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Stein NR, Stolzmann KL, Abel EA, Burgess CM, Franz A, Connolly SL, Meshberg N, Bailey HM, Osser DN, Smith EG, Bauer MS, Godleski L, Miller CJ. Ten Years of Bipolar Telehealth: Program Evaluation of a Team-Based Telemental Health Clinic. Telemed J E Health 2025; 31:269-278. [PMID: 39421937 DOI: 10.1089/tmj.2024.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024] Open
Abstract
Objectives: Telemental health via videoconferencing (TMH-V) can overcome many of the barriers to accessing quality mental health care. Toward this end, in 2011, the U.S. Department of Veterans Affairs (VA) established the National Bipolar Disorders TeleHealth (BDTH) Program to provide expert mental health consultation and treatment to Veterans with bipolar spectrum disorders. Methods: Initial analyses of BDTH services suggested that participants had positive changes in quality-of-care indices and clinical outcomes; however, that evaluation was based on a limited sample of both participants and VA medical centers. We were able to confirm and expand upon those early results by using nearly eight times the number of participants and more than twice as many medical centers. Results: For the 2,456 Veterans who completed the intake to our program, there were significant improvements in some of the quality metrics (e.g., lithium use) and a 54% reduction in positive suicide screens (p < 0.05). The Veterans who completed the initial and postprogram assessments (n = 815) reported a 16.6% reduction in manic symptoms (p < 0.001), a 29.3% reduction in depressive symptoms (p < 0.001), and a 21.2% reduction in mood episodes (p < 0.001). Additionally, these Veterans demonstrated significant improvements (p < 0.001) in mental health-related quality of life between the two assessments. Conclusions: These analyses provide further support for the general effectiveness and safety of telemental health via videoconferencing. Future research should examine the generalizability of these findings across various subgroups (e.g., minority patients, patients in rural areas), populations, and health care systems.
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Affiliation(s)
- Nathan R Stein
- VA Boston Healthcare System, Brockton, Massachusetts, USA
- VA National Expert Consultation & Specialized Services, West Haven, Connecticut, USA
| | - Kelly L Stolzmann
- VA Boston Healthcare System, Center for Health Optimization and Implementation Research (CHOIR), Boston, Massachusetts, USA
| | - Erica A Abel
- VA National Expert Consultation & Specialized Services, West Haven, Connecticut, USA
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Claire M Burgess
- VA Boston Healthcare System, Brockton, Massachusetts, USA
- VA National Expert Consultation & Specialized Services, West Haven, Connecticut, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Aleda Franz
- VA National Expert Consultation & Specialized Services, West Haven, Connecticut, USA
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Samantha L Connolly
- VA Boston Healthcare System, Center for Health Optimization and Implementation Research (CHOIR), Boston, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Nathaniel Meshberg
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Hannah M Bailey
- VA Boston Healthcare System, Center for Health Optimization and Implementation Research (CHOIR), Boston, Massachusetts, USA
| | - David N Osser
- VA Boston Healthcare System, Brockton, Massachusetts, USA
- VA National Expert Consultation & Specialized Services, West Haven, Connecticut, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Eric G Smith
- VA National Expert Consultation & Specialized Services, West Haven, Connecticut, USA
- VA Bedford Healthcare System, Center for Health Optimization and Implementation Research (CHOIR), Bedford, Massachusetts, USA
- University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Mark S Bauer
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Linda Godleski
- Yale School of Medicine, New Haven, Connecticut, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Christopher J Miller
- VA National Expert Consultation & Specialized Services, West Haven, Connecticut, USA
- VA Boston Healthcare System, Center for Health Optimization and Implementation Research (CHOIR), Boston, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
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Tenso K, Strombotne K, Garrido MM, Lum J, Pizer S. Virtual Mental Health Care and Suicide-Related Events. JAMA Netw Open 2024; 7:e2443054. [PMID: 39499516 PMCID: PMC11539012 DOI: 10.1001/jamanetworkopen.2024.43054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 09/12/2024] [Indexed: 11/07/2024] Open
Abstract
Importance The rising suicide rates in the US emphasize the need for effective prevention. While telehealth has transformed access to mental health care, the impact of telehealth on suicide outcomes is unknown. Objective To evaluate the association of virtual mental health services with individual-level suicide-related events (SREs). Design, Setting, and Participants This retrospective cohort study using broadband access as an instrumental variable assessed a national sample of Veterans Health Administration patients who received mental health care between March 1, 2020, and December 31, 2021. Participants were recently separated (ie, discharged or released from active duty) veterans who completed their active duty service between March 1, 2019, and December 31, 2020, and who received at least 2 outpatient or inpatient diagnoses related to major depressive disorder, substance use disorder, or posttraumatic stress disorder within the year before their most recent separation date. Data were analyzed May 1 to October 31, 2023. Exposure Percentage of a patient's total mental health visits that were conducted virtually by psychiatrists, psychologists, or social workers within a calendar month. Main Outcomes and Measures Binary measure indicating whether the patient had experienced an SRE (defined as a nonfatal suicide attempt, intentional self-harm, or suicide death) in a specific month and year as evaluated an instrumental variable probit model. Results The sample included 66 387 data points from 16 236 unique recently separated veterans. Among these entries, 44 766 were for male veterans (67.4%), the mean (SD) age across the sample was 32.9 (8.9) years, and the sample was representative of the US veteran population. There were 929 SREs (1.4%). Virtual mental health visits comprised a mean (SD) of 44.6% (46.1%) of all mental health visits. In instrumental variable probit analyses accounting for factors simultaneously associated with use of virtual mental health care and SRE risk, a 1% increase in the probability of virtual mental health visits was associated with a 2.5% decrease in SREs. Conclusions and Relevance Findings from this cohort study using a retrospective quasi-experimental design found that an increase in virtual mental health visits relative to total visits was associated with a statistically significant decrease in SREs, suggesting that providing virtual mental health services may reduce suicide-related outcomes.
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Affiliation(s)
- Kertu Tenso
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
- Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, Boston, Massachusetts
| | - Kiersten Strombotne
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
- Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, Boston, Massachusetts
| | - Melissa M. Garrido
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
- Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, Boston, Massachusetts
| | - Jessica Lum
- Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, Boston, Massachusetts
| | - Steven Pizer
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
- Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, Boston, Massachusetts
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Jaske E, Wheat CL, Rubenstein LV, Leung L, Curtis I, Wahlberg L, Felker B. Understanding How Contingency Staffing Programs Can Support Mental Health Services in the Veterans Health Administration. Telemed J E Health 2024; 30:1857-1865. [PMID: 38563753 DOI: 10.1089/tmj.2023.0573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Introduction: Beginning in 2019, the Department of Veterans Affairs (VA) prioritized improving access to care nationally to deliver virtual care and implemented 18 regionally based Clinical Resource Hubs (CRHs) to meet this priority. This observational study describes the quantity and types of care delivered by CRH Mental Health teams, and the professions of those hired to deliver it. Methods: A retrospective cohort study, based on national VA CRH mental health care utilization data and CRH staffing data for CRH's first 3 years, was conducted. Results: CRH Mental Health teams primarily used Telemental Health (TMH) to provide care (98.1% of all CRH MH encounters). The most common disorders treated included depression, post-traumatic stress disorder, and anxiety disorders. The amount of care delivered overtime steadily increased as did the racial and ethnic diversity of Veterans served. Psychologists accounted for the largest share of CRH staffing, followed by psychiatrists. Conclusions: CRH TMH delivered from a regional hub appears to be a feasible and acceptable visit modality, based on the continuously increasing CRH TMH visit rates. Our results showed that CRH TMH was predominantly used to address common mental health diagnoses, rather than serious mental illnesses. Traditionally marginalized patient populations increased over the 3-year window, suggesting that CRH TMH resources were accessible to many of these patients. Future research should assess barriers and facilitators for accessing CRH TMH, especially for difficult-to-service patient populations, and should consider whether similar results to ours occur when regional TMH is delivered to non-VA patient populations.
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Affiliation(s)
- Erin Jaske
- VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, Washington, USA
- Primary Care Analytics Team, Department of Veterans Affairs, Seattle, Washington, USA
| | - Chelle L Wheat
- VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, Washington, USA
- Primary Care Analytics Team, Department of Veterans Affairs, Seattle, Washington, USA
| | - Lisa V Rubenstein
- Center for the Study of Health care Innovation, Implementation and Policy, Veterans Affairs Greater Los Angeles Health Care System, Department of Veterans Affairs, Los Angeles, California, USA
- Division of General Internal Medicine-Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA, USA
| | - Lucinda Leung
- Center for the Study of Health care Innovation, Implementation and Policy, Veterans Affairs Greater Los Angeles Health Care System, Department of Veterans Affairs, Los Angeles, California, USA
- Division of General Internal Medicine-Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Idamay Curtis
- VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, Washington, USA
- Primary Care Analytics Team, Department of Veterans Affairs, Seattle, Washington, USA
| | - Lawrence Wahlberg
- Department of Veterans Affairs, National Clinical Resource Hub, VA Central Office, Washington, District of Columbia, USA
- Department of Psychiatry, School of Medicine, University of Colorado Denver, Aurora, Colorado, USA
| | - Bradford Felker
- VA Puget Sound Health Care System, Department of Veterans Affairs, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, Seattle, Washington, USA
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Goldfus TB. The impact of social media use on depression, anxiety, and well-being for teens/young people: using hypnosis to build a strong sense of self. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2024; 66:140-156. [PMID: 37586041 DOI: 10.1080/00029157.2023.2240863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
The national conversation continues to focus on the negative impact of social media on teens/young people. The lingering effects of the pandemic revealed sharp increases in the common practice of "compare and despair" as well as higher rates of loneliness, isolation, depression, and self-harming behaviors. In May 2023, the US Surgeon General warned that social media "is the defining public issue of our time" and is driving the teen mental health crisis. These concerns for the mental health of humans across the globe are real and dramatic. Social media's impact on young people can be neutral, negative, positive or shades of each. The hypnosis community has an opportunity to be a more vital presence in helping young people navigate, manage, and reduce negative social media impact and to harness social media's very positive contributions, many of which are well documented. This article focuses on assessing social media use in teens and young adults, identifying developmental tasks being practiced on social media, and how factors such as time spent on social media and social media experiences have promoted trauma, stress, depression and anxiety. In addition, it will consider some of the ways in which the isolating effects of COVID-19 have further impacted well-being. Finally, the article will discuss how hypnotherapists can leverage social media to foster stronger ego strengthening using therapeutic interventions that employ hypnosis, hypnotherapy techniques and interventions, hypnotic scripts, and social media to lower mental health risks in teens/young adults.
