The potential of non-clinical guidance alongside e-mental Health to overcome non adherence

Abstract Background Mental health problems account worldwide for over an eighth of the global burden of disease and waiting lists nowadays are commonplace. E-Health has potential to reduce mental illness, whilst waiting for therapy or as a stand alone. A big problem with implementation of E-health in clinical practice is non adherence. Non-clinical guidance could make a difference as compared to the non guidance modus. Our research question is: what factors contribute to the potential of non-clinical guidance in overcoming non adherence for e-mental Health for patients with depressive, anxiety and stress symptoms? Methods We did a qualitative study in a Dutch general practice. The treatment consisted of several modules accompanied by non-clinical guidance by a healthcare assistant. Out of 190 invited patients, 31 patients participated. Eight weeks after being invited, 11 semi-structured interviews were conducted until data saturation. Thematic analysis was used with open, axial and selective coding. Results Three major themes emerged: 1) The patients were satisfied with the non-clinical guidance in almost all aspects: Negative comments arose from an urge for more contact or tailoring. 2) The form of the guidance (e.g. non-clinical; used interface) was subordinate to the amount and tailoring of it. 3) Adherence could further be improved through a more personal introduction, explaining the benefits of certain exercises and more time management. Conclusions The potential of non-clinical guidance in overcoming non adherence for e-mental Health can be improved by further tailoring and increasing the interactivity when needed. Further research is also needed, after the suggested improvements, whether the intervention is effective, compared to a therapist guided and a non guided version. This study needs to be repeated in other clinical settings. Key messages • Non-clinical guidance, alongside e-mental health has potential to help with non adherence, thereby decreasing the burden of waiting lists. • Non-clinical guidance was positively received by patients who received e-mental health, although further tailoring could make online treatment even a larger success.