Use Of Mental Health Resources Research Articles

Emerging Adult Mental Health Resource Access, Use, and Sufficiency During COVID-19

Purpose While Emerging Adults (EAs) report the highest rates of psychopathology, age-related barriers to access and use of mental health resources (MHR) leave many EAs to struggle. Contextualized within the COVID-19 pandemic, the present study explores factors related to EAs’ perceptions of access, use, and sufficiency of MHR. Method Four hundred twenty-three EAs enrolled in post-secondary education at the onset of the pandemic were recruited for an online survey. An age-related COVID questionnaire and multiple empirically validated measures were used to assess mental health status and MHR use throughout the pandemic. Results Those who reported Reduced or Eliminated Access to MHR during the pandemic were likely to have experienced at least one Change in Residence. Reduced or Eliminated Access to MHR and higher levels of depression accounted for the greatest variance in MHR Sufficiency. Conclusion This study underscores the importance of efforts to expand access to MHR amongst EAs.

Depression, anxiety, and suicidal behaviors in a large-scale national survey of student athletes versus non-athlete college students: risk and protective factors

Objective This study investigates the prevalence and risk factors of internalizing disorders and suicidal behaviors in student-athletes and their non-athlete peers. Participants The sample consisted of 223,226 college students (69,404 student-athletes [31.09%]) who participated in the NCHA-ACHA II survey (Fall 2015–2018). Methods Items from the NCHA-ACHA II were used to assess severity of depression, anxiety, and suicidal behaviors. Chi-squared Test of Independence and multinomial logistic regressions were used to examine self-reported internalizing symptoms, previous diagnosis, previous use of mental health resources, and suicidal behaviors within student-athletes and non-athletes. Results Findings indicated high rates of internalizing symptoms. Student-athletes, both varsity and intramural/club, displayed decreased odds of internalizing symptoms, self-reported mental health diagnosis, and suicidal behaviors. Conclusions This study with a national sample expands previous studies showing concerning rates of mental health difficulties, student-athletes demonstrated lower odds. These findings highlight the importance of further research and need for targeted intervention within this population.

The Mental Health Care Act 2017 and Mental Health Resource Allocation in India

Abstract Mental health policymakers are now tasked with maximizing the efficient and effective use of mental health resources as a result of fundamental changes to mental health laws. A crucial step in this process is ensuring optimal resource allocation across the service. Multiple biases prevent policymakers from allocating resources to mental health, resulting in a violation of the right to health, an increase in suffering, and a heavy economic burden associated with mental illness. This article provides a summary of Indian mental health policy, examines Indian public perceptions of mental health, and assesses the impact of these perceptions on legislation and mental health resource allocation. Understanding resource allocation from the perspective of policymakers can enhance psychiatrists’ ability to influence the process.

Mental distress and virtual mental health resource use amid the COVID-19 pandemic: Findings from a cross-sectional study in Canada.

This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress. Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults (N = 3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use. Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons. This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.

Lessons for mental health systems from the COVID-19 front line: Chinese healthcare workers’ challenges, resources, resilience, and cultural considerations.

Frontline health providers who worked in Hubei, China, during the initial outbreak of the novel coronavirus (COVID-19) experienced poorer mental health outcomes than those who worked elsewhere in China, but many of these workers denied psychological challenges and did not use resources when offered. This study investigated challenges, mental health, sources of strength, and coping strategies among frontline healthcare professionals working in the initial Hubei COVID-19 outbreak. Healthcare workers (N = 23) who went to Hubei during the COVID-19 outbreak completed a semistructured interview about their experiences at the front line and use of mental health resources. Thematic analysis revealed several challenges participants faced as a result of their work conditions. The vast majority of participants reported physical and psychological symptoms. Nevertheless, some denied experiencing any distress, and none accessed psychological assistance as a way of self-care. Participants described their social network as particularly helpful as they were coping with the intensive work demands and that their strong sense of responsibility for patients and trust in the medical system were sources of strength. Our findings highlight that even in the face of stress-related challenges, healthcare workers may not seek care for their physical and psychological symptoms, which may lead to persistent mental health consequences. Implications for providing mental health services to healthcare providers and first responders are discussed in the Chinese cultural and societal context;we offer considerations for bridging health resources in China with the potential for establishing a more responsive and equitable mental health infrastructure. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

