Jay with her team at the Clinical Research Unit for Anxiety and Depression (CRUfAD) in Sydney
By Jay Court MACN
In the first article of this two-part series, I spoke about my journey through the nursing profession and how my participation in the Australian College of Nursing’s (ACN) Emerging Nurse Leader program helped me land my current role as Digital Engagement Lead on the THIS WAY UP project. Today, I focus on the TWU project, the speciality of digital mental health nursing and explore how it can be used to improving the wellbeing of the health care workforce.
- THIS WAY UP: An innovative digital mental health service
THIS WAY UP (TWU) is a digital mental health service that uses interactive comic strips to teach Cognitive Behaviour Therapy (CBT) skills in an online format. Unlike telehealth and face to face clinician visits, digital mental health services like TWU offer another treatment modality that is self-guided, asynchronous and instantaneous. This means the treatment can be flexibly accessed by the client at any time or place that is convenient for them, and not just during a one-on-one consultation. In fact, we know that up to 50% of TWU users access the service outside of business hours. We’ve also seen good results when digital mental health is used alongside face-to-face or telehealth therapy to enhance care.
TWU was developed by the Clinical Research Unit for Anxiety and Depression (CRUfAD) which also runs alongside the Anxiety and Depression Clinic (ADC), a tertiary referral centre for anxiety and depression and The Virtual Clinic (VC), where our online programs have been tested in more than 40 randomised controlled trials. The programs are therefore safe, effective and evidence-based and have been shown in our trials to be effective in treating anxiety and depression for 80% of people who complete them. It may come as a surprise to learn that internet-based CBT has been shown to be as effective as face-to-face therapy. Currently, we have over 14,000 clinicians registered to supervise their clients while completing a course, and over 51,000 people across Australia and around the world have used our programs since its inception.
The uncertainty brought on by the COVID-19 pandemic triggered a massive increase in stress and anxiety across the community. To address this growing need, CRUfAD received additional funding and was able to offer all our TWU online treatment programs on stress, anxiety and depression for free. As a result, we have had a spike of 24,000 registrations, demonstrating the scalability of digital mental health treatment options.
- The role of digital mental health in supporting the health care workforce
Nurses are sometimes described as “accidental counsellors” because they work on the frontlines of the health system with families and patients adjusting to life-altering or life-limiting conditions, trauma, shock, uncertainty and death. We know that co-morbidity of mental health and physical conditions, especially chronic conditions, is common, meaning patients presenting with physical issues also frequently have mental health needs. However, many nurses do not receive targeted psychotherapeutic training and instead learn to develop therapeutic communication skills on the job.
I’m a vocal advocate of supporting the mental health of the health care workforce and destigmatising mental health conditions within this cohort. Given the occupational hazards of being a health care worker, which have only been heightened during the COVID-19 pandemic, I’m aiming to raise awareness of high prevalence mental health conditions amongst health care workers, and to empower us to take an active role in managing our own mental health. A major benefit of digital mental health treatment for health care workers is that it is discreet and can fit in well around the demands of shift work. Digital mental health can also work well as an adjunct to other forms of treatment, including face-to-face and telehealth, and it can be useful in maintaining wellness and relapse prevention.
Some of the ways digital mental services can support health care workers include:
- UPSKILLING: I see a huge potential for digital mental health to better equip nurses and healthcare workers more broadly to care for patients experiencing anxiety, depression and distress in clinical settings and in primary care. Completing one of our iCBT courses provides healthcare workers with psychoeducation and a better understanding of the symptomology, emotional experience and treatment strategies for someone experiencing anxiety and/or depression.
- SUPPORTING THE MENTAL HEALTH OF THE HEALTH WORKFORCE: Digital Mental Health treatment programs offer private and timely mental health treatment option to support the Mental Health of the health workforce who may find it difficult or stigmatising to seek help themselves, especially in rural, remote and regional areas. Digital Mental Health treatments are accessible, anonymous and effective. CBT in particular is not only evidence-based, but it is also a first-line treatment in the Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders and anxiety.
I urge you all to check out thiswayup.org.au to explore our free online mental health and wellbeing resources and to find ways to protect your mental health during the COVID-19 pandemic.