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Dr. Heleen Riper hriper@trimbos.nl Innovation Centre of Mental Health & Technology

Sustainable prevention with e-mental health INPES April 2010. Dr. Heleen Riper hriper@trimbos.nl Innovation Centre of Mental Health & Technology. What would. do?. What would. do?. 1 out of 4 mental health problem in lifetime. 1 per 15 YP. 1 million suicides per year.

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Dr. Heleen Riper hriper@trimbos.nl Innovation Centre of Mental Health & Technology

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  1. Sustainable prevention with e-mental health INPES April 2010 Dr. Heleen Riper hriper@trimbos.nl Innovation Centre of Mental Health & Technology

  2. What would do?

  3. What would do?

  4. 1 out of 4 mental health problem in lifetime

  5. 1 per 15 YP

  6. 1 million suicides per year

  7. Disease burden in 2030 High-income countries Worldwide • Depression • Alzheimer / dementias • Depression % of total DALY • Alcohol % of total DALY • HIV/AIDS • COPD • COPD • Hearing loss • Road traffic • Perinatal • Ostearthritis • Cerebrovasculair • Is. heart disease • Cerebrovasculair Cataracts • Hearing loss Diabetes • Is. heart disease • chest infections • Lung cancers / infections Source: Mathers & Loncar, 2006

  8. more people less moneytransition chonic diseases • self-management • life style

  9. health decisions are made by ..

  10. EMH 2000 - 2010 population health gain large medium small self-management tools care relapse prevention treatment costs  prevention mental fitness effect sizes small medium large treatment duration and intensity © Riper 2008

  11. Is it scalablefrom research into the Real World?

  12. Developed World % mobile subs.  Developing Internet Penetration 73% 90% 25% 17% 5% 5% 33% 60%

  13. Color Your Life

  14. Drinking Less

  15. Drinking Less Real World N= 378 ITT • 2.750 monthlyvisitors • 1 out of 16 starts with DL • Mean 40.9 (25.2 SD) SU Weekly • AUDIT: M 20.27 (sd 6.30) • 6 monthsstudyperiod: N= 972 • Response rate 39% • Drop out 59% & 56% 18,8 %* 17,5 %* *P<0.001

  16. Modelling cost-effectiveness of eHealth interventions Theory: 4 possible outcomes More costs Less effect More costs More effect Fewer costs Less effect Fewer costs More effect

  17. Modelling cost-effectiveness of eHealth interventions Example 1: Self-help in depression Smit F, Willemse G, Koopmanschap M, Onrust S, Cuijpers P, Beekman A. (2006) Cost-effectiveness of preventing depression in primary care patients: randomised trial. British Journal of Psychiatry 188: 330-336

  18. Modelling cost-effectiveness of eHealth interventions Example 2: eHealth v waitlist

  19. Modelling cost-effectiveness of eHealth interventions Example 3: eHealth v Group CBT

  20. Modelling cost-effectiveness of eHealth interventions Key messages

  21. low ses • etniccultural minorities • recruitment • acceptable interventions • visual screener

  22. Visual Screener

  23. Validadion Visual Screener

  24. effectivescalableacceptable • planned efforts • knowledge • turning point sustainable • filling the gap • health gain

  25. thank you for your attention Heleen Riper hriper@trimbos.nl

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