In consultation with NSW Health, this project is aims to develop an online portal, to improve access to evidence based e-Health treatment packages for co-occurring mental health and substance use problems. The overall objective of the eCliPSE portal is to embed online resources for mental health and substance use comorbidity within existing NSW Health clinical services and to establish an optimal means of translating evidence-based eHealth interventions into practice. It is envisioned that this portal, will provide NSW Health services that currently have insufficient resources to manage comorbidity, with evidence-based interventions that can supplement existing treatments. The development and implementation of this portal is intended to increase access to resources which have been shown to reduce severity of mental health and substance use problems and related harms. Doing so would constitute a significant contribution to promoting and maintaining the good health of the Australian community and reducing the burden of disease, social costs, and disability associated with these conditions.
Co-occurring mental health and substance use disorders are common, especially among treatment seeking populations. Such comorbidity is associated with a range of negative outcomes and severe illness course. In the longer term, these conditions are even associated with increased rates of cardiovascular disease and cancer.
Treatment studies of substance use and comorbid mental disorders suggest that interventions can be effective, but translation of treatment into practice is weak. Enabling mental health and drug and alcohol workers to better respond to people with co-occurring mental disorders and substance use will improve the outcomes for people with co-occurring disorders. Improved clinical management of people with comorbid mental health and drug and alcohol disorders is a priority for NSW Health. Central to this is ensuring the effective transfer of research findings to the clinical workforce and policy, which is critical to developing innovative responses to comorbidity.
The aim of the eCliPSE project is to develop an online portal, to improve access to evidence based e-Health treatment packages for co-occurring mental health and substance use problems. The overall objective of the eCliPSE portal is to embed online resources for mental health and substance use comorbidity within existing NSW Health clinical services and to establish an optimal means of translating evidence-based eHealth interventions into practice.
This will involve consultation and collaboration with two NSW Local Health Districts (LHD) specifically designated by NSW Health (Murrumbidgee and South Western Sydney) as well as web development company Netfront. Clients and health professionals from the two LHDs will be recruited for focus groups and interviews throughout the program development phase of the study. Following this, a pilot trial will occur in these two LHDs. Training sessions will be held with clinicians in the participating LHDs, run by the research team, to encourage active use of the online comorbidity tool. During these sessions, the clinical pathway developed above will be presented, and role-play sessions carried out to assist clinicians communicate with service users about introducing the online comorbidity tool into their clinical practice. Clinicians will be introduced to the online comorbidity tool and provided with time to familiarise themselves with the content of the resource.
Following training, clinicians will be asked to implement the online comorbidity tool, via the clinical pathway, with all service users. Screening questionnaires built into the online comorbidity tool, along with data tracking and website analytics will determine the extent to which service users and clinicians engaged with, used, and benefitted from the tool.
An external evaluator will be contracted to conduct an evaluation of the acceptability and feasibility of the online comorbidity tool and clinical pathway for the integration of the tool in the two LHD service contexts. The aim of this evaluation effort will be threefold:
(a) To determine the extent to which the online comorbidity tool meets the needs of the service users; and clinicians selected to participate in the pilot, and
(b) To determine the usefulness of the clinical pathway to use of the online comorbidity tool;
(c) The sustainability/likelihood of continued use of the online comorbidity tool and clinical pathway into the future.
If effective, the online comorbidity tool will be made available for use across public mental health and drug and alcohol services across NSW.
Study in progress. To date, focus groups have been held with staff and clients of both Murrumbidgee and South Western Sydney Local Health Districts. Specifically these have taken place in Narrandera and Wagga Wagga (Murrumbidgee) and in Campbelltown (South Western Sydney). Feedback from focus group participants has informed the development of the eCliPSE portal with content finalized. Researchers are currently working with web developers from Netfront to translate this content into a functional web portal.
Focus group feedback about the eHealth tools has been positive. Staff and clients have all been enthusiastic about accessing eCliPSE.
The eCliPSE web portal is ready to be launched in January 2017 with staff training to commence soon.
The major outcome of the current project is the development of an online mental health and substance use comorbidity tool to improve health system responsiveness to comorbidity within the public health system. Improved access to evidence-based treatment and improved health outcomes through the development and subsequent piloting of the tool are also anticipated. The development of this online comorbidity tool is likely to have a significant impact on building the capacity of mental health and substance use treatment services to manage people with comorbidities.