Telebehavioral Health During the COVID-19 Pandemic: A Qualitative Analysis of Provider Experiences and Perspectives

Abstract

Introduction: Due to the COVID-19 pandemic and prompted by recent federal and state policy shifts impacting behavioral health care delivery, the use of telebehavioral health has rapidly increased. This qualitative study describes behavioral health provider perspectives on the use of telebehavioral health before and during the pandemic and how policy changes impacted access to and utilization of behavioral health services in Michigan. Materials and Methods: A convenience sample of 31 licensed and nonlicensed behavioral health providers operating in Michigan participated in semi-structured interviews between July and August 2020. Interviews were audio-recorded, transcribed, and analyzed by using inductive methods. Results: The thematic analysis resulted in four overarching themes: (1) increased access to care; (2) maintenance of quality of care; (3) minimal privacy concerns; and (4) client and provider satisfaction. Discussion: During and post-pandemic, providers need flexibility to determine whether in-person or telebehavioral health services, including audio-only, best meet client needs. Providers identified several populations for which telebehavioral health was less accessible: clients with serious mental illness and substance use disorder, those with no broadband Internet access, children, and older adults. Additional training in telebehavioral health service provision can positively impact quality of care. Conclusion: Policies that support reimbursement parity and expand provider use of telebehavioral health services should be maintained after the COVID-19 pandemic ends to avoid imposing barriers to accessing behavioral health care barriers post-pandemic.

Federally Qualified Health Centers Use of Telehealth to Deliver Integrated Behavioral Health Care During COVID-19

“…Overall, the expansion of telehealth gave providers additional tools to provide treatment, which can increase patient satisfaction (Kruse et al, 2017 ). Several studies of IBH providers across disciplines have documented providers’ overwhelming support for adding telecommunication options for care (Guinart et al, 2021 ; Lombardi et al, 2022 ; Schoebel et al, 2021 ).…”

“…Tele-BH for one-to-one psychotherapy is an effective treatment modality (Aboujaoude et al, 2015 ; Hilty et al, 2013 ) that has proven to be particularly advantageous during the pandemic (Lombardi et al, 2022 ; Schoebel et al, 2021 ). However, the transition to tele-BH also posed challenges to FQHC’s ability to maintain critical components of IBH.…”

COVID-19, Rural Communities, and Implications of Telebehavioral Health Services: Addressing the Benefits and Challenges of Behavioral Health Services via Telehealth in Nebraska

“…When issues such as these arise, they create an interruption in services. It is also important to note that rural areas, which tend to lack behavioral health access, also often lack sufficient internet services to fully benefit from telehealth services [29], or in certain context may mean that there is literally no access to broadband internet [30].…”

“…Such efforts not only prepare practitioners to be better service providers, but can also lead to better outcomes for clients. Additional training and educational opportunities should also be made available to current practitioners [30].…”

What affects employment by NGOs? Counteraction to precarious employment in the Polish non-profit sector in the perspective of COVID-19 pandemic crises

“…This study proves that the lack of people ready to selflessly involve themselves in an organization's activities decreases the probability of employing contract workers, which in the face of the declining trend of the number of people disinterestedly willing to get involved in the activities of the organization is a real challenge for them; in addition, the risk of contracting COVID-19 may reduce the opportunities for disinterested support of the organization by personal direct actions (Díaz, 2020). In this context, it should also be noted that rapidly increasing number of infected people may also cause a strong feeling of powerlessness, and consequentlyburnout of paid staff and volunteers engaged in preventing undesirable effects of COVID-19 (Deitrick et al, 2020;Schoebel et al, 2021).…”