Abstract
BackgroundOnline preventive interventions can help to reduce the incidence of mental disorders. Whereas knowledge on stakeholders’ attitudes and factors relevant for successfully integrating online treatment into existing healthcare systems is available, knowledge is scarce for online prevention.MethodsStakeholders from Germany, Switzerland, Austria and Spain were surveyed. Potential facilitators/delivery staff (e.g. psychologists, psychotherapists) completed an online questionnaire (n = 183), policy makers (i.e. from the governing sector or health insurance providers) participated in semi-structured interviews (n = 16) and target groups/potential users of mental illness prevention (n = 49) participated in ten focus groups. Thematic analysis was used to identify their experiences with and attitudes and needs regarding online programmes to prevent mental disorders. Additionally, it was examined which groups they consider underserved and which factors they consider as fostering and hindering for reach, adoption, implementation and maintenance (cf. RE-AIM model) when integrating online prevention into existing healthcare systems.ResultsMain advantages of online mental illness prevention are perceived in low structural and psychological barriers. Lack of personal contact, security, privacy and trust concerns were discussed as disadvantages. Relevant needs are high usability and target group appropriateness, evidence for effectiveness and the use of motivational tools.ConclusionsPositive attitudes among stakeholders are the key for successful integration of online mental illness prevention into existing healthcare systems. Potential facilitators/delivery staff must receive training and support to implement these programmes; the programmes must be attractive and continuously evaluated, updated and promoted to ensure ongoing reach; and existing infrastructure and contextual factors must be considered.
Highlights
European healthcare systems are facing enormous challenges at various levels, whereby mental disorders are regarded as one of the most pressing issues with 13% of the global burden of disease attributable to them.[1]
We obtained 183 online questionnaires from potential facilitators/delivery staff (F), conducted 16 interviews with policy makers (PMs) and 10 focus groups involving a total of 49 participants representing the target groups (TGs)/potential users of the individual programs (TG)
The emerging themes across all stakeholder groups, countries and topics did not differ. This points to the positive fact, that there seems to be a common understanding regarding the implementation of online interventions to prevent mental health disorders into existing healthcare systems in Europe
Summary
European healthcare systems are facing enormous challenges at various levels, whereby mental disorders are regarded as one of the most pressing issues with 13% of the global burden of disease attributable to them.[1]. Whereas knowledge on stakeholders’ attitudes and factors relevant for successfully integrating online treatment into existing healthcare systems is available, knowledge is scarce for online prevention. Thematic analysis was used to identify their experiences with and attitudes and needs regarding online programmes to prevent mental disorders. It was examined which groups they consider underserved and which factors they consider as fostering and hindering for reach, adoption, implementation and maintenance (cf RE-AIM model) when integrating online prevention into existing healthcare systems. Conclusions: Positive attitudes among stakeholders are the key for successful integration of online mental illness prevention into existing healthcare systems. Potential facilitators/delivery staff must receive training and support to implement these programmes; the programmes must be attractive and continuously evaluated, updated and promoted to ensure ongoing reach; and existing infrastructure and contextual factors must be considered
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