Program Overview
Project Methodology
Objective
The aim of this project is to identify and summarize online mental health resources available across the 21 countries of the Asia-Pacific Economic Corporation (APEC) region. To our knowledge, there is currently no formal collection of online mental health resources available for the APEC Digital Hub. This project focused on compiling a catalogue of current online mental health resources in response to emerging concerns that Covid-19 and associated emergency public health measures are both exacerbating mental health conditions and limiting access to in-person resources and services. The resulting catalogue will form an online global resource to assist public health practitioners identify new models and interventions to treat depression and mental wellness for their clients.
Methodology
The project used an exploratory research approach to determine the resources available. Initially, an exploratory search of online mental health evaluations, approaches, and interventions was undertaken on PubMed and Google Scholar to provide context. Then a wide-ranging Google-led search was used to identify online mental health resources for each region. Google was used in order to identify both established and emerging governmental, private, and NGO-online mental health resources. While COVID-19 and emergent services were a priority for this search, the study utilized an exhaustive search method in order to include all comprehensive mental health services that fit the evaluation criteria listed below. We sought additional resources by “snowballing” through grey literature such as government websites, news articles, as well as links affiliated with social media platforms Instagram and Facebook.
Method
First, a search was completed for North American Countries within the APEC region (Canada, Mexico, and the United States). A survey of Indigenous resources was conducted additionally in Australia, Canada, and New Zealand. Second we searched for resources in Australia and New Zealand. Next we completed a review of services in South America (Chile and Peru), China, Hong Kong, Japan, Korea, Japan, Malaysia, Philippines, Singapore, Thailand, Brunei, Papau New Guinea, Russia, Tai Pei, and Vietnam.
Services that fit into our criteria were collected into a catalogued document according to region and service. Additionally, due to the rapid-changing nature of mental health information and services during the pandemic, services that were found were confirmed twice during the review process.
The review was also opened to members of the APEC TEAM-CAP’s Digital Hub. This action was to ensure that the catalogue would have the oppourtunity to include feedback and resources from researchers in different countries across the Asia-Pacific region.
Search Strategy and Inclusion and Exclusion Criteria
Search Strategy
The Google review began on June 22, 2020 and was completed in late August. In the search for web-based internet tools and resources, keywords related to mental health and mental health services (“eHealth” “mental health” “wellbeing” “counselling services” “mental health help line” “online mental health services”) were used. Initially, articles were also included to provide breadth and context for the search in a pandemic world.
A search in English was first conducted for countries that spoke other languages. However, we knew that this would likely skew the quantity of our findings, so we also implemented a reverse translation method in each country’s national languages using our keywords through the Google Translate Search Engine.
Four major categories of e-mental health interventions emerged: wellness apps, wellness websites, crisis lines and online counselling services. A fifth smaller category emerged of learning resources (courses and podcasts). In addition to these categories, resources aimed specifically for children were included as a separate section. Additionally, a Google search specifically for Indigenous services in Australia, Canada, New Zealand, and the United States was conducted and documented in a separate section.
Inclusion and Exclusion Criteria
Resources were eligible for inclusion if (1) the background of the founders, organization, and funding were available on the website or app, (2) the site was associated with a well-known reputable organization or government department, (3) they provided a service for a marginalized population, (4) they were accessible and relatively low-cost and accessible to a large demographic. Using John Torous’ (Tourous, et al., 2019) framework for mHealth standards we evaluated wellness resources based on data safety and privacy, app effectiveness, and user experience and adherence. While Torous (2019) suggests that apps should allow for appropriate electronic health record (EHR) integration, this review did not explicitly evaluate apps based on internal data characteristics. Due to the breadth of this review, there was not enough time to determine whether a particular service provided health record integration to primary care providers as an aspect of its service. Additionally, many of the resources (learning resources, guided meditations, journal prompts) did not have interactive components that housed data pertinent for the individual’s primary care provider and health records. When evaluating counselling services, private practices were excluded due to the large volume of private counselling practices, especially given that the pandemic has led to a shift to online platforms for many private practices.
Resources were excluded if they did not meet this criteria, and/or if the resource was deleted during the site-confirmation components of this review, or if the intervention was inaccessible or too costly.
Search Results
After the review, a total of 257 resources were found. 56 of these resources were deleted, as upon further examination, they did not meet the standards of our criteria framework. 201 resources were included in the catalogue.
Apps: 30
Counselling: 45
Websites: 76
Crisis Lines: 21
Children’s Resources: 8
Online Courses: 4
Podcasts: 2
Indigenous Services 15
If a particular platform offered additional resources (articles, videos, interactive toolkits) in addition to online therapy services and a helpline, they were categorized under the Wellness Website section.
References
Torous, J., Andersson, G., Bertagnoli, A., Christensen, H., Cuijpers, P., Firth, J., Haim, A., Hsin,
H., Hollis, C., Lewis, S., Mohr, D., Pratap, A., Roux, S., Sherrill, J., & Arean, P. (2019). Towards a consensus around standards for smartphone apps and digital mental health. World Psychiatry, 118(1), 97-98.
DOI:10.1002/wps.20592