The impact of COVID-19 on teachers' mental health

PurposeThe purpose of this paper is to examine teachers’ experiences with mental health during the COVID-19 pandemic.Design/methodology/approachThe authors administered an online survey to full-time public school teachers simultaneously enrolled in a master’s degree program in education. Out of 455 teachers who were sent the survey, 96 completed it, resulting in a 21.1% survey completion rate. The survey was composed of both quantitative and qualitative items which assessed teachers’ self-perceptions about their mental health before and during the COVID-19 pandemic, as well as their use of mental health resources. Most questions were drawn from the Patient Health Questionnaire-4 (PHQ-4), so focused primarily on symptoms of depression and anxiety.FindingsThe results of the survey indicated that overall, teachers felt an increase in symptoms of anxiety and depression between March 2020 and February 2021. A noteworthy percentage of participants said they were seeking mental health supports.Research limitations/implicationsThis study was conducted with teachers in an alternative certification program, so their experiences might not be widely generalizable to teachers enrolled in traditional pathways to certification.Originality/valueWhile some research has been conducted on mental health, less has been conducted with public school teachers and even less has assessed the impact of the COVID-19 pandemic. This study aims to add to the existing literature about teachers' experiences with anxiety and depression, as well as the specific impact of COVID-19.

Increased paediatric emergency mental health and suicidality presentations during COVID-19 stay at home restrictions.

ObjectiveAnecdotal reports indicate an increase in mental health presentations and acuity to EDs during the COVID‐19 pandemic and associated stay at home restrictions. Paediatric and adolescent data to confirm this are unavailable in the Australian setting.MethodsRetrospective electronic medical record review of all ED patients with mental health discharge codes at a large tertiary children's hospital in Australia during the period of stay at home restrictions from 1 April to 30 September 2020 compared with the same dates in 2019.ResultsWe found a 40% decrease in ED presentations (18 935–11 235) with a concurrent 47% increase in mental health presentations (809–1190) to ED during the study periods between 2019 and 2020. This resulted in an increase of 100 mental health admissions from ED. Diagnoses with greatest percentage increases were eating disorders, social issues and suicidality. We found suicidality presentation numbers were highest in June to September 2020 compared with 2019. Patients with a diagnosis of suicidality had a higher rate of re‐presentation in 2020 (1.83 presentations per patient) compared to 2019 (1.38 presentations per patient).ConclusionsDespite an overall decrease in ED presentations, the absolute increase in mental health presentations for children and adolescents during the stay at home restriction period was pronounced. It is unclear how sustained this change and the impact on mental health resource use will be post‐pandemic.

Access to Mental Health Care during the First Wave of the COVID-19 Pandemic in Italy: Results from the COMET Multicentric Study.

The COVID-19 pandemic represents an unprecedented public health emergency, with consequences at the political, social, and economic levels. Mental health services have been called to play a key role in facing the impact of the pandemic on the mental health of the general population. In the period March–May 2020, an online survey was implemented as part of the Covid Mental Health Trial (COMET), a multicentric collaborative study carried out in Italy, one of the Western countries most severely hit by the pandemic. The present study aims to investigate the use of mental health resources during the first wave of the pandemic. The final sample consisted of 20,712 participants, mainly females (N = 14,712, 71%) with a mean age of 40.4 ± 14.3 years. Access to mental health services was reported in 7.7% of cases. Among those referred to mental health services, in 93.9% of cases (N = 1503 subjects) a psychological assessment was requested and in 15.7% of cases (N = 252) a psychiatric consultation. People reporting higher levels of perceived loneliness (OR 1.079, 95% CI 1.056–1.101, p < 0.001), practicing smart-working (OR 1.122, 95% CI 0.980–1.285, p = 0.095), using avoidant (OR 1.586, 95% CI 1.458–1.725, p < 0.001) and approach (OR 1.215, 95% CI 1.138–1.299, p < 0.001) coping strategies more frequently accessed mental health services. On the other hand, having higher levels of perceived social support (OR 0.833, 95% CI 0.795–0.873, p < 0.001) was associated with a reduced probability to access mental health services. The COVID-19 pandemic represents a new threat to the mental health and well-being of the general population, therefore specific strategies should be implemented to promote access to mental healthcare during the pandemic and afterwards.

