title: Online mental health resources in rural Australia: clinician perceptions of acceptability.
abstract: BACKGROUND
  Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients.
  
  
  OBJECTIVE
  To understand rural clinicians' attitudes towards the acceptability of online mental health resources as a treatment option in the rural context.
  
  
  METHODS
  In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method.
  
  
  RESULTS
  Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources.
  
  
  CONCLUSIONS
  Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing services, and provide opportunities for renegotiating the socially defined role of the clinician in the eHealth era.
authors.affiliation: Rural Clinical School of Western Australia, University of Western Australia, Perth, Australia. craig.sinclair@rcswa.edu.au
authors.forename: Craig
authors.identifier: 0000-0003-2734-2951
authors.initials: C
authors.lastname: Sinclair
authors.forename: Kristi
authors.initials: K
authors.lastname: Holloway
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Riley
authors.forename: Kirsten
authors.initials: K
authors.lastname: Auret
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000706:statistics & numerical data; D017216:Telemedicine / Q000706:statistics & numerical data
keywords: Internet; mental health; qualitative research; rural health