Abstract
BackgroundTo explore the characteristics and compare clinical outcomes of non-Australian born (migrant) and Australian-born users of an Australian national digital mental health service.MethodsThe characteristics and treatment outcomes of patients who completed online treatment at the MindSpot Clinic between January 2014 and December 2016 and reported a country of birth other than Australia were compared to Australian-born users. Data about the main language spoken at home were used to create distinct groups. Changes in symptoms of depression and anxiety were measured using the Patient Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder Scale – 7 Item (GAD-7), respectively.ResultsOf 52,020 people who started assessment at MindSpot between 1st January 2014 and 22nd December 2016, 45,082 reported a country of birth, of whom 78.6% (n = 35,240) were Australian-born, and 21.4% (n = 9842) were born overseas. Of 6782 people who completed the online treatment and reported country of birth and main language spoken at home, 1631 (24%) were migrants, 960 (59%) were from English-speaking countries, and 671 (41%) were from non-English speaking countries. Treatment-seeking migrant users reported higher rates of tertiary education than Australian-born users. The baseline symptom severity, and rates of symptom reduction and remission following online treatment were similar across groups.ConclusionsOnline treatment was associated with significant reductions in anxiety and depression in migrants of both English speaking and non-English speaking backgrounds, with outcomes similar to those obtained by Australian-born patients. DMHS have considerable potential to help reduce barriers to mental health care for migrants.
Highlights
To explore the characteristics and compare clinical outcomes of non-Australian born and Australian-born users of an Australian national digital mental health service
These two steps) were used to form the following six distinct cohorts of online treatment users: (1) non-English-Speaking background (NESB) Asian (South or East Asian regions; Asian language; n = 182); (2) NESB Middle East or North Africa language regions (MidEast) (Middle East or North Africa; Middle Eastern or Arabic language; n = 43); (3) NESB Europe (Europe; European language; n = 115); (4) English-speaking background (ESB) and ESB migrants with a main language spoken at home other than English (n = 30) were excluded; (5) NESB English
NESB English and ESB migrants who access MindSpot tended to have lived in Australia for longer (> 10 years)
Summary
To explore the characteristics and compare clinical outcomes of non-Australian born (migrant) and Australian-born users of an Australian national digital mental health service. Research shows that migrants, especially those of NESB, experience barriers to Kayrouz et al BMC Psychiatry (2020) 20:111 accessing treatment, including low mental health literacy, a lack of suitable services and a lack of trust of services [5], as well as the more universal barriers of stigma and cost [6]. In Australia, there is emerging evidence of increasing uptake of face-to-face treatment by migrants [7], but despite this trend, the use of mental health services by many migrant groups remains low. An important development in the effort to increase access to mental health care for common mental disorders has been the introduction of digital mental health services (DMHS), that is, treatment delivered via the internet. Studies have shown that psychological treatments are just as effective in non-Western countries as they are in Europe and Anglophone countries [11]
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