A scene showing a patient in a cozy home setting, engaging in a mental health video consultation with a caring therapist on a screen. The atmosphere is calm and supportive, emphasizing the connection and comfort of remote therapy.
The PROVIDE-C trial, conducted in Germany, investigates how mental health video consultations can be integrated into primary care settings to treat patients with depression and anxiety. The trial involved 376 adults aged 18 to 81, all presenting to their general practitioners with symptoms of either or both mental health conditions. The researchers randomly assigned participants to one of two groups: those receiving traditional care and those receiving mental health video consultations as part of the PROVIDE model.
The study took place in 29 primary care practices, with patients receiving either usual care or the PROVIDE intervention. The PROVIDE model consisted of five video consultations between the patient and an offsite mental health specialist. The goal was to reduce the severity of depression and anxiety symptoms over time through a scalable and accessible mental health care model.
“One of the key goals of this trial was to improve the availability of mental health specialists by integrating them virtually into primary care,” explains Dr. Haun, one of the lead researchers. The intervention was designed to help patients engage in treatment without needing to visit a mental health clinic physically.
At the six-month mark, the PROVIDE model showed a significant reduction in the severity of both depression and anxiety symptoms. The reduction was measured using the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Those receiving the video consultations experienced a decrease of 2.4 points compared to the control group. This difference, while modest, was maintained at 12 months with a 2.9-point reduction.
According to Dr. Haun, “The PROVIDE model offers a low-intensity, accessible intervention that can be deployed in a variety of settings, including rural areas where mental health services are often scarce.”
The benefits of the PROVIDE model were not just immediate. The researchers found that patients continued to experience reduced symptoms over the long term, which is crucial for those with chronic anxiety and depression. Importantly, no serious adverse events were reported in either group, making the intervention not only effective but also safe.
Additionally, Dr. Hartmann highlighted that “the PROVIDE model is scalable and holds promise as a solution to the global mental health crisis, particularly in areas with limited access to specialized care.” The study also underscores the importance of continuing to explore remote and digital health solutions in the post-pandemic era.
Beyond the improvement in depressive and anxiety symptoms, the PROVIDE model also positively impacted patients’ overall quality of life. The researchers found that patients who received the video consultations were more likely to feel satisfied with their care, and they reported improvements in their ability to manage daily tasks and interactions.
The study highlights the potential for video consultations to fill critical gaps in mental health care. As Dr. Wensing noted, “In a world where access to in-person therapy is not always feasible, virtual mental health care offers a valuable alternative, especially for those who might otherwise go untreated.”
With the increasing prevalence of depression and anxiety worldwide, this trial demonstrates that even small, scalable interventions can have a meaningful impact on population health. The next steps for the researchers will include further testing of the PROVIDE model in different healthcare settings and populations to explore its broader applicability.
More information: Haun MW, Tönnies J, Hartmann M, et al. Model of integrated mental health video consultations for people with depression or anxiety in primary care (PROVIDE-C): assessor masked, multicentre, randomised controlled trial. BMJ. 2024;386. doi:10.1136/bmj-2024-079921.
Journal information: The BMJ
This content is generated from the original article which is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited.