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Choi J, Kim G, Choi S, Chang JE. A Year After Implementation of the Telehealth Waiver: Being Offered and Utilizing Video-Specific Telehealth Among Dual-Eligible Medicare Recipients During the COVID-19 Pandemic. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:255-266. [PMID: 37938810 DOI: 10.1097/phh.0000000000001845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Telehealth is an essential tool to provide access to care while reducing infection exposure for high-risk populations during the COVID-19 pandemic. Our study aims to examine factors associated with telehealth availability and usage among Medicare and dual-eligible recipients 1 year after implementation of the Medicare's temporary telehealth waiver. DESIGN, SETTING, AND PARTICIPANT A cross-sectional, phone survey with a national representative sample of Medicare recipients. We obtained a final study sample from the Winter 2021 COVID-19 Supplement of Medicare Current Beneficiary Survey dataset (N = 10 586). We examined associations for being offered and having had telehealth visits or any video telehealth visits during the pandemic since November 1, 2020. MAIN OUTCOME MEASURES Our primary outcomes were being offered any telehealth, being offered any video telehealth, having had any telehealth visit, and having had any video telehealth. RESULTS Although dual eligibility was not significantly associated with being offered or having had any telehealth services during the pandemic, those who were dual eligible were more likely to have had video telehealth visits (adjusted odds ratio = 1.39, 95% confidence interval 1.04-1.86, P = .03) compared with those with non-dual eligibility. Recipients with disability eligibility, technology access, and severe chronic conditions were more likely to have been offered or have had telehealth. At the same time, those who lived in the nonmetropolitan area were less likely to have been offered or have had telehealth, including video telehealth. CONCLUSIONS Our findings suggest that the federal waivers to expand telehealth services were successful in continuing care for vulnerable Medicare recipients. The providers' specific outreach and intervention efforts to offer telehealth visits are crucial for dual-eligible recipients. To increase video telehealth uptake, technology access and services to rural areas should be prioritized.
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Affiliation(s)
- Jasmin Choi
- Departments of Social and Behavioral Sciences (Ms J. Choi) and Public Health Policy and Management (Dr Chang), School of Global Public Health, New York University, New York, New York; Robert F. Wagner Graduate School of Public Service, New York University, New York, New York (Dr Kim); and Department of Population Health, Grossman School of Medicine, New York University, New York, New York (Dr S. Choi)
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Ricklan SJ, Sohler N, Ezie CEC, Avalone L, Dinsell V, Lewis C, Fattal O, Balan S, McQuistion H, Pastore F, Sarcevic N, Swift R, Espejo G, Lorenz C. Impact of Telemedicine on Utilization of Psychiatric Resources in New York City during the COVID-19 Pandemic. Community Ment Health J 2024; 60:115-123. [PMID: 38105337 DOI: 10.1007/s10597-023-01210-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/04/2023] [Indexed: 12/19/2023]
Abstract
This study sought to evaluate the impact of telepsychiatry during the COVID-19 pandemic among patients discharged from psychiatric inpatient units in the New York City Health and Hospitals Corporation system. We compared patients discharged to telepsychiatry (April 2020, n = 739) and in-person follow-up (May 2019, n = 527); we collected number, timing and attendance for follow-up appointments and number and timing of emergency room (ER) visits and readmissions. We used logistic regression to evaluate the odds of having these encounters and Kaplan-Meier analyses to compare time to these encounters. Patients discharged in 2020 were more likely to have a follow-up (29.4 vs. 19.9%, p < 0.001) and an ER visit or readmission (40.5 vs. 28.7%, p < 0.001). Kaplan-Meier analyses showed shorter time to first follow-up (chi-square = 14.69, d.f.=1, p < 0.0001, follow-ups = 322) and ER visit or readmission (chi-square = 19.57, d.f.=1, p < 0.0001, ER visits or admissions = 450) in the 2020 cohort. In multivariable analyses, patients discharged in 2020 were more likely to have a follow-up visit (adjusted OR 1.85, 95% confidence interval 1.40, 2.45, p < 0.0001). We found an increase in psychiatric service utilization during the pandemic, with an increase in and shorter time until outpatient visits and ER visits or readmissions. Although increased use of psychiatric services during the height of the COVID-19 pandemic is encouraging, it also points to the depth of the crisis among vulnerable populations; this pattern warrants further exploration and intervention.
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Affiliation(s)
- Sarah J Ricklan
- NYU Grossman School of Medicine, 550 First Ave, New York, NY, 10016, USA.
| | - Nancy Sohler
- CUNY School of Medicine, Harris Hall, 160 Convent Avenue, New York, 10031, NY, USA
| | - C E Chiemeka Ezie
- NYU Grossman School of Medicine, 550 First Ave, New York, NY, 10016, USA
| | - Lynsey Avalone
- NYC Health and Hospitals, 125 Worth Street, New York, NY, 10013, USA
| | - Victoria Dinsell
- NYU Grossman School of Medicine, 462 1st Avenue, New York, NY, 10016, USA
| | - Crystal Lewis
- NYU Grossman School of Medicine, One Park Ave, New York, NY, 10016, USA
| | - Omar Fattal
- NYC Health and Hospitals, 125 Worth Street, Office 423, New York, NY, 10013, USA
| | - Sabish Balan
- Harlem Hospital, 506 Lenox Avenue, New York, NY, 10037, USA
| | - Hunter McQuistion
- NYU Grossman School of Medicine, One Park Ave, 8th Floor, New York, NY, 10016, USA
| | - Frank Pastore
- North Central Bronx Hospital, 3424 Kossuth Avenue, New York, NY, 10467, USA
| | - Nermica Sarcevic
- Jacobi Hospital, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
| | - Ronnie Swift
- NY Health and Hospitals/Metropolitan, 1901 First Avenue, New York, NY, 10029, USA
| | - Gemma Espejo
- Montefiore Medical Center, 111 East 210th St, New York, NY, 10467, USA
| | - Carina Lorenz
- NYC Health and Hospitals-Bellevue, 462 1st Avenue, New York, NY, 10016, USA
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Gravina AG, Pellegrino R, Durante T, Palladino G, D'Onofrio R, Mammone S, Arboretto G, Auletta S, Imperio G, Ventura A, Romeo M, Federico A. Telemedicine in inflammatory bowel diseases: A new brick in the medicine of the future? World J Methodol 2023; 13:194-209. [PMID: 37771865 PMCID: PMC10523254 DOI: 10.5662/wjm.v13.i4.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 09/20/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic digestive disease that requires continuous monitoring by healthcare professionals to determine the appropriate therapy and monitor short-term and long-term complications. The progressive development of information technology has enabled healthcare personnel to deliver care services to patients remotely. Therefore, various applications of telemedicine in IBD management have evolved, including telemonitoring, teleconsulting, teleducation, telenursing, telenutrition, and telepathology. While evidence has been provided for some telemedicine applications, targeted studies are still required. This review summarises the major studies that have evaluated telemedicine and its application in the management of IBD.
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Affiliation(s)
| | - Raffaele Pellegrino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Tommaso Durante
- Mental Health Department, “S. Pio” Hospital, Benevento 82100, Italy
| | - Giovanna Palladino
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Rossella D'Onofrio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Simone Mammone
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giusi Arboretto
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Salvatore Auletta
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Giuseppe Imperio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Andrea Ventura
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Mario Romeo
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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Saif-Ur-Rahman KM, Islam MS, Alaboson J, Ola O, Hasan I, Islam N, Mainali S, Martina T, Silenga E, Muyangana M, Joarder T. Artificial intelligence and digital health in improving primary health care service delivery in LMICs: A systematic review. J Evid Based Med 2023; 16:303-320. [PMID: 37691394 DOI: 10.1111/jebm.12547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
AIM Technology including artificial intelligence (AI) may play a key role to strengthen primary health care services in resource-poor settings. This systematic review aims to explore the evidence on the use of AI and digital health in improving primary health care service delivery. METHODS Three electronic databases were searched using a comprehensive search strategy without providing any restriction in June 2023. Retrieved articles were screened independently using the "Rayyan" software. Data extraction and quality assessment were conducted independently by two review authors. A narrative synthesis of the included interventions was conducted. RESULTS A total of 4596 articles were screened, and finally, 48 articles were included from 21 different countries published between 2013 and 2021. The main focus of the included studies was noncommunicable diseases (n = 15), maternal and child health care (n = 11), primary care (n = 8), infectious diseases including tuberculosis, leprosy, and HIV (n = 7), and mental health (n = 6). Included studies considered interventions using AI, and digital health of which mobile-phone-based interventions were prominent. m-health interventions were well adopted and easy to use and improved the record-keeping, service deliver, and patient satisfaction. CONCLUSION AI and the application of digital technologies improve primary health care service delivery in resource-poor settings in various ways. However, in most of the cases, the application of AI and digital health is implemented through m-health. There is a great scope to conduct further research exploring the interventions on a large scale.
