Barriers and Facilitators of Digital Mental Health Use in Regional, Rural, and Remote Australia: A Comparison of Clinician and Consumer Perspectives

Introduction: Consumers living in regional, rural, and remote areas of Australia face significant barriers to accessing mental healthcare. Digital mental health interventions (DMHIs) are a promising avenue to improve access to mental health treatment in these areas, but uptake has yet to reach its full potential. Objective: This study evaluated the perceived barriers and facilitators of engagement with DMHIs for clinicians and consumers in regional, rural, and remote Australia. Methods, Design, and Participants: We surveyed consumers (n = 896) and clinicians (n = 104) using cross-sectional surveys to examine perceived barriers and facilitators of DMHI use. Setting: This study was conducted within the context of an established digital mental health service, THIS WAY UP. Main Outcome MeasuresSurvey responses were mapped onto the Capability, Opportunity, Motivation, Behaviour (COM-B) model, and quantitative analyses of response frequencies partitioned the influence of each factor on engagement with DMHIs. Results: Clinicians and consumers familiar with DMHIs reported barriers that spanned capability, opportunity, and motivation domains. Lack of consumer motivation was the most frequent barrier perceived by clinicians (51%) and reported by consumers (27%). Consumers valued many accessibility benefits of DMHIs and frequently endorsed the importance of clinicians in facilitating their use of DMHIs by supporting knowledge and motivation. Conclusions: DMHIs have the potential to alleviate service-related barriers to mental healthcare in regional/remote areas, and successful implementation must consider both clinician and consumer perspectives. Our findings underscore several capability, opportunity, and motivational targets for improving consumer and clinician engagement with DMHI in these areas.