MindStep gives outpatients strong support

Anxiety and depressive disorders are increasingly putting demands on Australia’s hospitals and health care systems, putting significant burden on people’s lives and the community.

People hospitalised for these debilitating mental health issues often go home with little followup support, except for appointments with a psychologist or self-help.

Trials of a new 16-month program offering telephone and support materials to hundreds of outpatients under the MindStep initiative, supported by six major Australian private health care funds, is showing a promising success rate of almost 50% in preliminary findings.

Flinders University Professor of Psychiatry Sharon Lawn says the program is a useful adjunct to other services and encourages people with depression, anxiety and other disorders to take important steps to recovery.

“The pilot study of 561 of the first participants in MindStep indicates a success rate of more than 50 per cent, which is very encouraging given there is also a strong completion rate in the first cohort,” says Professor Lawn, co-director of the Flinders Human Behaviour and Health Research Unit.

“We are seeing more participation in the program after people find it accessible, flexible, efficient and safe within the stepped models of mental health care delivery in Australia.”

The low intensity cognitive behaviour therapy (LiCBT) program, adapted from a British Government ‘Improving Access to Psychological Therapies’ (IAPT) initiative, offers Australians with symptoms of anxiety and depression with a history of hospital admission for mental illness the opportunity to use MindStep under the private health system.

There were 867 people referred to MindStep and 757 (87.3%) went on to enrol after an initial phone assessment. Of the 680 clients who proceeded with the 16-week program, the 427 (62.7%) who completed were further assessed for generalised anxiety disorder, general health questionnaire and some in-depth interviews.

As well as the reliable recovery rate of 49%, participants were positive about MindStep’s telephone delivery and use of mental health coaches.

University of Oxford Professor David M Clark, the National Clinical and Informatics Advisor for England’s IAPT program says it’s great to see the program take off and adapt in Australia and other countries.

He says the UK Government’s support for the program since 2006 means more than 1 million people per year are now helped by the services.

“Very encouragingly, the Government has committed to further expand the UK program and we anticipate nearly 1.9 million people per year will benefit by the end of 2024,” Professor Clark says.

The Australian pilot review, outlined in the journal article ‘Outcomes of telephone-delivered low-intensity cognitive behaviour therapy (LiCBT) to community dwelling Australians with a recent hospital admission due to depression or anxiety: MindStep™’ (2019), by Sharon Lawn, Nancy Huang, Sara Zabeen, David Smith, Malcolm Battersby, Paula Redpath, Fiona Glover, Anthony Venning, Jane Cameron and Kate Fairweather-Schmidt has been published by BMC Psychiatry (Springer) DOI: 10.1186/s12888-018-1987-1

MindStep was adapted and developed by experts at Flinders University Psychiatry and is being run by Remedy Health Services in Melbourne.

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College of Medicine and Public Health

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