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Affiliation(s)
- K M Saif-Ur-Rahman
- College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Galway, Ireland
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Md Shariful Islam
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Joan Alaboson
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Oluwadara Ola
- Sacred Heart Hospital, Abeokuta, Ogun State, Nigeria
| | - Imran Hasan
- Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Nazmul Islam
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Shristi Mainali
- Department of Operations, Marie Stopes International, Kathmandu, Nepal
| | - Tina Martina
- General Hospital of Haji Padjonga, South Sulawesi, Indonesia
| | - Eva Silenga
- Department of Mother and Child Health, Ministry of Health, Lusaka, Zambia
| | - Mubita Muyangana
- Lewanika School of Nursing and Midwifery, Ministry of Health, Mongu, Zambia
| | - Taufique Joarder
- SingHealth Duke-NUS Global Health Institute, National University of Singapore, Singapore
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Maria Michael J, Reyes MES. Online Mindfulness-Based Logotherapy Program: A Pilot Study Targeting Depressive Symptoms of Cyberbullied Adolescents During the Covid-19 Pandemic. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023; 8:1-9. [PMID: 36117749 PMCID: PMC9464054 DOI: 10.1007/s41347-022-00279-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 07/07/2022] [Accepted: 09/02/2022] [Indexed: 12/04/2022]
Abstract
The outbreak of the Covid-19 pandemic has led to the intensive use of the internet for educational and recreational purposes, leading adolescents to be more exposed to cyberbullying. Empirical studies indicate that cyberbullying has become a pervasive problem among adolescents causing negative consequences like depression. Moreover, the global pandemic lockdown and quarantine measures gave rise to the demand for telepsychology and teletherapy to virtually address the psychological needs of netizens. Thus, utilizing Conklin's program development model, we created and experimentally tested an online intervention program to target the depressive symptoms experienced by cyberbullied adolescents. We integrated logotherapy and mindfulness to develop an eight-modular, Online Mindfulness-based Logotherapy Program (OnlineMLP). After being validated by experts in various disciplines, we experimentally pilot tested the efficacy of the OnlineMLP in a 3-h session per module in four weeks to a group (N = 10) of cyberbullied adolescents in Tamilnadu, India. The pilot study showed significantly that the OnlineMLP had a positive effect on the participants reducing their depressive symptoms. Furthermore, it confirmed that the online program's concepts and structure are reliable, feasible, and efficacious for testing a more extensive base of cyberbullied adolescents experiencing depressive symptoms.
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Affiliation(s)
| | - Marc Eric S. Reyes
- The Graduate School, University of Santo Tomas, Manila, Philippines
- Department of Psychology, College of Science, University of Santo Tomas, Manila, Philippines
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Gluckman NS, Eagle A, Michalitsi M, Reynolds N. Adapting to the COVID-19 Pandemic: A Psychological Crisis Support Call Service Within a Community Mental Health Team. Community Ment Health J 2023; 59:25-34. [PMID: 35737200 PMCID: PMC9219371 DOI: 10.1007/s10597-022-00985-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/06/2022] [Indexed: 01/07/2023]
Abstract
To mitigate potential mental health crises within a Community Mental Health Team (CMHT) the psychology department implemented a short-term, rapid access, crisis telephone support service for clients during the COVID-19 pandemic. We aimed to evaluate the feasibility and acceptability. Data was collected on who the service was offered to and whom engaged. Demographic information, referral and crisis support call information was collected from the service's electronic database. Forty-four participants were referred to the service. Seventy seven percent of participants engaged in one or more telephone sessions. Participants rated the service as highly useful, with simply 'talking to someone' seen as the most important aspect of the calls. A number of age differences were noted regarding the content that was discussed in sessions. The psychological crisis telephone support service was feasible and acceptable to service users during the COVID-19 pandemic.
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Affiliation(s)
- Nicole S Gluckman
- North Kensington and Chelsea Community Mental Health Team, Central and North West London NHS Trust, Pall Mall Mental Health Centre, 150 Barlby Road, London, W10 6BS, UK.,Department of Clinical Psychology, University of East London, London, UK
| | - Andrew Eagle
- North Kensington and Chelsea Community Mental Health Team, Central and North West London NHS Trust, Pall Mall Mental Health Centre, 150 Barlby Road, London, W10 6BS, UK
| | - Maria Michalitsi
- North Kensington and Chelsea Community Mental Health Team, Central and North West London NHS Trust, Pall Mall Mental Health Centre, 150 Barlby Road, London, W10 6BS, UK
| | - Nicola Reynolds
- North Kensington and Chelsea Community Mental Health Team, Central and North West London NHS Trust, Pall Mall Mental Health Centre, 150 Barlby Road, London, W10 6BS, UK. .,Department of Clinical Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
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11
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Palmer CS, Brown Levey SM, Kostiuk M, Zisner AR, Tolle LW, Richey RM, Callan S. Virtual Care for Behavioral Health Conditions. Prim Care 2022; 49:641-657. [PMID: 36357068 PMCID: PMC9581698 DOI: 10.1016/j.pop.2022.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The COVID-19 pandemic has highlighted the urgent need for behavioral health care services. A substantial portion of mental health care transitioned to virtual care during the COVID-19 pandemic, remains virtual today, and will continue that way in the future. Mental health needs continue to grow, and there has been growing evidence showing the efficacy of virtual health for behavioral health conditions at the system, provider, and patient level. There is also a growing understanding of the barriers and challenges to virtual behavioral health care.
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Affiliation(s)
- Christina S Palmer
- Department of Family Medicine, University of Colorado School of Medicine.
| | | | | | - Aimee R Zisner
- Department of Family Medicine, University of Colorado School of Medicine
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12
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Waite MR, Diab S, Adefisoye J. Virtual Behavioral Health Treatment Satisfaction and Outcomes Across Time. J Patient Cent Res Rev 2022; 9:158-165. [PMID: 35935523 PMCID: PMC9302910 DOI: 10.17294/2330-0698.1918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
Purpose The COVID-19 pandemic continues to have major and long-lasting impacts on health care delivery and mental health. As health care shifted to telehealth, legislation was adjusted to expand telehealth allowances, creating a unique opportunity to elucidate outcomes. The aim of this study was to assess long-term patient and clinician satisfaction and outcomes with virtual behavioral health. Methods Data were obtained over 16 months from surveys to patients and clinicians receiving/providing virtual treatment. Outcomes data also were collected from medical records of adults receiving in-person and virtual behavioral health treatment. Data were summarized using descriptive statistics. Groups were compared using various chi-squared tests for categorical variables, Likert response trends over time, and conditional independence, with Wilcoxon rank-sum or Jonckheere trend test used to assess continuous variables. P-values of ≤0.05 were considered statistically significant. Results Patients gave high ratings to virtual treatment and indicated a preference for virtual formats. Both patient and clinician preference for virtual visits increased significantly with time, and many clinicians perceived virtual services to be equally effective to in-person. Virtual programs had higher completion rates, attendance rates, and number of treatment visits, suggesting that virtual behavioral health had equivalent or better outcomes to in-person treatment and that attitudes toward telehealth changed over time. Conclusions If trends found in this study continue, telehealth may emerge as a preferred option long term This is important considering the increase in mental health needs associated with the COVID-19 pandemic and the eventuality that in-person restrictions ease as the pandemic subsides.
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Affiliation(s)
- Mindy R. Waite
- Aurora Behavioral Health Services, Advocate Aurora Health, Wauwatosa, WI
- Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI
| | - Sara Diab
- Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - James Adefisoye
- Aurora University of Wisconsin Medical Group, Advocate Aurora Health, Milwaukee, WI
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13
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Healthcare Professional Perspectives on the Use of Remote Patient-Monitoring Platforms during the COVID-19 Pandemic: A Cross-Sectional Study. J Pers Med 2022; 12:jpm12040529. [PMID: 35455645 PMCID: PMC9025393 DOI: 10.3390/jpm12040529] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion in healthcare services, protect health professionals, and help them maintain satisfactory quality and safety of care. Remote monitoring platforms (RPM) emerged as potential solutions. In this study, we evaluate, from health professionals’ perspectives, the capacity and contribution of two different digital platforms to maintain quality, safety, and patient engagement in care. A cross-sectional study was conducted using a survey in which a total of 491 health professionals participated. The results show that, in general, user perceptions of the quality and safety of care provided through the platforms were positive. The ease of access to health professionals’ services in general and shorter waiting times for patients were the two main features that were highly appreciated by most participants. However, some problems were encountered during the use of these two platforms, such as a lack of training and/or direct support for users. To improve the two platforms and maximize their use, the areas for improvement and the issues identified should be addressed as part of a collaborative process involving health professionals and patients as well as health system leaders, decision-makers, and digital platform providers.
