What is telehealth and how is it supporting mental health in Australia?

Mental healthcare through telehealth is now widely available for those who prefer to receive counselling or therapy from the comfort of their own home.

After being admitted to hospital for a relapse of depression, HCF member Julia, who is 29 and lives in Victoria, was offered telehealth counselling through PSYCH2U, a dedicated online mental health service. While apprehensive about how different telehealth counselling would be compared to face-to-face, Julia says it helped her, and also says the process was simple. “It was easy and quick to arrange, and within two weeks I had my appointment.”

Since the COVID-19 pandemic began, there’s been an increase in people reaching out for help with anxiety, depression and general mental wellbeing.

Headspace reported that 74% of young people aged 12-25 said their mental health had worsened since the restrictions enforced by COVID-19. Lifeline reported an increase in calls of almost 20% in April 2021 compared to the same period two years before, while Beyond Blue saw an increase of more than 30% in that same two-year period. 

A shortage of practitioners, combined with lockdown restrictions, and remote and regional areas having less access to care, meant that telehealth treatment for mental health went from being an exception to a necessity. In April 2020, the Australian Government’s Medicare Benefits Schedule saw almost half of its mental health services being delivered through telehealth. 

So far, research shows that the benefits of telehealth counselling far outweigh the challenges, and telehealth for mental health concerns is a service that most practitioners want to maintain and increase in availability even post-pandemic.

“The fact is that there are some people who simply would not get the help they want and need without telehealth,” says PSYCH2U psychologist Jeremy Cowden. “My big hope is that the things put in place now aren’t reversed. That would be a tragedy.”

What is mental health support through telehealth?

Like a telehealth appointment with your GP, telehealth for mental healthcare is a pre-arranged appointment with a psychologist or counsellor that takes place over video call or by phone.

Aside from the psychologist and patient being in different places – sometimes even different states – the appointments are set up with the same outcomes in mind as a face-to-face session. This means that a counsellor and client have a set time to talk, with the intention that the client will feel helped to develop a more positive outlook and sense of self.

With some in-person services not available in certain areas, and more populated areas having extensive waitlists, telehealth is providing mental health services to those who need it – and at a critical time.

“No one should have to wait for the mental health support they need because of a lack of availability, government restrictions and other barriers,” says Julia.

Who uses telehealth services?

While it may feel to some like telehealth appeared overnight in response to restrictions related to COVID-19, people have actually been using remote healthcare services for various medical needs for almost 60 years.  

Traditionally, telehealth catered to Australia’s rural and remote areas, which often didn’t have the amount of healthcare providers or specialists that are more widely available in cities.

From new mums who are time-poor, to those who may need to stay home because of illness or have mobility challenges, access to healthcare professionals through telehealth services is now readily available through local and national organisations.

When it comes to mental health treatments, telehealth can provide a lifeline to those who need an option other than face-to-face treatment.

“Telehealth has been very important for people with social phobias, who literally find getting out of their front door the hardest thing in the world. For those people, they wouldn’t get the help they needed if it wasn’t for telehealth,” says Jeremy.

The benefits of telehealth

The primary benefit of any kind of telehealth appointment is that it gives people who may not otherwise get it the medical help and advice they need, by providing another avenue of care.

When it comes to mental health counselling, there are other advantages, like some clients might feel less intimidated by seeing a therapist from the comfort of their own home, rather than going into an office or clinic.

Other positives for the patient include things like zero travel time and costs. It might also be easier to find the time to have regular telehealth counselling sessions, by eliminating travel time, which means people may be able to access the help they need more quickly and more consistently.

The availability of telehealth appointments for those that want them also has the potential to free up healthcare professionals to see emergency patients, or those who simply prefer face-to-face appointments.

The challenges of treating mental health with telehealth

While the option of a telehealth session with a psychologist or counsellor has a variety of benefits, some people are sceptical about how comfortable counselling can be for the client when the therapist isn’t in the same room.

Julia admits she had her own reservations going into her first telehealth mental health appointment.

“I’ve had counselling and therapy in the past and love the face-to-face experience. Connecting with someone, gauging body language and facial expression is important.”

While Julia admits it took time to get used to looking at a screen rather than at someone’s face, overall she was happy with her experience.

“It surprised me that I was still able to connect with my therapist on a meaningful level, even when in different states.”

It’s true that telehealth may suit some more than others, such as those more comfortable with technology or with some experience of using platforms like Zoom to talk to colleagues or friends.

Making the most of a telehealth session

Jeremy suggests some physical and mental preparation might help before going into your telehealth appointment and ensure you have the most positive experience.

“Practically speaking, finding a quiet, private place is important. Some people do sessions in their car (although not driving!). People in areas where the internet isn’t great are sometimes able to access private rooms at a health clinic or GP’s office.”

Mental preparation can also help, says Jeremy. “Just like face-to-face counselling, it can be helpful to write a few things down that you’d like to talk about prior to your session.”

Here are some ways to prepare for a telehealth mental health appointment:

• The day before your session, make sure you have all the details you need to connect to your counsellor, like the phone number or Zoom link.
• Make sure you have a quiet, private space where you won’t be interrupted for the length of your appointment. This might include closing doors or windows so you’re not overheard or distracted by outside noise.
• Get comfortable. A glass of water, a comfy chair or a throw rug can help make you feel more comfortable during the session.
• Put your phone on silent and out of reach so you aren’t tempted to let your mind wander mid-session.
• Make some notes prior to the appointment about things you’d like to discuss. If you lose your train of thought in the session, this will be useful to refer to.
• Where possible make sure you have a good phone or Wi-Fi signal. At the start of the appointment, ask your clinician what to do if your connection drops out mid-session so you’re able to reconnect and continue.

Is telehealth for mental health effective?

While access to telehealth mental health services have increased, it’s important to know whether these services are as effective in helping clients and patients when compared to traditional face-to-face methods. So far, the research is positive.

One study from the United States showed roughly equal outcomes and standards around “clinical effectiveness, cost effectiveness, patient and provider acceptance, and safety” were met in telehealth offerings across a wide variety of disorders and psychological challenges.

Practitioners in Australia have seen similar results, with very little difference in outcomes when mental health counselling was delivered through telehealth rather than face-to-face.

“There are some people who will be better suited to face-to-face counselling, but others who find the process easier via telehealth,” says Jeremy. “When it comes to issues of helping people, the more options, the better.”

Accessing mental health support

If you or anyone you know needs mental health help, there are services you can reach out to for extra support.

Eligible HCF members* can access online video support with mental health professionals through PSYCH2U, and navigation to other mental health services as needed.

You can also access a range of online programs through This Way Up^{^}, a not-for-profit initiative developed by experienced psychiatrists and clinical psychologists, to help you take control of your mental wellbeing. Clinically proven to help, the programs understand and improve mental challenges like stress, insomnia, worry, anxiety and depression.

If you're struggling with depression or anxiety, and need to speak to someone now, call Lifeline on 13 11 14.

Where to find more mental health help:

• Head to Health
• Headspace
• ReachOut Australia
• SANE Australia

First published October 2021