Survivorship care planning, quality of life, and confidence to transition to survivorship: a randomized controlled trial with women ending treatment for breast cancer

Purpose The Polaris Oncology Survivorship Transition (POST) system is a computer-based program that integrates information from the electronic health record, oncology team, and the patient to produce a personalized Survivorship Care Plan. The purpose of this study was to compare the POST to treatment as usual on confidence, quality of life, and interest in mental health referrals in women ending treatment for breast cancer. Sample Two hundred women (100 POST, 100 treatment as usual) ending treatment for breast cancer were enrolled in a randomized controlled trial. Design Women randomized to the POST condition received a personalized care plan during a baseline/intervention appointment. At enrollment and baseline/intervention, a number of outcomes were examined in this study, including confidence to enter survivorship measured by the Confidence in Survivorship Index (CSI) and Quality of Life (QOL). One, three, and six month follow up assessments were also conducted. Findings Treatment groups did not differ in terms of QOL scores at any time points. Mean CSI scores were statistically different between POST and treatment as usual at baseline for the total CSI score and both subscales, but only for confidence in knowledge about prevention and treatment at the 1-month follow-up. All significant differences were in favor of the POST intervention as mean CSI scores were higher for participants who received the POST intervention as opposed to treatment as usual. These findings disappeared at the 3 and 6 month follow up assessments. Finally, patients who received the POST intervention were twice as likely to request mental health/social services referrals compared to women who received treatment as usual. Implications Oncologists may use the POST to build personalized care plans for women ending treatment for cancer, which may enhance patients’ confidence in the short term as well as encourage use of mental health resources.

Mental Health Resource Use Among Patients Undergoing Curative Intent Treatment for Bladder Cancer.

Patients with bladder cancer may experience mental health distress. Mental health-care service (MHS) use can quantify the magnitude of the problem. The Ontario Cancer Registry was used to identify all patients with bladder cancer treated with curative-intent cystectomy or radiotherapy in Ontario, Canada (2004-2013). Population-level databases were used to identify MHS use (visits to general practitioner, psychiatrist, emergency department, or hospitalization). Generalized estimating equations were used to compare rates of MHS use. Baseline, peritreatment, and posttreatment MHS use were defined as visits from 2 years to 3 months before, 3 months before to 3 months after, and from 3 months after to 2 years after start of treatment, respectively. From 2004 to 2013, 4296 patients underwent cystectomy (n = 3332) or curative-intent radiotherapy (n = 964). Compared with baseline, the rate of MHS use was higher in the peritreatment (adjusted rate ratio [aRR] = 1.64, 95% confidence interval [CI] = 1.48 to 1.82) and posttreatment periods (aRR = 1.45, 95% CI =1.30 to 1.63). By 2 years posttreatment, 24.6% (95% CI = 23.4% to 25.9%) of all patients had MHS use. Patients with baseline MHS use had substantially higher MHS use in the peritreatment (aRR = 5.77, 95% CI = 4.86 to 6.86) and posttreatment periods (aRR = 4.58, 95% CI = 3.78 to 5.55). Female patients had higher use MHS use overall, but males had a higher incremental increase in the posttreatment period compared with baseline (2-sided Pinteraction = .02). Male patients had a statistically significant increase in MHS use following surgery or radiotherapy, whereas female patients only had an increase following surgery. MHS use is common among patients undergoing treatment for bladder cancer, particularly in the peritreatment period. Screening for mental health concerns in this population is warranted.

Predictors of Psychological Distress and Mental Health Resource Utilization among Employees in Malaysia.

We sought to examine predictors of psychological distress among employees as well as the level of awareness and usage of available mental health resources by employees through their own organizations. The Malaysian Healthiest Workplace survey cross-sectional dataset was used to explore the association between psychological distress, a range of health conditions, as well as mental health resource awareness and usage in a sample of 11,356 working Malaysian adults. A multivariate logistic regression was conducted to determine predictors of high psychological distress. Comorbid illnesses that were associated with psychological distress were mental illness (OR 6.7, 95% CI 4.39–10.14, p = 0.001), heart conditions (OR 2.17, 95% CI 1.18–3.99, p = 0.012), migraines (OR 1.59, 95% CI 1.33–1.90, p = 0.001), bronchial asthma (OR 1.43, 95% CI 1.11–1.85, p = 0.006), and hypertension (OR 1.42, 95% CI 1.07–1.88, p = 0.016) compared to individuals with no comorbid conditions. A total of 14 out of 17 comorbid medical illnesses were associated with elevated levels of psychological distress among employees. Awareness and usage of support services and resources for mental health were associated with lower psychological distress. These findings extend the literature by providing further evidence on the link between chronic illness, occupational type, as well as awareness and use of mental health resources by psychological distress status.

