title: The first 30 months of the MindSpot Clinic: Evaluation of a national e-mental health service against project objectives.
abstract: OBJECTIVE
  The MindSpot Clinic provides online mental health services to Australian adults with anxiety and depression. This paper describes users of MindSpot between January 2013 and June 2015. Outcomes are considered against three key objectives: improving access to mental health services, improving public awareness of how to access services and providing evidence-based treatments.
  
  
  METHODS
  Website traffic data were examined to determine patterns of use. Demographic characteristics, past service utilisation and reasons for contacting MindSpot were analysed. Outcomes for patients enrolled in a MindSpot treatment course were also analysed. Primary outcomes were scores on the 9-Item Patient Health Questionnaire, Generalised Anxiety Disorder 7-Item, Yale-Brown Obsessive Compulsive Scale and Post-Traumatic Stress Disorder Checklist-Civilian Version, administered at assessment, post-treatment and 3-month follow-up.
  
  
  RESULTS
  The website was visited by almost 500,000 Australians, of which 33,990 adults started assessments, and 25,469 people completed assessment and were eligible for analysis. Mean age was 36.4 years (standard deviation = 13.3 years; range = 18-94 years), and 72% were female. The proportion living in rural or remote regions and who identified as Aboriginal and Torres Strait Islander closely matched national statistics. The majority (82%) reported that they were not currently in contact with mental health services. Most patients sought an assessment, information about treatment options, or referral to another service, and only 24% of those completing an assessment commenced a MindSpot treatment course. Of these, large clinical effects ( d: 0.7-2.4; average symptom reductions: 25.5% to 61.6%) were found from assessment to follow-up on all outcome measures. Deterioration ranged from 1.0% to 4.3%.
  
  
  CONCLUSIONS
  Based on the number of website visits, completed assessments and treatment outcomes, MindSpot achieved its three programme objectives. This model of service provision has considerable value as a complement to existing services, and is proving particularly important for improving access for people not using existing services.
authors.affiliation: 1 Department of Psychology, Macquarie University, Sydney, NSW, Australia.|2 MindSpot Clinic, Sydney, NSW, Australia.|3 eCentreClinic, Macquarie University, Sydney, NSW, Australia.
authors.forename: Nickolai
authors.initials: N
authors.lastname: Titov
authors.affiliation: 1 Department of Psychology, Macquarie University, Sydney, NSW, Australia.|2 MindSpot Clinic, Sydney, NSW, Australia.
authors.forename: Blake F
authors.initials: BF
authors.lastname: Dear
authors.affiliation: 1 Department of Psychology, Macquarie University, Sydney, NSW, Australia.|2 MindSpot Clinic, Sydney, NSW, Australia.
authors.forename: Lauren G
authors.initials: LG
authors.lastname: Staples
authors.affiliation: 4 Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Bennett-Levy
authors.affiliation: 5 Faculty of Health, Federation University Australia, Ballarat, VIC, Australia.
authors.forename: Britt
authors.initials: B
authors.lastname: Klein
authors.affiliation: 1 Department of Psychology, Macquarie University, Sydney, NSW, Australia.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Rapee
authors.affiliation: 6 Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.affiliation: 2 MindSpot Clinic, Sydney, NSW, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Purtell
authors.affiliation: 2 MindSpot Clinic, Sydney, NSW, Australia.
authors.forename: Greg
authors.initials: G
authors.lastname: Bezuidenhout
authors.affiliation: 2 MindSpot Clinic, Sydney, NSW, Australia.
authors.forename: Olav B
authors.initials: OB
authors.lastname: Nielssen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D001315:Australia / Q000453:epidemiology; D015928:Cognitive Behavioral Therapy / Q000706:statistics & numerical data*; D054626:Consumer Health Information / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D055317:Evidence-Based Practice / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Internet treatment; anxiety; cognitive behaviour therapy; depression; service implementation