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14
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Pyne JM, Kelly PA, Fischer EP, Miller HJ, Connolly SL, Wright P, Zamora K, Koenig CJ, Seal KH, Fortney JC. Initial concurrent and convergent validity of the Perceived Access Inventory (PAI) for mental health services. Psychol Serv 2022; 19:118-124. [PMID: 33030947 PMCID: PMC8552404 DOI: 10.1037/ser0000504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Access to high-quality health care, including mental health care, remains a high priority for the Department of Veterans Affairs and civilian health care systems. Increased access to mental health care is associated with improved outcomes, including decreased suicidal behavior. Multiple policy changes and interventions are being developed and implemented to improve access to mental health care. The Perceived Access Inventory (PAI) is a patient-centered questionnaire developed to understand the veteran perspective about access to mental health services. The PAI is a self-report measure that includes 43 items across 5 domains: Logistics (6 items), Culture (4 items), Digital (9 items), Systems of Care (13 items), and Experiences of Care (11 items). This article is a preliminary examination of the concurrent and convergent validity of the PAI with respect to the Hoge Perceived Barriers to Seeking Mental Health Services scale (concurrent) and the Client Satisfaction Questionnaire (CSQ; convergent). Telephone interviews were conducted with veterans from 3 geographic regions. Eligibility criteria included screening positive for posttraumatic stress disorder, alcohol use disorder, or depression in the past 12 months. Data from 92 veterans were analyzed using correlation matrices. PAI scores were significantly correlated with the Hoge total score (concurrent validity) and CSQ scores (convergent validity). The PAI items with the strongest correlation with CSQ were in the Systems of Care domain and the weakest were in the Logistics domain. Future efforts will evaluate validity using larger data sets and utilize the PAI to develop and test interventions to improve access to care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Jeffrey M. Pyne
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,Center for Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham, #554, Little Rock, AR
| | - P. Adam Kelly
- Southeast Louisiana Veterans Healthcare System, New Orleans, LA,Tulane University School of Medicine, New Orleans, LA
| | - Ellen P. Fischer
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, North Little Rock, AR,Center for Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham, #554, Little Rock, AR
| | - hristopher J. Miller
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Samantha L. Connolly
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Patricia Wright
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Kara Zamora
- San Francisco VA Healthcare System, 4150 Clement Street, San Francisco, CA,Department of Anthropology, History, and Social Medicine, University of California San Francisco, San Francisco, CA
| | - Christopher J. Koenig
- Department of Communication Studies, San Francisco State University, 1600 Holloway Avenue, Humanities Building, Room 282, San Francisco, CA,Center from Innovation to Implementation, Palo Alto Healthcare System, 795 Willow Road (152-MPD), Menlo Park, CA
| | - Karen H. Seal
- San Francisco VA Healthcare System, 4150 Clement Street, San Francisco, CA
| | - John C. Fortney
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle WA,Division of Population Health, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
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15
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Weiskittle R, Tsang W, Schwabenbauer A, Andrew N, Mlinac M. Feasibility of a COVID-19 Rapid Response Telehealth Group Addressing Older Adult Worry and Social Isolation. Clin Gerontol 2022; 45:129-143. [PMID: 33870881 PMCID: PMC8522175 DOI: 10.1080/07317115.2021.1906812] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES During the early months of the COVID-19 pandemic, virtual and telephone visits rapidly replaced most in-person care within the Veterans Health Administration (VA) to reduce the virus spread. To address the emerging mental health needs of older Veterans (e.g., social isolation) in the context of chronic underlying mental health needs (e.g., trauma), we developed an 8-week virtual group treatment manual. This article describes the results from a survey of geriatric mental health clinicians who used the COVID group manual to determine its acceptability and feasibility in these settings. METHODS Clinicians across three VA integrated care settings (home-based primary care, community living centers, and geriatric primary care) were surveyed about their experiences implementing this treatment (n = 21). RESULTS Clinicians found this intervention to be effective with their patients and useful and adaptable beyond the early pandemic period. CONCLUSIONS This group teletherapy intervention was feasible and acceptable when treating Veterans in integrated geriatric healthcare settings. Despite technical challenges experienced by older Veterans, clinicians found this manual to be effective in addressing COVID-related worry and social isolation. CLINICAL IMPLICATIONS This rapid response manual has remained clinically useful in geriatric mental health care settings beyond the initial weeks of the pandemic.
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Affiliation(s)
- Rachel Weiskittle
- VA New England Geriatric Research Education and Clinical Center (GRECC)
- VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - William Tsang
- VDepartment of Psychology, William Paterson University, Wayne, NJ
| | | | | | - Michelle Mlinac
- VA Boston Healthcare System, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
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16
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Hickey C, Schubmehl JQ, Beeber A. Technology, Transference, and
COVID
‐19 — With Reference to Davanloo's Intensive Short‐term Dynamic Psychotherapy. BRITISH JOURNAL OF PSYCHOTHERAPY 2021. [DOI: 10.1111/bjp.12693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Bouabida K, Malas K, Talbot A, Desrosiers MÈ, Lavoie F, Lebouché B, Taguemout M, Rafie E, Lessard D, Pomey MP. Remote Patient Monitoring Program for COVID-19 Patients Following Hospital Discharge: A Cross-Sectional Study. Front Digit Health 2021; 3:721044. [PMID: 34859244 PMCID: PMC8630581 DOI: 10.3389/fdgth.2021.721044] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion from healthcare services, protect healthcare providers, and help them maintain satisfactory quality and safety of care. Remote COVID-19 monitoring platforms emerged as potential solutions. Objective: The purpose of this study was to evaluate the capacity and contribution of two different platforms used to remotely monitor patients with COVID-19 to maintain quality, safety, and patient engagement in care, as well as their acceptability, usefulness, and user-friendliness from the user's perspective. The first platform is focused on telecare phone calls (Telecare-Covid), and the second is a telemonitoring app (CareSimple-Covid). Methods: We performed a cross-sectional study. The data were collected through a phone survey from May to August 2020. Data were analyzed using descriptive statistics and t-test analysis. Participants' responses and comments on open-ended questions were analyzed using content analysis to identify certain issues and challenges and potential avenues for improving the platforms. Results: Fifty one patients participated in the study. Eighteen participants used the CareSimple-Covid platform and 33 participants used the Telecare-Covid platform. Overall, the satisfaction rate for quality and safety of care for the two platforms was 80%. Over 88% of the users on each platform considered the platforms' services to be engaging, useful, user-friendly, and appropriate to their needs. The survey identified a few significant differences in users' perceptions of each platform: empathy toward users and the quality and safety of the care received were rated significantly higher on the CareSimple-Covid platform than on the Telecare-Covid platform. Users appreciated four aspects of these telehealth approaches: (1) the ease of access to services and the availability of care team members; (2) the user-friendliness of the platforms; (3) the continuity of care provided, and (4) the wide range of services delivered. Users identified some technical limitations and raised certain issues, such as the importance of maintaining human contact, data security, and confidentiality. Improvement suggestions include promoting access to connected devices; enhancing communications between institutions, healthcare users, and the public on confidentiality and personal data protection standards; and integrating a participatory approach to telehealth platform development and deployment efforts. Conclusion: This study provides preliminary evidence that the two remote monitoring platforms are well-received by users, with very few significant differences between them concerning users' experiences and views. This type of program could be considered for use in a post-pandemic era and for other post-hospitalization clienteles. To maximize efficiency, the areas for improvement and the issues identified should be addressed with a patient-centered approach.
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Affiliation(s)
- Khayreddine Bouabida
- University of Montreal Hospital Centre de Recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Montreal, QC, Canada.,École de Santé publique, Département de Gestion, Université de Montréal, Montreal, QC, Canada
| | - Kathy Malas
- Excutive Office, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, QC, Canada.,Département de Recherche, Montreal Cancer Institute, University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada.,Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada
| | - Annie Talbot
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Marie-Ève Desrosiers
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Frédéric Lavoie
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Bertrand Lebouché
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in Human Immunodeficiency Virus (HIV), Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Melissa Taguemout
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada
| | - Edmond Rafie
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada
| | - David Lessard
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in Human Immunodeficiency Virus (HIV), Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Marie-Pascale Pomey
- Département de Recherche, Montreal Cancer Institute, University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada.,Center of Excellence of Patient Partnership and the Public, Montreal, QC, Canada.,Department of Health Management, Evaluation, and Policy, School of Public Health, Université de Montréal, Montreal, QC, Canada
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18
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McKee GB, Pierce BS, Donovan EK, Perrin PB. Examining models of psychologists' telepsychology use during the COVID-19 pandemic: A national cross-sectional study. J Clin Psychol 2021; 77:2405-2423. [PMID: 34028018 PMCID: PMC8242572 DOI: 10.1002/jclp.23173] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/03/2021] [Accepted: 05/08/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The aim of this study is to apply the theory of reasoned action (TRA) and technology acceptance model (TAM) to psychologists' telepsychology use during the COVID-19 pandemic. METHODS A sample of 2619 US-licensed psychologists completed a survey assessing telepsychology use and aspects of both models in May 2020. RESULTS Cross-sectional TRA and TAM path models evidenced excellent fit in explaining psychologists' telepsychology use. The TRA indicated that psychologists' attitudes concerning telepsychology and subjective norms were associated with intentions to use telepsychology, which related to percentage of clinical work performed via telepsychology. The TAM showed that perceived usefulness of telepsychology and perceived ease of use were associated with attitudes toward telepsychology. Perceived usefulness was associated with psychologists' intention to use telepsychology, as was perceived ease of use. CONCLUSION Efforts to facilitate telepsychology provision during the pandemic and broadly may benefit from trainings and campaigns to address attitudes toward telepsychology, subjective norms, and perceived ease of use.
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Affiliation(s)
- Grace B. McKee
- Advanced Fellowship Program in Mental Illness Research and Treatment, Mid‐Atlantic Mental Illness Research Education and Clinical Center (MIRECC)Central Virginia Veterans Affairs Health Care SystemRichmondVirginiaUSA
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Bradford S. Pierce
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Emily K. Donovan
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Paul B. Perrin
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
- Mental Health ServiceCentral Virginia Veterans Affairs Health Care SystemRichmondVirginiaUSA
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19
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Abstract
The present study was designed to assess mental health provider attitudes and perceptions of telemental health (TMH) prior to and during the COVID-19 Pandemic, as well as the nature of their TMH utilization. The study aimed to gather information about positive and negative attitudes towards TMH, perceptions and correlates based on the modality of care, and beliefs about the overall effectiveness of TMH as compared to face-to-face care. 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 1448 mental health providers and included demographic and professional information, experiences with and perceptions of TMH prior to and during the COVID-19 Pandemic, as well as a brief measure of pandemic-related stress. The COVID-19 Pandemic resulted in an increased use of TMH in the study sample. During COVID-19, providers reported increased agreement with TMH being necessary, important, and effective for care delivery. Providers who primarily used video, compared with telephone, reported that TMH was more useful, satisfying, and effective. While negative attitude towards TMH was predicted only by prior attitudes and belief in TMH effectiveness, positive attitude towards TMH was also predicted by female sex and current level of pandemic related stress. TMH use during the pandemic was predicted by primary use of video platform and previous TMH use. The 2020 COVID-19 Pandemic resulted in increased use of TMH and significantly increased positive perceptions about TMH among mental health providers.
