An Observational Study of the Impact of COVID-19 and the Transition to Telehealth on Community Mental Health Center Providers

Abstract

Background: The COVID-19 pandemic has swiftly and remarkably altered community mental health service delivery and evidence-based practice (EBP) implementation. This study reports provider perspectives on the impact that COVID-19 had on their work and EBP implementation. Methods: Providers (n = 93) completed online surveys with quantitative measures and open-ended items targeting their responses and/or reactions to COVID-19, and to the transition to providing services via telehealth.Results: Perceptions of personal risk and rumination around COVID-19 were low, while telehealth was viewed positively by providers. Three major themes emerged regarding the major impacts of COVID-19 on work: 1) the altered nature of interactions between patient/client and provider, 2) changes in provider expectations regarding productivity, and 3) challenges maintaining work-life balance. In regard to the major impacts of COVID-19 on EBP implementation, three themes emerged: 1) increased difficulty delivering certain therapies via telehealth, 2) potential limitations to session confidentiality, and 3) challenge of engaging children in telehealth. Conclusions: In the context of the COVID-19 pandemic, community mental health providers continued to engage with clients and implement EBPs while navigating a number of changes related to the transition to telehealth. This study highlights the need for further work on what supports providers need to effectively engage with clients and deliver EBPs via telehealth and has implications for how telehealth is sustained or de-implemented in response to COVID-19.

Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

“…A survey of 2,180 mental health staff in the UK [16] found infection control and lack of meaningful activity for service users were major concerns for inpatient and residential settings, while staff in community services typically struggled with rapid adaptation to new ways of working, including remote care, and lack of other community and voluntary sector services to refer into. Increased workload, introducing telehealth technologies and altered patient/provider interactions have been identified as key challenges by US mental health staff [17]. Increased use of individual self-management strategies has been reported by people with mental health conditions (such as engaging in purposeful creative or relaxing activities, keeping journals or using mindfulness or meditation); as has increased use of peer or community support [10].…”

Urgent Psychiatric Consultations at Mental Health Center during COVID-19 Pandemic: Retrospective Observational Study

“…In 2020, the outcomes of UPC at MHC presented statistically significant differences in comparison with those of the previous year: drug prescription and /or administration were reduced whereas discharge at home was increased. Reduced drug prescription can be explained by the high number of teleconsultations which did not permit the delivery of therapy, as observed by other authors [43]. We believe that the most frequent outcome of UPC in 2020, home discharge, may have been conditioned by the need to manage psychiatric disorders, albeit urgent and acute, on an outpatient basis, avoiding hospitalization when possible due to the risk of COVID-19 contagion, as other studies highlighted [27,37,44].…”

“…This result highlights the importance of so called tele-psychiatry, which permitted professional contacts with patients by telephone, messages and video calls with patients even during social distancing periods. Another study has recently highlighted that telehealth has permitted health services to maintain the continuity of care during this COVID-19 pandemic despite the difficulties in delivering therapies and the potential limitations to confidentiality [43]. Telehealth service has been evaluated as particularly feasible and appropriate for patients and their families and /or caregivers during this COVID-19 pandemic [32].…”

Experiences of living with mental health problems during the COVID-19 pandemic in the UK: a coproduced, participatory qualitative interview study

“…Increased workload, introducing telehealth technologies and altered patient/provider interactions have been identified as key challenges by US mental health staff. [17] Individual approaches to self-management and increased use of peer or community support by people with mental health conditions have been reported. [10] However, a lived experience commentary on this paper questioned the sustainability of such self-management.…”