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The Online Couch: Mental Health Care on the Web

Jane Sarasohn-Kahn

Innovative online tools are giving people with depression easier access to therapy, self-care, and peer-to-peer help.

Although depression is one of the most common health problems in the United States, only about one-third of those with symptoms are treated. Barriers include a shortage and maldistribution of mental health professionals, cost, and stigma associated with having a mental illness.

Fortunately, a wide array of computer-based and online solutions is now available to those with mild-to-moderate depression, and the inventory is growing. This report by health economist Jane Sarasohn-Kahn looks at the changing landscape of technology-enabled mental health care products and services.

The interventions are divided into these categories:

  • Computer-based cognitive behavioral therapies, either self-driven or provider-assisted
  • Online professional counseling over email, chat, and video
  • Online social networks that offer support from peers
  • Mobile apps for self-management and support
  • Behavioral health games that promote engagement
  • Virtual reality environments used to diagnose and treat symptoms

The report also discusses market issues, including challenges of patient engagement and adherence, provider acceptance, reimbursement and payment arrangements, and barriers to online access for consumers.

An appendix provides the results of a survey of California County Mental Health Departments on online cognitive behavioral therapy conducted by the California Institute for Mental Health in March 2012.

The report is available as a Document Download.