Work

Understanding factors related to treatment retention in an online mental health support service: Analysis of a service database

Year: 2025

Type: article

Abstract: Engagement with and retention in mental health treatment remains a significant barrier to accessing effective mental health care. Early discontinuation of mental health treatments negatively impacts recovery, as well as other aspects of life such as education, employment and overall mental wellbeing. This study examined, among adults aged ≥18 years, the factors associated with mental health treatment retention via an online service in Australia. A secondary analysis of 2021-2025 data from Talked , an Australian online therapy platform. Attendance of 1-2 therapy sessions was classed as lower retention; attendance of 3+ sessions was classed as higher retention. The association between treatment retention and sociodemographic, health and treatment-related variables were explored via multivariable logistic regression. Data for 7,424 individuals were analysed. Among the sample, 52.7% (n=3,911) engaged in 1-2 treatment sessions, and 47.3% (n=3,513) engaged in 3+ treatment sessions. Those who had previously undertaken therapy, those reporting consuming alcohol more frequently and those who had selected three or more mental health-related issues at time of therapy booking, had greater odds of engaging with treatment. Those with dependents had lower odds of engaging with treatment. The factors found to be associated with treatment retention can be used to identify targeted strategies to enhance treatment retention. These findings support the role of early identification and prioritisation of at-risk clients at the time of booking, such as those with dependants, and those who had not undertaken previous therapy, as they may require increased flexibility and accessibility considerations for psychological support. • Mental health and substance use disorders are the lead cause of non-fatal health burden in Australia • Early discontinuation of psychological treatment increases the risk of relapse and lowers the rate of the likelihood of future help seeking • This study is a secondary data analysis of data from an Australian online therapy platform • Of the sample, 52.7% discontinued treatment early. Those who had previously undertaken therapy, regularly used alcohol and who had reported three or more mental health-related issues at time of therapy booking, had higher rates of treatment retention. Those with dependents had lower rates of retention • These findings emphasise the importance of personalised care planning and tailoring therapeutic processes to encompass the complexity of individual experiences

Source: Behaviour Research and Therapy

DOI: 10.1016/j.brat.2025.104875

Authors: Breanne Hobden, Lauren Pollock, Vincent Lau, Sarah Leask, Kristy Fakes

Institutions: Bond University, Hunter Medical Research Institute, University of Newcastle Australia

Language: English

Topic: Digital Mental Health Interventions

Subfield: Applied Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,580