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Affiliation(s)
- Jennifer M. Doran
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT USA
| | - Jessica L. Lawson
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT USA
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20
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Ilagan GS, Heatherington L. Advancing the understanding of factors that influence client preferences for race and gender matching in psychotherapy. COUNSELLING PSYCHOLOGY QUARTERLY 2021. [DOI: 10.1080/09515070.2021.1960274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Haidous M, Tawil M, Naal H, Mahmoud H. A review of evaluation approaches for telemental health programs. Int J Psychiatry Clin Pract 2021; 25:195-205. [PMID: 33243045 DOI: 10.1080/13651501.2020.1846751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Although studies have examined the effectiveness of telemental health programs, optimal approaches for their evaluation remain unclear. We sought to review the outcomes used to evaluate telemental health programs. METHODS We conducted a literature search in PubMed and Google Scholar for peer-reviewed studies published between January 2010 until October 2019, and we excluded review articles, opinion papers, presentations, abstracts, and program report without data. RESULTS 1310 articles were identified, 34 of which were reviewed. Studies used a combination of non-clinical and clinical outcomes, most commonly engagement and impact rates, and standardised clinical measures. Very few studies examined technological feasibility, cost-effectiveness, and qualitative satisfaction reports. CONCLUSIONS This review is the first to summarise approaches to evaluate telemental health programs. Strengths and weaknesses of the evaluation outcomes are discussed in this review, highlighting essential factors that should be taken into consideration when developing a standardised framework for the evaluation of future telemental health programs.KEY POINTSThe methods used to evaluate telemental health programs are varied and no gold-standard for measurement of success exists.Clinical and non-clinical outcomes are being used to evaluate telemental health programs.More emphasis should be placed on feasibility measures such as cost-effectiveness.Therapeutic alliance should be a crucial part of evaluation of any telemental health program.Longer follow up times and larger sample sizes, as well as more diverse populations, are needed to generalise outcomes.Utilisation of clinical tools to assess success should be limited to standardised measures commonly used in clinical practice.
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Affiliation(s)
- Mohammad Haidous
- Department of Internal Medicine, St. Vincent Charity Medical Center, Cleveland, OH, USA
| | - Michel Tawil
- Department of Pathology and Laboratory Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Hady Naal
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Hossam Mahmoud
- Clinical Assistant Professor, Tufts University School of Medicine, Boston, MA
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22
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Fischer EP, Curran GM, Fortney JC, McSweeney JC, Williams DK, Williams JS. Impact of Attitudes and Rurality on Veterans' Use of Veterans Health Administration Mental Health Services. Psychiatr Serv 2021; 72:521-529. [PMID: 33691490 PMCID: PMC8638372 DOI: 10.1176/appi.ps.201900275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Veterans, especially those residing in rural areas, continue to underutilize mental health care. This longitudinal study assessed attitudes relevant to seeking mental health care services from the Veterans Health Administration (VHA) over 12 months, adjusting for residence. METHODS A questionnaire addressing attitudes, sociodemographic factors, residence, place identity, perceived health status and needs, and structural barriers was administered by telephone to 752 veterans with previous VHA service use. Service use data were obtained from a VHA database. RESULTS In adjusted models, four attitudes were significantly associated with underuse of VHA mental health care (no use vs. any use; no use vs. nonsustained use vs. sustained use). Higher levels of mistrust of others (adjusted odds ratio [AOR]=1.06, p=0.046), emotional stoicism (AOR=1.08, p=0.003), belief in the self-resolving nature of mental health problems (AOR=1.91, p=0.015), and belief in the efficacy of religious counseling for such problems (AOR=1.09, p=0.022) were associated with no subsequent service use versus any use. Place identity (suburban), older age, and greater need were associated with greater odds of VHA use. For the comparison of no use versus sustained use, women had lower odds of no use (AOR=0.49, p<0.001); similarly, women had lower odds of nonsustained use versus sustained use (AOR=0.45, p<0.001). CONCLUSIONS The association of potentially modifiable attitudes with underuse of VHA mental health services suggests that attitudes offer useful targets for efforts to increase mental health care use. That these attitudes were influential regardless of residence suggests that programs addressing attitudinal barriers can be broadly targeted.
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Affiliation(s)
- Ellen P Fischer
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock (Fischer, Curran, J. S. Williams); Department of Psychiatry, College of Medicine (Fischer), Department of Pharmacy Practice, College of Pharmacy (Curran), Department of Nursing Science, College of Nursing (McSweeney), and Department of Biostatistics (D. K. Williams), University of Arkansas for Medical Sciences, Little Rock; Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle (Fortney); Department of Psychiatry, University of Washington School of Medicine, Seattle (Fortney)
| | - Geoffrey M Curran
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock (Fischer, Curran, J. S. Williams); Department of Psychiatry, College of Medicine (Fischer), Department of Pharmacy Practice, College of Pharmacy (Curran), Department of Nursing Science, College of Nursing (McSweeney), and Department of Biostatistics (D. K. Williams), University of Arkansas for Medical Sciences, Little Rock; Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle (Fortney); Department of Psychiatry, University of Washington School of Medicine, Seattle (Fortney)
| | - John C Fortney
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock (Fischer, Curran, J. S. Williams); Department of Psychiatry, College of Medicine (Fischer), Department of Pharmacy Practice, College of Pharmacy (Curran), Department of Nursing Science, College of Nursing (McSweeney), and Department of Biostatistics (D. K. Williams), University of Arkansas for Medical Sciences, Little Rock; Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle (Fortney); Department of Psychiatry, University of Washington School of Medicine, Seattle (Fortney)
| | - Jean C McSweeney
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock (Fischer, Curran, J. S. Williams); Department of Psychiatry, College of Medicine (Fischer), Department of Pharmacy Practice, College of Pharmacy (Curran), Department of Nursing Science, College of Nursing (McSweeney), and Department of Biostatistics (D. K. Williams), University of Arkansas for Medical Sciences, Little Rock; Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle (Fortney); Department of Psychiatry, University of Washington School of Medicine, Seattle (Fortney)
| | - D Keith Williams
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock (Fischer, Curran, J. S. Williams); Department of Psychiatry, College of Medicine (Fischer), Department of Pharmacy Practice, College of Pharmacy (Curran), Department of Nursing Science, College of Nursing (McSweeney), and Department of Biostatistics (D. K. Williams), University of Arkansas for Medical Sciences, Little Rock; Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle (Fortney); Department of Psychiatry, University of Washington School of Medicine, Seattle (Fortney)
| | - J Silas Williams
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock (Fischer, Curran, J. S. Williams); Department of Psychiatry, College of Medicine (Fischer), Department of Pharmacy Practice, College of Pharmacy (Curran), Department of Nursing Science, College of Nursing (McSweeney), and Department of Biostatistics (D. K. Williams), University of Arkansas for Medical Sciences, Little Rock; Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle (Fortney); Department of Psychiatry, University of Washington School of Medicine, Seattle (Fortney)
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23
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Little J, Schmeltz A, Cooper M, Waldrop T, Yarvis JS, Pruitt L, Dondanville K. Preserving Continuity of Behavioral Health Clinical Care to Patients Using Mobile Devices. Mil Med 2021; 186:137-141. [PMID: 33499516 DOI: 10.1093/milmed/usaa281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/17/2020] [Accepted: 08/19/2020] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The current model for treating behavioral health patients requires that providers and patients be in the same location for appointments. However, deploying warfighters present a challenge to this current model. Recent advances in technology make telehealth or virtual visits a viable option to replace the current model. This project leveraged mobile technology to see if performing tele-behavioral health visits presented a viable option to the current in-person model for future deployed warfighters. At the time of this publication, the authors note the current pandemic lends all the more urgency to the need for enhancing our video communication platforms for remote monitoring with the Military Health System. MATERIALS AND METHODS The research team assessed existing Internet protocol-based desktop teleconferencing solutions, generically known as a Web Real-Time Communications (WebRTC) system, for establishing a secure connection to a Service Members personal mobile device outside of the Department of Defense (DoD) network. Of the five existing WebRTC systems evaluated, only the backbone component to the existing Defense Information Systems Agency Global Video Services (DISA GVS) known as Vidyo, was suitable to meet DoD security requirements and still connect with both major operating systems (OS) on mobile devices. An existing DoD program of record mobile application, mCare, was integrated with Vidyo desktop technologies to form what the research team called "Mobile Connect." RESULTS Deployment of the Mobile Connect product yielded distinct differences and high levels or variability between the .osd.mil and the army.mil network connections over time. These network differences impacted quality of service solution where Mobile Connect could not be used to provide care between the .mil and patient's personal mobile devices from a osd.mil domain connection. The current DoD WebRTC systems offer potential solutions but presently cannot connect with personal mobile devices in their current configurations. Additionally, any WebRTC system used by the DoD for future connections to personal mobile device must leverage commercial Single Socket Layer certificates (e.g., not DoD issued), or the communications with the mobile device will fail as a result of an authentication error. CONCLUSION It is technically feasible to provide desktop Video Tele-Conference capabilities from a .mil computer to a personal mobile device without compromising DoD security and information assurance requirements using future WebRTC systems. Approved ports, protocols, and system settings must be configured to accept both inbound and outbound, encrypted traffic to/from personal mobile devices to maintain consistent quality of service with all DoD networks. Of the current DoD WebRTC options, working with the DISA GVS Program Manager to expand services to support commercial mobile devices has the highest probability of future success.
