Telehealth Conversion of Serious Mental Illness Recovery Services During the COVID-19 Crisis

Medalia, Alice; Lynch, David A.; Herlands, Tiffany

doi:10.1176/appi.ps.71705

Cited by 27 publications

(23 citation statements)

References 1 publication

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“…Several studies also reported no psychiatric decompensations after switching to remote care e.g. (87, 89). However, it is important to note that clinical outcomes for telemental health were not comparable for all service users, for example Dores et al (61) found a quarter of psychiatrists reported poorer clinical outcomes after switching to remote care.…”

Section: Resultsmentioning

confidence: 98%

Implementation, adoption and perceptions of telemental health during the COVID-19 pandemic: a systematic review

Appleton

Williams

Juan

et al. 2021

Preprint

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Background: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health, and to debates on its future use in routine mental health care. Objective: To investigate the adoption and impacts of telemental health approaches during the COVID-19 Pandemic, and facilitators and barriers to optimal implementation. Methods: Four databases (PubMed, PsycINFO, CINAHL and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesised using framework synthesis. Results: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. Conclusions: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these.

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Section: Resultsmentioning

confidence: 98%

Implementation, adoption and perceptions of telemental health during the COVID-19 pandemic: a systematic review

Appleton

Williams

Juan

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…During lockdown, service users may face a number of uncertainties which they may want an opportunity to discuss, such as experiencing social isolation, and being concerned about access to medications (42). During lockdown, many services deemed non-essential stopped, leaving service users without the social and skills support that are important to them (43).…”

Section: Discussionmentioning

confidence: 99%

“…For example, though technically adaptable, team members were concerned that online WRAP sessions would not provide an adequately supportive and safe environment, and that online staff training would be less effective than in-person training because staff would not be able to interact with each other in the same way. WRAP however has reportedly been delivered online in during the COVID-19 pandemic elsewhere [43]. Hasson-Ohayon and Lysaker [42] found that intersubjective connections can be maintained even after switching to online platforms.…”

Section: Discussionmentioning

confidence: 99%

“…Authors have begun describing the impact the COVID-19 pandemic has had on their projects and how organizations have or have not adapted [26,42,43]. Becker et al [26] describe how one of three outcomes was observed among Opioid Treatment Programs implementing contingency planning as a result of the COVID-19 pandemic-discontinuation with no plan for resumption, pause and develop plans to resume services once social distancing guidelines were relaxed, and adaptation to an online version without service disruption.…”

Section: Mid-implementation Outcomes During the Covid-19 Pandemicmentioning

confidence: 99%

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Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services

Piat

Wainwright

Cherkas

et al. 2021

Implement Sci Commun

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Background Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan for its implementation. At the time of the COVID-19 outbreak and lockdown measures, six of the seven organizations had begun implementing their chosen innovation (peer workers, wellness recovery action planning facilitator training, staff training and a family support group). This mid-implementation study used the Consolidated Framework for Implementation Research (CFIR) to identify contextual factors that influenced organizations to continue or postpone implementation of recovery-oriented innovations in the early months of the COVID-19 pandemic. Methods Twenty-seven semi-structured 45-min interviews were conducted between May and June 2020 (21 implementation team members and six providers of the innovation (trainers, facilitators, peer workers). Interview guides and analysis were based on the CFIR. Content analysis combined deductive and inductive approaches. Summaries of coded data were given ratings based on strength and valence of the construct’s impact on implementation. Ratings were visualized by mid-implementation outcome and recovery innovation to identify constructs which appear to distinguish between sites with a more or less favorable mid-implementation outcomes. Results Four mid-implementation outcomes were observed at this snapshot in time (from most to least positive): continued implementation with adaptation (one site), postponement with adaptation and estimated relaunch date (four sites), indefinite postponement with no decision on relaunch date (one site), and no implementation of innovation yet (one site). Two constructs had either a negative influence (external policies and incentives—renamed COVID-19-related external policy for this study) or a positive influence (leadership engagement), regardless of implementation outcome. Four factors appeared to distinguish between more or less positive mid-implementation outcome: adaptability, implementation climate and relative priority, available resources, and formally appointed internal implementation leaders (renamed “engaging implementation teams during the COVID-19 pandemic” for this study). Conclusions The COVID-19 pandemic is an unprecedented outer setting factor. Studies that use the CFIR at the mid-implementation stage are rare, as are studies focusing on the outer setting. Through robust qualitative analysis, we identify the key factors that shaped the course of implementation of recovery innovations over this turbulent time.

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“…Prior to the pandemic, national survey data indicated that the use of telemedicine services had grown in facilities providing ACT at a rate proportional to its growth in all mental health facilities (Spivak et al, 2019 ; Talley et al, 2021 ). Easing of telehealth regulations during the pandemic allowed for flexibility to approach recovery-oriented behavioral health services differently (Medalia et al, 2020 ).…”

Section: Lessons From the Covid-19 Pandemicmentioning

confidence: 99%

Further Adaptations and Reflections by an Assertive Community Treatment Team to Serve Clients with Severe Mental Illness During COVID-19

Couser

Taylor-Desir

Lewis³

et al. 2021

Community Ment Health J

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In September of 2020, Guan and colleagues wrote about their experience of an Assertive Community Psychiatry Program responding to the COVID-19 pandemic. We describe our own experience as an Assertive Community Treatment team in Minnesota responding to challenges of effectively and safely delivering service to clients. As the pandemic has progressed since last year, so has the literature, and updated references are highlighted. Common threads are woven between our experience, the experience of Guan and colleagues, and others to suggest the beginnings of a template to adapt services to a new post-pandemic world.

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Telehealth Conversion of Serious Mental Illness Recovery Services During the COVID-19 Crisis

Cited by 27 publications

References 1 publication

Implementation, adoption and perceptions of telemental health during the COVID-19 pandemic: a systematic review

Implementation, adoption and perceptions of telemental health during the COVID-19 pandemic: a systematic review

Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services

Further Adaptations and Reflections by an Assertive Community Treatment Team to Serve Clients with Severe Mental Illness During COVID-19

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