Evaluation of The Practitioner Online Referral and Treatment Service (PORTS): the first 18 months of a state-wide digital service for adults with anxiety, depression, or substance use problems

ABSTRACT

The Practitioner Online Referral and Treatment Service (PORTS) is a new digital mental health service (DMHS) providing assessment, treatment, and consultation across Western Australia, for adults with anxiety, depression, or substance use problems, and experiencing financial hardship or geographical disadvantage. From July 2017 to December 2018, a total of 2,527 individuals were referred to PORTS. Of these, 150 (6%) did not give consent for their results to be analysed. Of the remaining 2,377 patients, 615 (26%) could not be contacted to confirm the referral, 596 (25%) received assessment or information from PORTS, 427 (18%) were referred to another service, and 739 (31%) commenced treatment at PORTS. Almost half (47%) of patients were from areas with significant socio-economic disadvantage. Those referred by another mental health service were more likely to engage in treatment than those referred by a General Practitioner (GP). Overall outcomes were excellent, with large effect sizes (Cohen’s d: 1.1–1.4), from assessment to post-treatment and 3-month follow-up, reliable deterioration was low, and GP and patient satisfaction was high. These results indicate that the PORTS DMHS model is a promising method for engaging primary care patients with anxiety and depression, including those experiencing financial and geographical disadvantage.

KEYWORDS:

• Internet
• remote
• treatment
• iCBT
• anxiety
• depression
• Practitioner online referral treatment service
• primary care

Acknowledgments

We wish to acknowledge the support and feedback from patients, GPs, Portals and other stakeholders. We thank the PORTS relationship managers, Steve Andrew, Anthea Hodgson, and Jane Lautrec for their contributions to the development and deployment of PORTS. We also acknowledge the efforts of the entire PORTS team and the support of WAPHA staff.

Disclosure statement

N. Titov and B. F. Dear are the developers of the Wellbeing Course but derive no personal financial benefit.