title: E-Mental Health Innovations for Aboriginal and Torres Strait Islander Australians: A Qualitative Study of Implementation Needs in Health Services.
abstract: BACKGROUND
  Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities.
  
  
  OBJECTIVE
  This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians.
  
  
  METHODS
  Qualitative interviews were conducted with 32 managers, directors, chief executive officers (CEOs), and senior practitioners of mental health, well-being, alcohol and other drug and chronic disease services.
  
  
  RESULTS
  The implementation of e-mental health approaches in this context is likely to be influenced by characteristics related to the adopter (practitioner skill and knowledge, client characteristics, communication barriers), the innovation (engaging and supportive approach, culturally appropriate design, evidence base, data capture, professional development opportunities), and organizational systems (innovation-systems fit, implementation planning, investment).
  
  
  CONCLUSIONS
  There is potential for e-mental health approaches to address mental illness and poor social and emotional well-being amongst Indigenous people and to advance their quality of care. Health service stakeholders reported that e-mental health interventions are likely to be most effective when used to support or extend existing health services, including elements of client-driven and practitioner-supported use. Potential solutions to obstacles for integration of e-mental health approaches into practice were proposed including practitioner training, appropriate tool design using a consultative approach, internal organizational directives and support structures, adaptations to existing systems and policies, implementation planning and organizational and government investment.
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Casuarina , NT, Australia. Stefanie.Puszka@menzies.edu.au.
authors.forename: Stefanie
authors.identifier: http://orcid.org/0000-0002-5008-8122
authors.initials: S
authors.lastname: Puszka
authors.forename: Kylie M
authors.identifier: http://orcid.org/0000-0002-7841-4751
authors.initials: KM
authors.lastname: Dingwall
authors.forename: Michelle
authors.identifier: http://orcid.org/0000-0002-7890-0477
authors.initials: M
authors.lastname: Sweet
authors.forename: Tricia
authors.identifier: http://orcid.org/0000-0002-4123-7229
authors.initials: T
authors.lastname: Nagel
keywords: Indigenous health services; culturally appropriate technology; diffusion of innovation; eHealth; mental health services