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Affiliation(s)
- Jeanette Little
- Telemedicine and Advanced Technology Research Center, Mobile Health Innovation Center, Fort Gordon, GA 10905, USA
| | - Amanda Schmeltz
- Telemedicine and Advanced Technology Research Center, Mobile Health Innovation Center, Fort Gordon, GA 10905, USA
| | - Mabel Cooper
- Telemedicine and Advanced Technology Research Center, Mobile Health Innovation Center, Fort Gordon, GA 10905, USA
| | - Tabitha Waldrop
- Telemedicine and Advanced Technology Research Center, Mobile Health Innovation Center, Fort Gordon, GA 10905, USA
| | - Jeffrey S Yarvis
- University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.,9th Hospital Center, Fort Hood, TX 76544, USA
| | - Larry Pruitt
- Puget Sound Health Care System, U.S. Department of Veteran Affairs, Seattle, WA 98108, USA
| | - Katy Dondanville
- University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
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Maier CA, Riger D, Morgan‐Sowada H. "It's splendid once you grow into it:" Client experiences of relational teletherapy in the era of COVID-19. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:304-319. [PMID: 33721348 PMCID: PMC8251155 DOI: 10.1111/jmft.12508] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
The novel Coronavirus pandemic (COVID-19) and subsequent social distancing practices have altered the way we move through the world and access physical and mental healthcare. While researchers and clinicians have begun to explore the impact of telehealth delivery on psychotherapy and treatment outcomes, the purpose of this study was to explore the lived experiences of individuals in teletherapy, specifically those engaging in teletherapy with a romantic partner or family member. Using a thematic analysis of open-ended online survey questions, we explored the experiences of 25 individuals who engaged in couple or family teletherapy after social distancing began. The resulting themes included "making do," safe therapeutic space, convenience, logistical challenges, and therapist accommodation. We discuss the clinical implications of these themes to support effective couple and family teletherapy and offer suggestions and considerations for remote clinical interventions and practices. [Correction added on 22 March 2021, after first online publication: The term '19' has been changed to '(COVID-19)' in the first line of the Abstract section, in this version.].
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Affiliation(s)
| | - Dana Riger
- University of North Carolina‐Chapel HillChapel HillNCUSA
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Hardy NR, Maier CA, Gregson TJ. Couple teletherapy in the era of COVID-19: Experiences and recommendations. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:225-243. [PMID: 33742712 PMCID: PMC8250910 DOI: 10.1111/jmft.12501] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
The unprecedented times of the novel Coronavirus quarantine and subsequent stay-at-home orders have changed the way many couple therapists provide clinical services. Understanding couple therapists' experiences with teletherapy is important for optimizing future telehealth delivery with couples. Thus, the purpose of this mixed methods survey study was to explore couple therapists' experiences of transitioning from in-person/traditional therapy to online/telehealth delivery. A total of 58 couple therapists completed an online survey for this study. Reported are both quantitative and qualitative findings. Overall, this study found that couple therapists experienced a positive shift from traditional/in-person therapy to online/telehealth therapy, with a majority of couple therapists (74%) reporting they would continue providing teletherapy after the novel Coronavirus pandemic and social distancing regulations had ended. Thematic analysis was used to identify themes from couple therapists' experiences related to advantages, challenges, and recommendations for practice. Implications for clinical training and future research are discussed.
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Morgan AA, Landers AL, Simpson JE, Russon JM, Case Pease J, Dolbin‐MacNab ML, Bland KN, Jackson JB. The transition to teletherapy in marriage and family therapy training settings during COVID-19: What do the data tell us? JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:320-341. [PMID: 33742728 PMCID: PMC8250895 DOI: 10.1111/jmft.12502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/11/2021] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
In the wake of the COVID-19 pandemic, little is known about how university training programs transitioned to teletherapy. This study describes the transition of two university marriage and family therapy (i.e., master's and doctoral) training clinics to teletherapy and presents preliminary analyses of the types of clients and cases that converted to teletherapy. A series of chi-square analyses, a t-test, a logistic regression model, and a multiple linear regression model were employed. Four key findings emerged: (1) most cases converted to teletherapy; (2) Hispanic ethnicity was the only demographic characteristic to significantly predict conversion to teletherapy; (3) individual cases were significantly more likely to convert to teletherapy than relational cases; and (4) the number of prior in-person sessions attended significantly predicted conversion to teletherapy. Teletherapy conversion implications are discussed across four systemic levels: client, student trainee, supervision, and larger systems.
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Affiliation(s)
- Amy A. Morgan
- Department of Family ScienceSchool of Public HealthUniversity of MarylandCollege ParkMDUSA
| | - Ashley L. Landers
- Department of Human Development and Family ScienceCollege of Liberal Arts and Human SciencesVirginia TechBlacksburg & Falls ChurchVAUSA
| | - Jessica E. Simpson
- Department of Family Social ScienceCollege of Education and Human DevelopmentUniversity of MinnesotaSt PaulMNUSA
| | - Jody M. Russon
- Department of Human Development and Family ScienceCollege of Liberal Arts and Human SciencesVirginia TechBlacksburg & Falls ChurchVAUSA
| | - Jenene Case Pease
- Department of Human Development and Family ScienceCollege of Liberal Arts and Human SciencesVirginia TechBlacksburg & Falls ChurchVAUSA
| | - Megan L. Dolbin‐MacNab
- Department of Human Development and Family ScienceCollege of Liberal Arts and Human SciencesVirginia TechBlacksburg & Falls ChurchVAUSA
| | - Krista N. Bland
- Department of Human Development and Family ScienceCollege of Liberal Arts and Human SciencesVirginia TechBlacksburg & Falls ChurchVAUSA
| | - Jeffrey B. Jackson
- Department of Human Development and Family ScienceCollege of Liberal Arts and Human SciencesVirginia TechBlacksburg & Falls ChurchVAUSA
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Malgaroli M, Hull TD, Schultebraucks K. Digital Health and Artificial Intelligence for PTSD: Improving Treatment Delivery Through Personalization. Psychiatr Ann 2021. [DOI: 10.3928/00485713-20201203-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sampaio M, Haro MVN, De Sousa B, Melo WV, Hoffman HG. Therapists Make the Switch to Telepsychology to Safely Continue Treating Their Patients During the COVID-19 Pandemic. Virtual Reality Telepsychology May Be Next. FRONTIERS IN VIRTUAL REALITY 2021; 1:576421. [PMID: 33585834 PMCID: PMC7880047 DOI: 10.3389/frvir.2020.576421] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Before COVID-19, most therapists had concerns about telepsychology, and only treated patients in person. During the COVID-19 lockdown, patients still needed therapy, but in-person therapy sessions became unsafe. The current study measured how many therapists are using online therapy before vs. during COVID-19, how much training they have received, and their knowledge about legal restrictions on using telepsychology. A sample of 768 U.S.A. mental health professionals completed a 29-item online survey. Results show that before COVID-19, most therapists only saw their patients in person (e.g., at the therapists office), but during the COVID-19 pandemic, nearly all therapists used a wide range of telecommunication technologies to communicate with their quarantined patients, including texting, telephones, video conferences, and even virtual reality. According to within-subject related samples comparisons, 39% of survey respondents used telepsychology before COVID-19, vs. 98% during COVID-19 (χ2 = 450.02, p< 0.001). Therapists reported high treatment effectiveness using telepsychology (7.45 on 0-10 scale). However, overall, on a 0-10 scale, therapists reported a significant increase in feeling burned out during the COVID-19 pandemic, Mean = 3.93 (SD = 1.93) before vs. 6.22 (SD = 2.27) during the pandemic (Z = -18.57, p < 0.001). Although the APA ethics guidelines encourage therapists to use telepsychology with their patients during the crisis, gaps in respondents' knowledge identify a need for increased specialized training and education. Although the current study showed that virtual reality is rarely used by the therapists surveyed, virtual reality is a promising new telepsychology technology. Billions of dollars are currently being invested in mass producing immersive virtual reality systems. In the future, as networked immersive Virtual Reality becomes more widely available, therapists and patients in physically different locations will be able to "meet" in a shared computer-generated world designed for therapy sessions, potentially including group sessions. Telepsychology and virtual reality have the potential to be increasingly valuable tools to help therapists mitigate the consequences of COVID-19. Research, development and training is recommended.
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Affiliation(s)
- Mariana Sampaio
- Department of Psychology, University of Coimbra, Coimbra, Portugal
- Department of Social Work, Catholic University of Portugal, Lisbon, Portugal
| | - Maria Vicenta Navarro Haro
- Instituto Aragonés de Investigaciones Sanitarias, Universidad de Zaragoza, Zaragoza, Spain
- Department of Psychology and Sociology, Faculty of Economics and Business, University of Zaragoza, Zaragoza, Spain
| | - Bruno De Sousa
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Hunter G. Hoffman
- Department of Mechanical Engineering, Radiology and Psychology, University of Washington, Seattle, WA, United States
- Human Photonics Lab, Virtual Reality Research Center, University of Washington, Seattle, WA, United States
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Naal H, Mahmoud H, Whaibeh E. The potential of telemental health in improving access to mental health services in Lebanon: Analysis of barriers, opportunities, and recommendations. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1863743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hady Naal
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Hossam Mahmoud
- Cambia Health Solutions, Tufts University School of Medicine, Boston, MA, USA
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Chiauzzi E, Clayton A, Huh-Yoo J. Videoconferencing-Based Telemental Health: Important Questions for the COVID-19 Era From Clinical and Patient-Centered Perspectives. JMIR Ment Health 2020; 7:e24021. [PMID: 33180739 PMCID: PMC7725495 DOI: 10.2196/24021] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/19/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has intensified the search for digital approaches in mental health treatment, particularly due to patients and clinicians practicing social distancing. This has resulted in the dramatic growth of videoconferencing-based telemental health (V-TMH) services. It is critical for behavioral health providers and those in the mental health field to understand the implications of V-TMH expansion on the stakeholders who use such services, such as patients and clinicians, to provide the service that addresses both patient and clinical needs. Several key questions arise as a result, such as the following: (1) in what ways does V-TMH affect the practice of psychotherapy (ie, clinical needs), (2) to what extent are ethical and patient-centered concerns warranted in terms of V-TMH services (ie, patient needs), and (3) how do factors related to user experience affect treatment dynamics for both the patient and therapist (ie, patient and clinical needs)? We discuss how behavioral health providers can consider the future delivery of mental health care services based on these questions, which pose strong implications for technological innovation, the adaptation of treatments to new technologies, and training professionals in the delivery of V-TMH services and other digital health interventions.