4.67 Evaluation of Trainee Knowledge and Use of Mental Health Resources in the Community for Patients Who Do Not Speak English as a First Language

4.67 Evaluation of Trainee Knowledge and Use of Mental Health Resources in the Community for Patients Who Do Not Speak English as a First Language

A 6-Month, Prospective, Randomized Controlled Trial of Customized Adherence Enhancement Versus Bipolar-Specific Educational Control in Poorly Adherent Individuals With Bipolar Disorder.

Nonadherence in bipolar disorder (BD) ranges from 20% to 60%. Customized adherence enhancement (CAE) is a brief, BD-specific approach that targets individual adherence barriers. This prospective, 6-month, randomized controlled trial conducted from October 2012 to July 2017 compared CAE versus a rigorous BD-specific educational program (EDU) on adherence, symptoms, and functional outcomes in poorly adherent individuals. One hundred eighty-four participants with DSM-IV BD were randomized to CAE (n = 92) or EDU (n = 92). Primary outcome was adherence change measured by the Tablets Routine Questionnaire (TRQ) and BD symptoms measured by the Brief Psychiatric Rating Scale. Other outcomes were scores on the Global Assessment of Functioning, Montgomery-Asberg Depression Rating Scale, Young Mania Rating Scale, and Clinical Global Impressions Scale. Assessments were conducted at screening, baseline, 10 weeks, 14 weeks, and 6 months. The sample mean (SD) age was 47.40 (10.46) years; 68.5% were female, and 63.0% were African American. At screening, individuals missed a mean (SD) of 55.15% (28.22%) of prescribed BD drugs within the past week and 48.01% (28.46%) in the past month. Study attrition was < 20%. At 6 months, individuals in CAE had significantly improved past-week (P = .001) and past-month (P = .048) TRQ scores versus those in EDU. Past-week TRQ score improvement remained significant after adjustment for multiple comparisons. There were no treatment arm differences in BPRS scores or other symptoms, possibly related to low symptom baseline values. Baseline-to-6-month comparison showed significantly higher GAF scores (P = .036) for CAE versus EDU. Although both groups used more mental health services at 6 months compared to baseline, increase for CAE was significantly less than that for EDU (P = .046). Whereas both CAE and EDU were associated with improved outcomes, CAE had additional positive effects on adherence, functioning, and mental health resource use compared to EDU. ClinicalTrials.gov identifier: NCT00183495.

ASSOCIATIONS BETWEEN FUNCTIONAL MILESTONES AND PSYCHIATRIC ADMISSIONS IN AN URBAN AREA: UTILITY OF A CLUSTER-ANALYTICAL APPROACH

The purpose of the study was to identify homogenous subgroups, based upon achievement of two functional milestones (marriage and employment) and Global Assessment of Functioning (GAF) score in a sample of 848 acute patients admitted to the Psychiatric Emergency Service (PES) of the Città della Salute e della Scienza di Torino, during a 24-months period. A two-step cluster-analysis, using GAF total score and the achievements in the two milestones as input data was performed. In order to examine whether the identified subgroups differed in external variables that were not included in the clustering process, and consequently to validate the found functional profiles, chi-square tests for categorical variables and analyses of variance (ANOVA) for continuous variables were performed. Five clusters were found. Employed patients (Clusters 4 and 5) had more years of education, less illness chronicity (shorter duration of illness and lower proportion of previous voluntary hospitalizations), lower use of mental health resources in the last year yet higher treatment adherence, larger network size, and higher ordinary discharge. Married inpatients (Clusters 3 and 5) had lower frequencies of substance abuse. The remarkably high rate of unemployment in this inpatients' sample, and the evidence of associations between unemployment and poorer functioning, argue for further research and development of evidence-based supported employment programs, that put forth diligent effort in helping people obtain work quickly and sustain; they may also help to reduce health care service use among that clientele.

Improving Resident Use of Mental Health Resources: It's Time for an Opt-Out Strategy to Address Physician Burnout and Depression (Commentary).

Improving Resident Use of Mental Health Resources: It's Time for an Opt-Out Strategy to Address Physician Burnout and Depression (Commentary).

Promoting Mental Health Resource Use on Campus by "Trying Something New".

