Characterising reach and uptake of a national digital mental health service in the Australian community: This Way Up

Digital mental health services (DMHS) can increase the accessibility and scalability of evidence-based mental health care. DMHS have been integrated within health systems and shown to be clinically effective for anxiety and depressive disorders, but the nature of service reach within routine community care remains under-explored. This study aimed to characterise reach and uptake of an Australian digital mental health service (THIS WAY UP), describe the socio-demography of routine service users and investigate predictors of treatment uptake in a large community sample. A naturalistic, observational evaluation of routine service provision was conducted over a two-year period (July 2020–2022), including all adults who registered for a THIS WAY UP digital mental health program within routine care. Service reach and uptake were quantified via the number of program registrations, and commencements, respectively. Descriptive statistics and multivariable logistic regression were used to describe users’ socio-demography and examine predictors of treatment commencement. There were 66,004 registrations for a THIS WAY UP program during the study period, (averaging 2640 ± 557 each month); most commonly for mixed anxiety and depression (23%), insomnia (15%) and generalised anxiety (11%). Registrants were demographically diverse, with ages ranging from 18 to 94 (mean 39 ± 15), 35% residing in a regional or remote area, and spanning all quartiles of relative social (dis)advantage. 80% of registrants ( n = 53,032) proceeded to commence treatment. In multivariable models, individuals who were older, resided in regional areas, registered at the recommendation of, or under the supervision of, a clinician, and those who privately paid for treatment were more likely to commence treatment (Odd’s ratios’ ranging 1.05–4.36, p’s < 0.001). DMHS can confer broad reach and scalability of mental health treatment. Real-world users of THIS WAY UP were demographically diverse and primarily report clinically significant symptoms. DMHS can leverage predictors of treatment uptake to design accessible service models, promote engagement and support under-represented user groups.