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

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 7424 individuals were analysed. Among the sample, 52.7 % (n = 3911) engaged in 1-2 treatment sessions, and 47.3 % (n = 3513) 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.