Understanding and Accommodating Patient and Staff Choice When Implementing Video Consultations in Mental Health Services

Abstract

During the COVID-19 pandemic, some mental healthcare in the United Kingdom has moved online, with more likely to follow. The current evidence base for video consultations is modest; hence, this study seeks to aid decision-makers by reporting on one large National Health Service mental health trust's video-consultation pilot project. Patients' choices/preferences were gathered via online forms; and staff's views, through a focus group. The typical patient was female, 26 years old, living in a deprived locality. Consultations typically lasted 37 minutes, saving patients 0–30 minutes of travel and £0–£3.00. Satisfaction was high, and the software was intuitive. Audio quality varied, but patients felt able to disclose “as if in person,” were willing to use video consultation again, and found them more preferable than home visits and clinic attendance. Staff could foresee benefits but were concerned for their therapeutic relationships and were avoidant without familiarization, training, clinical coaching, and managerial reassurances especially regarding high-risk patients/situations. They argued video consultation would not suit all patients and should be used according to individual need. We found COVID-19 is necessitating staff to adopt video consultation and that patients are satisfied. However, unless staff's concerns are resolved, enabling them to use their full repertoire of interpersonal skills, therapeutic relationships will trump efficiency and video consultations may not remain their treatment modality of choice.

Acceptability of Tele-mental Health Services Among Users: A Systematic Review and Meta-analysis

“…Providers were represented either as healthcare workers (HCWs) or caregivers [ 16 , 31 , 37 , 38 , 51 , 56 , 58 ]. Some studies included both populations of providers and beneficiaries [ 26 , 42 , 48 ]. Studies covered many types of mental disorders, such as anxiety [ 13 , 15 , 17 , 32 , 35 , 37 , 44 – 46 ], mood changes [ 13 , 15 , 17 , 25 , 27 , 30 , 37 , 39 , 44 – 46 , 53 , 55 , 59 ], psychotic disorders [ 27 , 28 , 33 , 43 , 50 ], neurocognitive disorders [ 26 , 48 ], personality disorders [ 31 ], substance-related and addiction [ 29 , 56 , 57 ], severe mental illness [ 29 , 58 ], and other non-specified mental disorders [ 16 , 34 , 36 , 38 , 40 – 42 , 47 , 49 , 51 , 52 , 54 ].…”

“…Studies covered many types of mental disorders, such as anxiety [ 13 , 15 , 17 , 32 , 35 , 37 , 44 – 46 ], mood changes [ 13 , 15 , 17 , 25 , 27 , 30 , 37 , 39 , 44 – 46 , 53 , 55 , 59 ], psychotic disorders [ 27 , 28 , 33 , 43 , 50 ], neurocognitive disorders [ 26 , 48 ], personality disorders [ 31 ], substance-related and addiction [ 29 , 56 , 57 ], severe mental illness [ 29 , 58 ], and other non-specified mental disorders [ 16 , 34 , 36 , 38 , 40 – 42 , 47 , 49 , 51 , 52 , 54 ]. Acceptability of tele-mental health services was studied for either educational [ 55 ], therapeutic [ 13 , 15 – 17 , 25 , 28 , 29 , 31 , 33 – 39 , 42 , 44 – 49 , 52 , 54 , 56 , 58 ], or diagnostic [ 26 , 30 , 41 ,…”

“…Concerning the acceptance of tele- mental health services in studies involving both providers and beneficiaries, there were a total of four studies conducted in 2013–2021 [ 26 , 42 , 48 , 49 ], encompassing 734 participants. The pooled acceptance rate was 71.0% (95%CI, 51.0 − 85.0%), I 2 = 87%, Fig.…”