EMOTIONAL HEALTH
May 31, 2016

Mental Health Via Email

Online mental health services can help people with anxiety and depression. Good news for those with little access to therapy.

Access to good mental health care is not as easy as it should be. Many people can’t get the care they need, either because it’s too far away or too expensive. But help may be a few clicks away.

Email-based and online mental health programs can deliver therapy that is effective at a much lower cost, new studies are finding. Which can go a long way in helping people recover from mental health issues like depression and anxiety.

People who did the therapy-based exercises for the full two years had the most marked improvements in mental health and well-being.

About 73,000 people were recruited through a reality show in Finland for the study. The participants filled out questionnaires about their health, lifestyle, psychological well-being and resilience to stress. Of the total number, roughly 43,000 were assigned to receive an email treatment. The others served as a control group who didn’t receive the treatment.

People in the treatment group received emailed information and exercises based on solution-focused therapy, cognitive behavior therapy (CBT) and positive psychology. The group receiving therapy also chose between interpersonal therapy, which included information on improving social relationships or solving conflicts, and lifestyle interventions, which included information on quitting smoking, managing weight or developing an exercise routine.

The researchers, from Finland’s National Institute for Health and Welfare, did follow-up assessments at two months and two years. There was a high dropout rate, but those participants who did the therapy-based exercises for the full two years had the most marked improvements in mental health and well-being.

In addition, people who chose the interpersonal treatment option had improvements in confidence in the future and gratitude. Those who focused on lifestyle interventions showed improvements only at the two-month mark, but not at the two-year mark. “We were delighted to see that the effects of the interventions appeared to be consistent across all measures of wellbeing, and that small effects were observed even two years later,” said study author, Minna Torniainen-Holm, in a news release. “These results suggest that the improvement may be long-lasting.”

A computerized cognitive behavioral therapy (CCBT) online program called Beating the Blues was also very effective in helping people relieve the symptoms of those diagnosed with anxiety and depression, according to another recent study, this one from the University of Pittsburgh.

Participants who had both disorders were divided into three groups: one group was offered eight sessions of CCBT over six months; another received the same CCBT online program and participated in an online support group; a third group received standard care through their physician.

People in both treatment groups had significant reductions in their depression and symptoms of anxiety. The more sessions they completed (the average was just over five), the better they fared at the end. People who took part in the online CCBT and the support group had better results than those just receiving CCBT.

One of the benefits of online treatment is that it can be done at the user’s convenience, which can be attractive to people with very busy schedules. It can also be useful in rural areas where getting to mental health care is a challenge, given the distance between providers.

There is, of course, something to be said for face-to-face interaction between a person and a therapist, and sometimes advice or feedback is needed for the specific situation one is going through. So online and email therapy may not be perfect for all situations — but for those in which people wouldn’t otherwise get help, this type of therapy may be life-changing.

The first study is published in the journal BMC Psychology. The second study was presented at the Society of General Internal Medicine. It has not yet been published in a peer-reviewed journal.

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