The Good, The Bad, The Uncertain: Diverse Provider Experiences with Telemental Health During COVID-19

Abstract

This study assessed mental health provider attitudes and perceptions of telemental health (TMH) prior to and during the COVID-19 Pandemic. The study expands on earlier work by providing a more detailed qualitative analysis of provider perceptions of TMH, including its efficacy, advantages, and limitations. The current study is part of a larger mixed methods project utilizing a repeated cross-sectional design. An online survey was administered to a sample of 1,448 mental health providers. Of the survey participants, 934 offered narrative responses to open-ended questions and were included in the present study. Qualitative data was analyzed using a coding team and the Consensual Qualitative Research paradigm. Providers described both positive and negative feelings about using TMH during the COVID-19 Pandemic. Several advantages were identified, with providers clearly appreciating the role of TMH in allowing them to work continuously and safely during the public health emergency. An array of negative views and concerns were also expressed, including that TMH may not be optimal or effective in certain settings or situations. A portion of respondents also indicated a preference for face-to-face care and illuminated ways they found TMH lacking or limited.

Barriers and Facilitators to Psychologists’ Telepsychology Uptake during the Beginning of the COVID-19 Pandemic

“…The top five reported facilitators were increased safety, better access to patient care, patient demand, efficient use of time, and adequate technology for telepsychology use. Overall, the top facilitators in this study align with other studies [ 52 ] and highlight how these facilitators may be used to encourage further utilization in the modality, expansion in services, and policy changes [ 50 ] beyond the pandemic and more as a permanent tool for mental health services. Given the COVID-19 pandemic, it is somewhat unsurprising that the top facilitators of telepsychology use were increased safety to prevent the spread of COVID-19 and better access to patient care during the initial phase of the lockdown period; it is also not surprising that there would be high patient demand for telepsychology, considering the improved safety and access.…”

“…For instance, a qualitative study exploring the transition of 20 psychiatrists to telemedicine at the beginning of the pandemic found similar concerns related to patient privacy, disparities in access to reliable technology for visits, and concerns about the quality of delivered care [ 49 ]. A larger qualitative study examining 934 mental health professionals’ views at the beginning of the pandemic found similar barriers including concerns about its effectiveness, problems with technology use (i.e., poor connectivity and video quality), and worries about replicating the therapeutic environment [ 52 ]. The current findings provide additional context to these previous studies by exploring demographic and professional characteristic predictors for the endorsement of these barriers and facilitators.…”

Number and nature of psychiatric emergency department visits in a tertiary hospital before, during, and after coronavirus pandemic

“…However, the preference of patients is still face to face therapy, and these measures have often proven insufficient ( 43 ). Almost two thirds of mental health professionals expressed negative thoughts on the efficacy of telemental health, prominently technology problems and concerns on its safety in certain settings and disorders ( 44 ).…”