implementation of school-wide mental health promotions and examines the impact of implementation quality on academic performance in a major Australian mental health initiative. Method: Hierarchical linear modelling was used to investigate change in standardised academic performance across the 2-year implementation of a mental health initiative in 96 Australian primary (or elementary) schools that was focused on improving student social-emotional competencies. Results: After controlling for differences in socioeconomic background, a significant positive relationship existed between quality of implementation and academic performance. The difference between students in high- and low-implementing schools was equivalent to a difference in academic performance of up to 6 months of schooling. • Given the known relationship between student academic achievement and mental health, many nations are mounting school-based mental health interventions: however, the quality of program implementation remains a concern • The Australian KidsMatter primary school mental health intervention enabled the development of an Implementation Index allowing schools to be grouped into low- to high- implementing schools • The quality of implementation of KidsMatter appears to be positively associated with the level of student academic achievement, equivalent to 6 months more schooling by Year 7, over and above any influence of socioeconomic background
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paper_title: The internet as a setting for mental health service utilisation by young people

paper_content:

Objective: To explore patterns of internet use by young people in Australia and assess the usefulness of online resources for mental health problems, exploring functionality that may be relevant in the development of online mental health services. Design and participants: Cross-sectional survey of a nationally representative sample of young people (2000 randomly selected participants aged 12―25 years), via telephone interview, conducted in January―March 2008. Main outcome measures: Patterns of internet use including type of use, social networking, sources of information about mental health, alcohol or other substance use problems and levels of satisfaction with the information, and type of information accessed via websites. Results: Young people reported using the internet to connect with other young people (76.9%; 1464/1905) and to seek information about a mental health problem, regardless of whether they had a problem themselves (38.8%; 735/1894). Twenty per cent of young people (398/1990) had personally experienced a mental health problem in the previous 5 years; when these people were asked about sources of information used for this problem, 30.8% (70/227) reported searching the internet. Patterns of internet use and types of resources used differed by age and sex. Conclusion: Our findings suggest that technology is important in the everyday lives of young people, and online mental health services that encompass promotion and prevention activities should include a variety of resources that appeal to all ages and both sexes, such as "question and answer" forums and email.
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paper_title: Internet-based prevention for alcohol and cannabis use: final results of the Climate Schools course

paper_content:

AIMS ::: To establish the long-term efficacy of a universal internet-based alcohol and cannabis prevention programme in schools. ::: ::: ::: METHODS ::: A cluster-randomized controlled trial was conducted to assess the effectiveness of the Climate Schools: Alcohol and Cannabis Course. The evidence-based course, aimed at reducing alcohol and cannabis use, is facilitated by the internet and consists of 12 novel and curriculum consistent lessons delivered over 6 months. ::: ::: ::: PARTICIPANTS ::: A total of 764 year 8 students (13 years) from 10 Australian secondary schools were allocated randomly to the internet-based prevention programme (n = 397, five schools), or to their usual health classes (n = 367, five schools). ::: ::: ::: MEASURES ::: Participants were assessed at baseline, immediately post, and 6 and 12 months following completion of the intervention, on measures of alcohol and cannabis knowledge, attitudes, use and related harms. ::: ::: ::: RESULTS ::: This paper reports the final results of the intervention trial, 12 months following the completion of the Climate Schools: Alcohol and Cannabis Course. The effectiveness of the course 6 months following the intervention has been reported previously. At the 12-month follow-up, compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge, a reduction in average weekly alcohol consumption and a reduction in frequency of drinking to excess. No differences between groups were found on alcohol expectancies, cannabis attitudes or alcohol- and cannabis-related harms. The course was found to be acceptable by teachers and students as a means of delivering drug education in schools. ::: ::: ::: CONCLUSIONS ::: Internet-based prevention programs for school-age children can improve student's knowledge about alcohol and cannabis, and may also reduce alcohol use twelve months after completion.
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paper_title: E-Mental Health: A Rapid Review of the Literature

paper_content:

As e–mental health applications proliferate, the Internet is increasingly viewed as a potentially transformative tool that will broaden access to effective mental health services. This “rapid review” of the literature found an encouraging amount of rigorous research supporting the effectiveness of e–mental health applications, even therapist-assisted cognitive-behavioral therapy for anxiety and depression. Nevertheless, policy makers and health leaders must be sure to incorporate e–mental health applications into the existing service system so they complement—and not detract from—the provision of direct care, the authors said.
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Title: How E-Mental Health Services Benefit University Students with ADHD: A Literature Review
Section 1: Introduction
Description 1: This section introduces the concept of e-mental health (eMH) and highlights its potential benefits, especially for university students with ADHD.

Section 2: Research Methodology and Design
Description 2: This section describes the systematic literature review methodology used to explore the role of IS/IT in mental health and ADHD in university students.

Section 3: E-Mental Health Opportunities
Description 3: This section identifies validated eMH capabilities and discusses how they can address barriers in the current mental health system for university students.

Section 4: ADHD
Description 4: This section provides an overview of ADHD, including its prevalence among university students and the academic challenges they face.

Section 5: Discussion and Conclusion
Description 5: This section discusses the findings of the literature review and concludes on the potential for eMH to improve the treatment and management of ADHD in university students.

Section 6: Improved Accessibility
Description 6: This section considers how eMH can enhance access to mental health services for university students with ADHD.

Section 7: Reduced Cost and Increased Quality
Description 7: This section discusses how eMH can reduce mental health care costs while improving the quality and accessibility of services.

Section 8: Better Promotion Technique
Description 8: This section discusses the advantages of eMH in providing health promotion and psycho-education for university students with ADHD.

Section 9: Early Intervention and Prevention
Description 9: This section highlights how eMH enables early intervention and prevention strategies for university students with ADHD.

Section 10: Conclusion
Description 10: This section summarizes the review, identifies gaps in current research, and suggests directions for future studies on the use of IS/IT in ADHD treatments.