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Addressing depression and behavioral health needs through a digital program at scale. Healthc (Amst) 2021 Jun;9(2):100521



Pubmed ID




Scopus ID

2-s2.0-85100994947 (requires institutional sign-in at Scopus site)   1 Citation


Depression and anxiety disorders are prevalent mental health conditions; yet they are often unrecognized, under-addressed and/or under-treated, and specialty treatment for these conditions is oftentimes difficult to access. By acting either as a bridge to therapy or as a form of therapy, digital tools, such as those that provide internet-based cognitive behavioral therapy (iCBT), may help clinicians support their patients' mental health needs. At one academic health system, a digital mental health program was deployed in primary care and outpatient behavioral health programs to help patients meet needs identified through screening or clinical visits. Over the first two years of operation, 138 clinicians (40% of eligible clinicians) prescribed the program to 2,228 unique patients, from which 1,117 (48.9%) enrolled. Patients who enrolled tended to be younger and healthier than non-enrollees. On average, enrolled patients spent 114.6 minutes within the iCBT program. Clinical improvement was assessed using pre- and post PHQ-9 and GAD-7 scores for depression and anxiety, respectively. Pre/Post scores were compared using Wilcoxon Rank Sum test. Patients with at least moderate depression had an average 23% reduction in PHQ-9 scores (median change -3(interquartile range 7), p<0.001) and those with at least moderate anxiety had a 26% reduction in GAD-7 scores (-4(7), p<0.001). Improvements were clinically and statistically significant. Future steps include performing a cost analysis to understand whether models utilizing iCBT are net cost-saving for health systems.

Author List

Sharif-Sidi Z, Shen C, Wong W, Hanson R, Miller L, Fickel K, Green E, Burns J, Dunn C, Somai M, Crotty BH


Bradley H. Crotty MD Associate Professor in the Medicine department at Medical College of Wisconsin
Lawrence A. Miller PsyD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Melek Somai MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anxiety Disorders
Primary Health Care