To design and test a persuasive health promotion campaign that aligns with the qualities of trying something new for the first time. Given that a majority of students have not previously sought/considered professional mental health assistance before, the hypothesis tested in this study asked whether a campaign that takes this into account is effective with this audience. Participants viewed an online informational message (n = 84), information message plus first-time experience banner (n = 99), or 1 of 4 full campaigns, each depicting a student story and photo about a first-time experience (moving from home [n = 48], skydiving [n = 52], acting in a play [n = 48], and exercising with personal trainer [n = 48]). Visual poster items: appeal (visually pleasing, 7 items, α = .92), support (value of poster, 5 items, α = .86) and behavioral intention items: engagement (participant seek help/pay attention, 3 items, α = .86), relevance (content as relevant, 3 items, α = .84), and judgment (judgment of others for not seeking help, 2 items, α = .87). College students (N = 380). In comparison to information-only messages, framing mental health help seeking as a first-time experience was linked with increased appeal, support, and engagement (Minformationonly = 2.79 [standard deviation, SD = 1.34], Minformationplusbanner = 3.25 [SD = 1.23], Mfullcampaign = 4.07 [SD = 1.28], P < .001, Minformationonly = 4.38 [SD = 1.47], Minformationplusbanner = 4.92 [SD = 1.21], Mfullcampaign = 4.57 [SD = 1.26], P = .014, and Minformationonly = 3.13 [SD = 1.76], Minformationplusbanner = 3.56 [SD = 1.48], Mfullcampaign = 4.02 [SD = 1.42], P < .001, respectively). As anticipated, the full campaign garnered the highest affect and engagement scores. When comparing the 4 first-time experiences, there were main effects on support and engagement (Mtrain = 5.06 [SD = 1.17], Mplane = 4.27 [SD = 1.28], Mhome = 4.59 [SD = 1.19], Mplay = 4.38 [SD = 1.29], P = .009 and Mtrain = 4.50 [SD = 1.27], Mplane = 3.75 [SD = 1.43], Mhome = 4.01 [SD = 1.49], Mplay = 3.84 [SD = 1.39], P = .042, respectively), with the novel experience of "working with a personal trainer" rated highest. Findings from this study have implications for the design of health promotion materials on college campuses. Specifically, campaigns that frame seeking help for mental health as a new experience potentially increase student engagement in this behavior. A key finding from the present study is that a campaign in which this behavior is linked to a familiar form of interpersonal help seeking (personal training) can create receptivity to the stigmatized issue of mental health help seeking.

Do College Students Use Online Self-Help? A Survey of Intentions and Use of Mental Health Resources

ABSTRACTOnline self-help may help increase the reach of mental health services for college students, but little research has examined students’ actual interest/use of these resources. An online survey of 389 college students examined intentions and use of online mental health resources as compared with other support options. Findings indicated the highest intentions/use of informal supports (e.g., parents, friends) for mental health problems and lowest intentions/use for online self-help. However, a subset of students showed a preference for online self-help over other forms of support. Participants were also more likely to request online self-help resources (21%) than in-person therapy resources (9%) when offered these options. Reported barriers were also identified for using mobile applications (apps) specifically (e.g., stigma, credibility, privacy). Overall, results suggest mixed findings and relatively low interest for use of online self-help among college students, while highlighting potential barriers that might be addressed to increase engagement.

Predictors in use of mental health resources: The role of behaviour problems in patients with severe mental illness

In recent years, more variables are being included in the use of mental health resource prediction models. Some studies have shown that how well the patient can function is important for this prediction. However, the relevance of a variable as important as behaviour problems has scarcely been explored. This study attempted to evaluate the effect of behaviour problems in patients with severe mental illness on the use of mental health resources. A total of 185 patients at a Community Mental Health Unit were evaluated using the Behaviour Problem Inventory. Later, a bivariate logistic regression was done to identify what behaviour problems could be specific predictors of use of mental health resources. The results showed that the general index of behaviour problems predicts both use of hospitalization resources and outpatient attention. Underactivity/social withdrawal is the best predictor of all the different areas. These results confirm the role of behaviour problems as predictors of the use of mental health resources in individuals with a severe mental illness.

