Internet-based mental health programs: A powerful tool in the rural medical kit

Objective: To discuss, using two case examples, the potential utility of Internet-based depression information and automated therapy programs in rural regions. Design: Systematic review of evaluations of two Australian web-based mental health programs: MoodGYM and BluePages Depression Information. Setting: Community, school, university. Participants: A total of 12 papers and reports derived from nine separate studies of MoodGYM and BluePages involving sample sizes ranging from 78 to 19 607 people. Outcome measures: Depressive symptoms, anxiety symptoms, dysfunctional thoughts, depression literacy, stigma, help seeking and cost-effectiveness. Results: Internet-based applications were effective in reducing depressive symptoms and stigmatising attitudes to depression and in improving depression literacy. School-based programs also showed promise in decreasing depressive symptoms. Conclusions: Depression self-help and information programs can be delivered effectively by means of the Internet. As accessibility of face-to-face mental health services in rural areas is poor and as there is a strong culture of self-reliance and preference for self-managing health problems among rural residents, the Internet might offer an important platform for the delivery of help for depression in rural regions. Consideration should be given to developing programs tailored to rural settings and future research should evaluate the efficacy and effectiveness of such programs in rural settings.