E-health is the provision of health services and/or information via the Internet or associated technologies [821]. Examples of e-health interventions include those delivered online or via smartphone, programs with multimedia components, text message-support, gaming, virtual reality, biofeedback and wearable devices [822]. Since its relatively recent appearance, e-health has been referred to as one of the most important revolutionary additions to modern healthcare [821, 823]. Telehealth on the other hand, refers to the delivery of healthcare via online or other telecommunication methods. Telehealth is particularly important for those in rural and remote areas, and for people who have difficulty attending or accessing local services. The uptake of digital mental health services in Australia increased by over 100% for most services (e.g., online courses, clinician registrations) during the recent COVID-19 pandemic [824, 825]. Telehealth service consultations in Australia have similarly increased by up to 34% since the introduction of telehealth items to the Medicare Benefits Schedule [826].
E-health interventions overcome many of the traditional barriers to treatment that often prevent people seeking help, including social or cultural prejudices, stigma, difficulties accessing services, finding appropriate available services, as well as financial and geographical barriers [827–829]. E-health interventions also have the capacity to overcome difficulties associated with face-to-face treatment, including gender differences [827, 830], the inclusion of more marginalised socioeconomic and cultural groups [831], and reducing the costs and increasing the standardisation of traditional treatments [832–835]. Despite their benefits, e-health interventions are often underutilised by mental healthcare services in Australia, which is partly driven by clinician reluctance [836].
Advances in technology over the past decade have enabled e-health interventions to include strategies such as self-monitoring and assessment, psychoeducation, goal setting, skill building, and feedback through the use of telephone and videoconferencing, mobile phones, sensors and wearable devices, social media, virtual reality, biofeedback, and gaming [837, 838]. E-health interventions can also be used to supplement psychotherapy, or as an alternative for people who do not want, or are not suitable for pharmacotherapy [833, 839]. Therapy can be conducted at home and has 24-hour availability. Research has demonstrated that e-health interventions allow for the delivery of clinically effective, cost-effective treatment, based on gold standard programs, which are highly engaging [840–843]. A number of e-health interventions have been developed for AOD and specific mental disorders, and a systematic review of the efficacy of computer-based interventions at improving AOD use and mental health outcomes found that relative to baseline, several programs were effective at reducing AOD use, anxiety, social phobia, depression, stress, and improving quality of life [844]. Interventions that were CBT-based were found to be particularly effective, demonstrating significantly greater improvements in alcohol use, anxiety, and quality of life compared to waitlist and psychoeducation controls [844].