Relationship between behavioural problems and use of mental health services in patients with severe mental illness and the mediating role of the perceived burden of care

Mental health models proposed for predicting more use of mental health resources by patients with severe mental illness are including a wider variety of predictor variables, but there are still many more remaining to be explored for a complete model. The purpose of this study was to enquire into the relationship between two variables, behaviour problems and burden of care, and the use of mental health resources in patients with severe mental illness. Our hypothesis was that perceived burden of care mediates between behaviour problems of patients with serious mental illness and the use of mental health resources. The Behaviour Problem Inventory, which was filled out by the main caregiver, was used to evaluate 179 patients cared for in a community mental health unit. They also answered a questionnaire on perceived family burden. A structural equation analysis was done to test our hypothesis. The results showed that both the behaviour problems and perceived burden of care are good predictors of the use of mental health resources, where perceived burden of care mediates between behaviour problems and use of resources. These variables seem to be relevant for inclusion in complete models for predicting use of mental health resources.

Psychogeriatric SOS: A unique clinician-to-clinician web-based service for rural and remote clinicians

Introduction: The Norwegian Anti-Discriminatory and Accessibility Act adopted in 2008 states that web based electronic services geared towards the public should be accessible to all. Today, the web content accessibility guidelines (wcag-2) is an agreed standard in Norway. However, it should be fair to state that the developers of Norwegian e-health services have not focused on universal design to any particular extent. To obtain a brief estimate of the status in the field, we have investigated the accessibility to some randomly selected e-health services, applying a ad hoc user panel of 4 persons. Methods and materials: We have during 2015 set up a Windows 7 machine with NVDA synthetic speech output and a Brazie Powerbraille display installed. Using Mozilla Firefox, we have investigated the accessibility to 11 Norwegian web based health services. Our investigation included state, municipal and private service providers. The wcag-2 standard and “Referansekatalogen for e-helse” constituted the point of offset for our evaluation. Four users were given specific tasks in connection with each website, and we observed and interviewed the informants as they interacted with each service. We focused especially on the users' ability to operate the services with the keyboard, and if all the functionality on the web pages could be utilized without applying a mouse. Results: The Helseportalen (https://helsenorge.no) provides access to the electronic health record for Norwegian citizens and constitutes a major national initiative in the field of e-health. To which extent can this service be regarded as universally accessible? The html code was found to be robust and consistent, and the functionality, which we investigated, could be operated by the keyboard. This was not true for all of the services, which we evaluated. The login to Helseportalen can be done with mobile bank id, or by a code generator equipped with synthetic speech. However, the initial registration of login method could not be performed by our users. The login to Helseportalen relies on services from private enterprises, and are not necessarily free of charge. The quality of the code on the various sites varied considerably, which potentially causes problems for users of peripheral equipment. Inconsistent use of html headline-tags slows down navigation on several of the evaluated pages. Multimedia content is not followed by a descriptive text (not required by wcag-2 level aa). Discussion: If the construction of e-health services is regarded a work process involving planning, prototyping, implementation, testing, refinement and documentation, the users should be involved in each of this phases to ensure accessibility to the services made. User oriented design methods have a stronghold in Scandinavia, but if for economic or practical reasons such approaches are not regarded feasible, expert evaluations with emphasis on accessibility should be performed on each stage in the development cycle. Background : Rural mental health services are under-resourced and over-burdened. Given the aging population and escalating health costs, we need to innovate to solve this resourcing crisis. Psychogeriatric SOS is a unique service that offers information, advice, supervision, training, education and case conferencing to rural and remote clinicians working with older adults across all disciplines, allowing them to establish a supportive professional relationship with our psychogeriatric multidisciplinary team via a web-conferencing platform. This nascent service has the potential to be a pathway for more efficient use of time for primary clinicians and specialty psychogeriatric services. Aims: To describe rural clinician/user demographics, delineate how this model satisfies unmet clinician professional needs, and determine whether it improves clinician confidence. It will also provide a forum in which members of the Australian GP community can make comments and suggestions. Methods: Rural and remote clinicians in three under-resourced local health districts in NSW and one NGO were provided this service in 2015. During the first 12 months, demographic data, uptake rates, user satisfaction, and pre- and post- intervention clinician confidence measures were collected. Results: 100 registrants participated in a combination of 15 education forums, 25 case conferences and 14 supervision sessions. Confidence questionnaires indicated confidence depended on clinician, context of practice, and number of years practicing (with those having worked 1-5 years being the most confident followed by those having worked more than 21 years). The most prominent areas of need identified by clinicians were educating patients’ carers, and education and case conferencing around clinical psychogeriatric issues. All users returned to use the service more than once. Conclusion: There is a need for the Psychogeriatric SOS model of e-health rural outreach, which may constitute a step towards the more efficient and effective use of mental health resources in rural and remote Australia.