NZ Herald Column Kyle MacDonald

Is National right about e-therapy for mental health?

This is my column this week in the New Zealand Herald, which is published in the digital edition every Thursday…

When National’s record on mental health was questioned in the final Leaders Debate before the election, party leader Bill English made the bold claim that e-therapy works as well as face-to-face therapy. But does it? And what is e-therapy anyway?

Sometimes referred to as digital mental health care, e-therapy is any form of psychological intervention that is provided via a digital device. It includes guided video and text based treatment, sort of like an interactive self-help book. In some cases, it is aided by email or chat with professionals, or even video chat with a therapist or counsellor.

So does this work?

Well, like with most of these things, the answer isn’t a straight yes or no. It certainly isn’t true to say equivocally it works “as well as face to face therapy”.

The model used here in New Zealand – the “SPARX” programme – has shown some positive, albeit, limited effects. It has shown to be effective specifically with young people aged 12 to 19 suffering from mild to moderate depression, and anxiety.

There is no evidence this programme works beyond that. It explicitly isn’t a replacement for face-to-face therapies or medications, nor is it advised for more serious difficulties or anyone who is feeling suicidal or at risk.

Once you dig in to the detail you can see this programme works for a group of people a large range of interventions would likely work for. It’s certainly better than nothing, for that specific group, particularly if it is all that’s available.

But my main concern is encouraging the idea that the solutions to emotional distress can be found via a screen. Call me old fashioned (even if I am technically “youth adjacent”) but I worry about our growing reliance on devices and social media, especially as this reliance can lead to the absence of meaningful connections, isolation and loneliness.

To be fair to the people behind SPARX, and the various other pilots being rolled out, they clearly state its limitations, and spell out the need for it to be supported by other treatments and support.

But as often happens when these things get into the hands of politicians, especially at election time, the complexity is lost. Ultimately it’s politically appealing because replacing people with screens costs less, and it passes the “they’re doing something” test.

However, encouraging people who may already feel isolated, anxious and bereft of human connection to seek solace from a digital programme is like holding Alcoholics Anonymous meetings in a pub.

Sure, it makes it easy for people to find help, but ask yourself: Is it really a good idea?

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