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Affiliation(s)
| | - Ashley Clayton
- Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Jina Huh-Yoo
- Department of Information Science, College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
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31
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Richardson L, Reid C, Dziurawiec S. “Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12126] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Lisa Richardson
- School of Psychology and Exercise Science, Murdoch University,
| | - Corinne Reid
- School of Psychology and Exercise Science, Murdoch University,
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32
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Malgaroli M, Schultebraucks K. Artificial Intelligence and Posttraumatic Stress Disorder (PTSD). EUROPEAN PSYCHOLOGIST 2020. [DOI: 10.1027/1016-9040/a000423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract. Posttraumatic stress disorder (PTSD) is a debilitating disease that can occur after experiencing a traumatic event. Despite recent progress in computational research, it has not yet been possible to identify precise and reliable risk factors that enable predictive models of individual risk for posttraumatic stress after trauma. In this overview, we discuss recent advances in the use of Machine Learning (ML) and Artificial Intelligence (AI) for risk stratification and targeted treatment allocation in the context of stress pathologies and we critically review the benefits and challenges of emerging approaches. The vast heterogeneity in the manifestation and the etiology of PTSD is discussed as one major reason for the need to deploy ML-based computational models to better account for individual differences between patients. Striving for personalized medicine is one of the most important goals of current clinical research and is of great potential for the field of posttraumatic stress research. The use of ML is a promising and necessary approach for reaching more personalized treatments and to make further progress in the field of precision psychiatry.
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Affiliation(s)
- Matteo Malgaroli
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Katharina Schultebraucks
- Department of Emergency Medicine, Vagelos School of Physicians and Surgeon, Columbia University Irving Medical Center, New York, NY, USA
- Data Science Institute, Columbia University, New York, NY, USA
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Lessons Learned in Implementing VA Video Connect for Evidence-Based Psychotherapies for Anxiety and Depression in the Veterans Healthcare Administration. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2020; 6:320-326. [PMID: 32864423 PMCID: PMC7442884 DOI: 10.1007/s41347-020-00161-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/07/2020] [Accepted: 08/14/2020] [Indexed: 11/02/2022]
Abstract
A top priority for the Veteran's Healthcare Administration is improving access to high-quality mental healthcare. Mobile and telemental healthcare are a vital component of increasing access for veterans. The Veteran's Healthcare Administration is making efforts to further broaden how veterans receive their care through VA Video Connect, which allows veterans to connect with their provider from their residence or workplace. In this mixed-methods study, successes and challenges associated with the rapid implementation of VA Video Connect telemental health appointments are examined through (1) administrative data and (2) qualitative interviews at one medical center. Within 1 year of the telehealth initiative, the number of providers experienced with telemental health increased from 15% to 85%, and telehealth appointments increased from 5376 to 14,210. Provider reported barriers included administrative challenges and concerns regarding care. Having an implementation model of telehealth champions and a team of experienced mental health providers allowed for rapid adoption of telehealth. Utilizing a similar model in other settings will further enable more veterans with depression and anxiety to have access to evidence-based psychotherapy, regardless of location or national crisis. With the dramatic increase in both training for providers as well as veteran use of telemental healthcare during the COVID-19 pandemic response, future research should aim to better understand which teams were able to switch to telehealth easily versus those which struggled, along with examining system-wide and provider-level factors that facilitated continued use of telehealth after social distancing requirements related to COVID-19 were relaxed.
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Thomas RK, Suleman R, Mackay M, Hayer L, Singh M, Correll CU, Dursun S. Adapting to the impact of COVID-19 on mental health: an international perspective. J Psychiatry Neurosci 2020; 45:229-233. [PMID: 32584526 PMCID: PMC7828922 DOI: 10.1503/jpn.200076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Rejish K Thomas
- From the Nuns Community Hospital, Department of Psychiatry, Edmonton, Alta., Canada (Thomas, Dursun); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Thomas, Dursun, Suleman, Mackay, Hayer, Singh); the Department of Telepsychiatry, Alberta Health Services, Edmonton, Alta., Canada (Thomas, Hayer, Singh); the Neurochemical Research Unit and Bebensee Schizophrenia Research Unit, Edmonton, Alta., Canada (Mackay); the Recognition and Prevention Program, Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA (Correll); the Department of Psychiatry and Molecular Medicine, Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA (Correll); and the Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany (Correll)
| | - Raheem Suleman
- From the Nuns Community Hospital, Department of Psychiatry, Edmonton, Alta., Canada (Thomas, Dursun); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Thomas, Dursun, Suleman, Mackay, Hayer, Singh); the Department of Telepsychiatry, Alberta Health Services, Edmonton, Alta., Canada (Thomas, Hayer, Singh); the Neurochemical Research Unit and Bebensee Schizophrenia Research Unit, Edmonton, Alta., Canada (Mackay); the Recognition and Prevention Program, Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA (Correll); the Department of Psychiatry and Molecular Medicine, Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA (Correll); and the Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany (Correll)
| | - Marnie Mackay
- From the Nuns Community Hospital, Department of Psychiatry, Edmonton, Alta., Canada (Thomas, Dursun); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Thomas, Dursun, Suleman, Mackay, Hayer, Singh); the Department of Telepsychiatry, Alberta Health Services, Edmonton, Alta., Canada (Thomas, Hayer, Singh); the Neurochemical Research Unit and Bebensee Schizophrenia Research Unit, Edmonton, Alta., Canada (Mackay); the Recognition and Prevention Program, Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA (Correll); the Department of Psychiatry and Molecular Medicine, Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA (Correll); and the Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany (Correll)
| | - Lovneet Hayer
- From the Nuns Community Hospital, Department of Psychiatry, Edmonton, Alta., Canada (Thomas, Dursun); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Thomas, Dursun, Suleman, Mackay, Hayer, Singh); the Department of Telepsychiatry, Alberta Health Services, Edmonton, Alta., Canada (Thomas, Hayer, Singh); the Neurochemical Research Unit and Bebensee Schizophrenia Research Unit, Edmonton, Alta., Canada (Mackay); the Recognition and Prevention Program, Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA (Correll); the Department of Psychiatry and Molecular Medicine, Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA (Correll); and the Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany (Correll)
| | - Mohit Singh
- From the Nuns Community Hospital, Department of Psychiatry, Edmonton, Alta., Canada (Thomas, Dursun); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Thomas, Dursun, Suleman, Mackay, Hayer, Singh); the Department of Telepsychiatry, Alberta Health Services, Edmonton, Alta., Canada (Thomas, Hayer, Singh); the Neurochemical Research Unit and Bebensee Schizophrenia Research Unit, Edmonton, Alta., Canada (Mackay); the Recognition and Prevention Program, Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA (Correll); the Department of Psychiatry and Molecular Medicine, Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA (Correll); and the Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany (Correll)
| | - Christoph U Correll
- From the Nuns Community Hospital, Department of Psychiatry, Edmonton, Alta., Canada (Thomas, Dursun); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Thomas, Dursun, Suleman, Mackay, Hayer, Singh); the Department of Telepsychiatry, Alberta Health Services, Edmonton, Alta., Canada (Thomas, Hayer, Singh); the Neurochemical Research Unit and Bebensee Schizophrenia Research Unit, Edmonton, Alta., Canada (Mackay); the Recognition and Prevention Program, Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA (Correll); the Department of Psychiatry and Molecular Medicine, Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA (Correll); and the Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany (Correll)
| | - Serdar Dursun
- From the Nuns Community Hospital, Department of Psychiatry, Edmonton, Alta., Canada (Thomas, Dursun); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Thomas, Dursun, Suleman, Mackay, Hayer, Singh); the Department of Telepsychiatry, Alberta Health Services, Edmonton, Alta., Canada (Thomas, Hayer, Singh); the Neurochemical Research Unit and Bebensee Schizophrenia Research Unit, Edmonton, Alta., Canada (Mackay); the Recognition and Prevention Program, Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA (Correll); the Department of Psychiatry and Molecular Medicine, Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA (Correll); and the Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany (Correll)
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Kunkle S, Yip M, Ξ W, Hunt J. Evaluation of an On-Demand Mental Health System for Depression Symptoms: Retrospective Observational Study. J Med Internet Res 2020; 22:e17902. [PMID: 32554387 PMCID: PMC7333067 DOI: 10.2196/17902] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/04/2020] [Accepted: 05/20/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Depression is an extremely prevalent issue in the United States, with an estimated 7% of adults experiencing at least one major depressive episode in 2017. Although psychotherapy and medication management are effective treatments for depression, significant barriers in accessing care persist. Virtual care can potentially address some of these obstacles. OBJECTIVE We conducted a preliminary investigation of utilization characteristics and effectiveness of an on-demand health system for reducing depression symptoms. METHODS Data were analyzed from 1662 users of an on-demand mental health system that includes behavioral health coaching, clinical services (therapy and psychiatry), and self-guided content and assessments primarily via a mobile app platform. Measures included engagement characterized by mobile app data, member satisfaction scores collected via in-app surveys, and depression symptoms via the Patient Health Questionnaire-2 (PHQ-2) at baseline and 8-12 week follow-up. Descriptive statistics are reported for measures, and pre/post-PHQ-2 data were analyzed using the McNemar test. A chi-square test was used to test the association between the proportion of individuals with an improvement in PHQ-2 result and care modality (coaching, therapy, and psychiatry, or hybrid). RESULTS During the study period, 65.5% of individuals (1089/1662) engaged only in coaching services, 27.6% of individuals (459/1662) were engaged in both coaching and clinical services, 3.3% of individuals (54/1662) engaged only in clinical services, and 3.7% of individuals (61/1662) only used the app. Of the 1662 individuals who completed the PHQ-2 survey, 772 (46.5%) were considered a positive screen at intake, and 890 (53.6%) were considered a negative screen at intake. At follow-up, 477 (28.7%) of individuals screened positive, and 1185 (71.3%) screened negative. A McNemar test showed that there was a statistically significant decrease in the proportion of users experiencing depressed mood and anhedonia more than half the time at follow-up (P<.001). A chi-square test showed there was no significant association between care modality and the proportion of individuals with an improvement in PHQ-2 score. CONCLUSIONS This study provides preliminary insights into which aspects of an on-demand mental health system members are utilizing and levels of engagement and satisfaction over an 8-12 week window. Additionally, there is some signal that this system may be useful for reducing depression symptoms in users over this period. Additional research is required, given the study limitations, and future research directions are discussed.
