Carol Hood

Background: Suicide is a significant global health concern. In the context of increased demand for mental health services and workforce shortages, exacerbated by the COVID-19 pandemic, electronic mental health (eMH) tools represent a promising means of augmenting mental health care generally and for suicide prevention specifically. A significant research gap exists however with respect to the use and uptake of eMH tools, especially electronic mental health tools for suicide prevention (eMH-SP). Objective: This study aimed to investigate the use of eMH tools by Australian mental health professionals, both in general and with respect to suicide prevention specifically, examining changes in use since COVID-19. Further, it explored factors associated with frequent use of eMH-SP, including sociodemographic and professional characteristics. Methods: A web-based cross-sectional survey was conducted across 15 local health districts (LHDs) in New South Wales, Australia, from May 2022 to July 2023. The sample was drawn from over 10,000 mental health professionals working in government services statewide. The survey explored the use of electronic mental health tools for general mental health issues (eMH-gen) and eMH-SP, explored the changes in the use of both since COVID-19, and used multivariable logistic regression to identify factors associated with the current use of eMH-SP. Results: Among 469 participants, increased use since COVID-19 was reported by over half (247/469, 52.7%) for eMH-gen, and by approximately one-third (141/386, 36.6%) for eMH-SP. The proportion reporting frequent use increased significantly from before to after COVID-19 for both eMH-gen (243/469, 51.8% to 283/469, 60.3%; P<.001) and eMH-SP (152/386, 39.4% to 170/385, 44.2%; P=.01). Since COVID-19, the most frequently used types of eMH tools for eMH-gen and eMH-SP, respectively, were information sites (231/469, 49.3% and 130/385, 33.8%), phone/online counseling (173/469, 36.9% and 130/385, 33.8%), and apps (145/469, 30.9% and 107/385, 27.8%). Professionals more likely to use eMH-SP frequently were females (odds ratio [OR] 3.32, 95% CI 1.88-5.87; P<.001) compared with males; peer workers (OR 2.17, 95% CI 1.0-4.71; P<.001) compared with nurses; those located in regional/rural LHDs (OR 1.65, 95% CI 1.04-2.61; P=.03) compared with metropolitan LHDs; and those practicing in emergency health care settings (OR 8.31, 95% CI 2.17-31.75; P=.03) compared with inpatient settings. Conclusions: The study’s findings highlight the increasing adoption of eMH tools and delivery of remote care by mental health professionals and provide valuable new insights into sociodemographic factors associated with the use of eMH for suicide prevention specifically. Continued research on the role eMH is playing is essential for guiding policy, optimizing resources, and enhancing mental health care and suicide prevention efforts.

BACKGROUND Suicide is a significant global health concern. In the context of increased demand for mental health services and workforce shortages, exacerbated by the COVID-19 pandemic, electronic mental health (eMH) tools represent a promising means of augmenting mental health care generally and for suicide prevention specifically. A significant research gap exists however with respect to the use and uptake of eMH tools, especially electronic mental health tools for suicide prevention (eMH-SP). OBJECTIVE This study aimed to investigate the use of eMH tools by Australian mental health professionals, both in general and with respect to suicide prevention specifically, examining changes in use since COVID-19. Further, it explored factors associated with frequent use of eMH-SP, including sociodemographic and professional characteristics. METHODS A web-based cross-sectional survey was conducted across 15 local health districts (LHDs) in New South Wales, Australia, from May 2022 to July 2023. The sample was drawn from over 10,000 mental health professionals working in government services statewide. The survey explored the use of electronic mental health tools for general mental health issues (eMH-gen) and eMH-SP, explored the changes in the use of both since COVID-19, and used multivariable logistic regression to identify factors associated with the current use of eMH-SP. RESULTS Among 469 participants, increased use since COVID-19 was reported by over half (247/469, 52.7%) for eMH-gen, and by approximately one-third (141/386, 36.6%) for eMH-SP. The proportion reporting frequent use increased significantly from before to after COVID-19 for both eMH-gen (243/469, 51.8% to 283/469, 60.3%; P<.001) and eMH-SP (152/386, 39.4% to 170/385, 44.2%; P=.01). Since COVID-19, the most frequently used types of eMH tools for eMH-gen and eMH-SP, respectively, were information sites (231/469, 49.3% and 130/385, 33.8%), phone/online counseling (173/469, 36.9% and 130/385, 33.8%), and apps (145/469, 30.9% and 107/385, 27.8%). Professionals more likely to use eMH-SP frequently were females (odds ratio [OR] 3.32, 95% CI 1.88-5.87; P<.001) compared with males; peer workers (OR 2.17, 95% CI 1.0-4.71; P<.001) compared with nurses; those located in regional/rural LHDs (OR 1.65, 95% CI 1.04-2.61; P=.03) compared with metropolitan LHDs; and those practicing in emergency health care settings (OR 8.31, 95% CI 2.17-31.75; P=.03) compared with inpatient settings. CONCLUSIONS The study’s findings highlight the increasing adoption of eMH tools and delivery of remote care by mental health professionals and provide valuable new insights into sociodemographic factors associated with the use of eMH for suicide prevention specifically. Continued research on the role eMH is playing is essential for guiding policy, optimizing resources, and enhancing mental health care and suicide prevention efforts.

Summary: Background: Multiple common challenges exist for medical students transitioning to regional clinical placements, including a relative paucity of well‐being skills required for the promotion of work–life integration. Beginning Education at Central Coast Hospitals ( BEACCHES ) is an immersive orientation programme aimed at negotiating this transition and promoting student well‐being through improved social connectedness. The programme was evaluated with the objectives of understanding the most highly valued and effective components. Method: BEACCHES is offered to medical students commencing regional clinical placement at the Central Coast Medical School, Australia. The programme emphasises teamwork and self care, and promotes multidirectional interaction among peers, staff and the local community. A specific well‐being forum is an essential component of the programme. An evaluation of the inaugural programme was performed using semi‐structured surveys with a mixed‐method analysis of quantitative data (pre‐ and post‐programme knowledge and confidence scores) and qualitative data (emergent themes). Results: Knowledge acquisition significantly improved across all domains. Importantly, this included items that could positively impact on well‐being, including: knowledge of psychological first aid (p = 0.01), student support services (p < 0.01), connectedness with fellow students and staff (p < 0.01), and self‐management of health and workload (p = 0.01). Qualitative analysis also revealed substantial support for the importance of interaction with peers and staff outside of the formal education setting. According to the Australian Medical Association, medical schools‘ responsibilities include incorporating curricula designed to improve stress management Conclusion: Our survey results indicated that BEACCHES has the potential to foster student well‐being through targeted orientation and engagement to enhance connectedness. We highlight the value of embedding an interactive experiential programme for students beginning a new regional clinical placement.