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Affiliation(s)
| | - Manny Yip
- Ginger, San Francisco, CA, United States
| | - Watson Ξ
- Ginger, San Francisco, CA, United States
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Chen CK, Nehrig N, Wash L, Schneider JA, Ashkenazi S, Cairo E, Guyton AF, Palfrey A. When distance brings us closer: leveraging tele-psychotherapy to build deeper connection. COUNSELLING PSYCHOLOGY QUARTERLY 2020. [DOI: 10.1080/09515070.2020.1779031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Cory K. Chen
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Nicole Nehrig
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Lauren Wash
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
| | - Jennifer A. Schneider
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Sagiv Ashkenazi
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
| | - Elana Cairo
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
| | - Angel F. Guyton
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
| | - Amy Palfrey
- Veterans Affairs New York Harbor Healthcare System, Manhattan Campus, Psychology Service, New York, USA
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
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Diab O, DePierro J, Cancelmo L, Schaffer J, Schechter C, Dasaro CR, Todd A, Crane M, Udasin I, Harrison D, Moline J, Luft B, Southwick SM, Feder A, Pietrzak RH. Mental Healthcare Needs in World Trade Center Responders: Results from a Large, Population-Based Health Monitoring Cohort. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 47:427-434. [PMID: 31776767 PMCID: PMC7159995 DOI: 10.1007/s10488-019-00998-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Nearly two decades after the 9/11 attacks on the World Trade Center (WTC), the prevalence of mental disorders remains elevated among traditional (e.g., police) and non-traditional (e.g., construction workers) responders who were involved in the WTC rescue, recovery, and clean-up efforts. To date, however, scarce research has examined factors associated with perceived need for mental health care, which is critical to promoting engagement in mental health treatment in this population. Data were analyzed from 16,170 WTC responders, including 8881 police responders and 7289 non-traditional responders, who completed their first annual health monitoring visit with the WTC Health Program an average of 6.5 years after September 11, 2001. Predisposing, enabling, and need-based factors associated with perceived need for mental health care were examined using multivariable logistic regression analyses. Nearly half (48.7%) of non-traditional responders and a fifth (20.6%) of police responders reported a need for mental health care. The most common perceived needs were for psychotropic medication, individual psychotherapy, and stress management counseling. Predisposing (e.g., female gender) and need-based factors (e.g., WTC-related posttraumatic stress disorder) predicted perceived need for mental health care in both groups. Among non-traditional responders, Hispanic ethnicity and current suicidal ideation were additionally associated with this outcome. Non-traditional WTC responders are substantially more likely than police WTC responders to perceive a need for mental health treatment. Characterization of factors associated with perceived need for treatment can help inform population-based outreach and monitoring efforts designed to promote engagement in mental health treatment in WTC responders.
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Affiliation(s)
- Olivia Diab
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Jonathan DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.
| | - Leo Cancelmo
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Jamie Schaffer
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Clyde Schechter
- Department of Family and Social Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA
| | - Christopher R Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Crane
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Iris Udasin
- EOHSI Clinical Center, Rutgers University, Piscataway, NJ, USA
| | - Denise Harrison
- Department of Medicine, NYU Langone Medical Center, New York, NY, USA
| | - Jacqueline Moline
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, New York, NY, USA
| | - Benjamin Luft
- Stony Brook WTC Wellness Program, Stony Brook University, Stony Book, NY, USA
| | - Steven M Southwick
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Pickens JC, Morris N, Johnson DJ. The Digital Divide: Couple and Family Therapy Programs' Integration of Teletherapy Training and Education. JOURNAL OF MARITAL AND FAMILY THERAPY 2020; 46:186-200. [PMID: 31820834 DOI: 10.1111/jmft.12417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The mental health field is increasingly integrating and growing a teletherapy presence, and couple and family therapists are uniquely situated to offer these services based on our history of innovative approaches to therapeutic services. To do so successfully, careful consideration of training and education must occur. To evaluate current teletherapy training and education opportunities of COAMFTE accredited couple, marriage, and family therapy programs, an inductive qualitative content analysis was conducted on the responses of 95 faculty at COAMFTE accredited programs. Findings indicate that more than two thirds of the participants were in favor of teletherapy integration in training programs; however, most programs currently do not offer such opportunities. Barriers that prevent such integration were highlighted as well as existing concerns to training graduate students in teletherapy. Implications for training programs, policies, and regulations are discussed.
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Connolly SL, Miller CJ, Lindsay JA, Bauer MS. A systematic review of providers' attitudes toward telemental health via videoconferencing. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2020; 27:10.1111/cpsp.12311. [PMID: 35966216 PMCID: PMC9367168 DOI: 10.1111/cpsp.12311] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 11/12/2019] [Indexed: 11/29/2022]
Abstract
Telemental health conducted via videoconferencing (TMH-V) has the potential to improve access to care, and providers' attitudes toward this innovation play a crucial role in its uptake. This systematic review examined providers' attitudes toward TMH-V through the lens of the unified theory of acceptance and use of technology (UTAUT). Findings suggest that providers have positive overall attitudes toward TMH-V despite describing multiple drawbacks. Therefore, the relative advantages of TMH-V, such as its ability to increase access to care, may outweigh its disadvantages, including technological problems, increased hassle, and perceptions of impersonality. Providers' attitudes may also be related to their degree of prior TMH-V experience, and acceptance may increase with use. Limitations and implications of findings for implementation efforts are discussed.
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Affiliation(s)
- Samantha L. Connolly
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Christopher J. Miller
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jan A. Lindsay
- HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
- Baylor College of Medicine, Houston, Texas
- South Central Mental Illness Research, Education and Clinical Center, Houston, Texas
| | - Mark S. Bauer
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Mohr DC, Lattie EG, Tomasino KN, Kwasny MJ, Kaiser SM, Gray EL, Alam N, Jordan N, Schueller SM. A randomized noninferiority trial evaluating remotely-delivered stepped care for depression using internet cognitive behavioral therapy (CBT) and telephone CBT. Behav Res Ther 2019; 123:103485. [PMID: 31634738 PMCID: PMC6916718 DOI: 10.1016/j.brat.2019.103485] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 08/26/2019] [Accepted: 09/29/2019] [Indexed: 12/12/2022]
Abstract
This trial examined whether a stepped care program for depression, which initiated treatment with internet cognitive behavioral therapy, including telephone and messaging support, and stepped up non-responders to telephone-administered cognitive behavioral therapy (tCBT), was noninferior, less costly to deliver, and as acceptable to patients compared to tCBT alone. Adults with a diagnosis of major depressive episode (MDE) were randomized to receive up to 20 weeks of stepped care or tCBT. Stepped care (n = 134) was noninferior to tCBT (n = 136) with an end-of-treatment effect size of d = 0.03 and a 6-month post-treatment effect size of d = -0.07 [90% CI 0.29 to 0.14]. Therapist time in stepped care was 5.26 (SD = 3.08) hours versus 10.16 (SD 4.01) for tCBT (p < 0.0001), with a delivery cost difference of $-364.32 [95% CI $-423.68 to $-304.96]. There was no significant difference in pre-treatment preferences (p = 0.10) or treatment dropout (39 in stepped care; 27 in tCBT; p = 0.14). tCBT patients were significantly more satisfied than stepped care patients with the treatment they received (p < 0.0001). These findings indicate that stepped care was less costly to deliver, but no less effective than tCBT. There was no significant difference in treatment preference or completion, however satisfaction with treatment was higher in tCBT than stepped care. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01906476.
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Affiliation(s)
- David C Mohr
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, 750 N. Lakeshore Dr., 10th Floor, Chicago, IL, 60611, USA.
| | - Emily G Lattie
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, 750 N. Lakeshore Dr., 10th Floor, Chicago, IL, 60611, USA
| | - Kathryn Noth Tomasino
- Department of Medicine, Northwestern University, NMH/Arkes Family Pavilion, Suite 1400, 676 N. Saint Clair St., Chicago, IL, 60611, USA
| | - Mary J Kwasny
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, 750 N. Lakeshore Dr., 10th Floor, Chicago, IL, 60611, USA
| | - Susan M Kaiser
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, 750 N. Lakeshore Dr., 10th Floor, Chicago, IL, 60611, USA
| | - Elizabeth L Gray
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, 750 N. Lakeshore Dr., 10th Floor, Chicago, IL, 60611, USA
| | - Nameyeh Alam
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, 750 N. Lakeshore Dr., 10th Floor, Chicago, IL, 60611, USA
| | - Neil Jordan
- Department of Psychiatry and Behavioral Sciences, Mental Health Services & Policy Program, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Dr, 12th Flr, Chicago, IL, 60611, USA; Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, 5000 S 5th Ave., Hines, IL, 60141, USA
| | - Stephen M Schueller
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University, 750 N. Lakeshore Dr., 10th Floor, Chicago, IL, 60611, USA
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Abstract
Telemental health is a demonstrated and effective aspect of the overall mental health system and considered a standard of care for many treatments. Adoption has not been as robust as expected and failure to properly develop implementation plans is a significant barrier. This article provides an overview of a step-by-step planning process to more effectively implement and sustain telemental health programs.
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Affiliation(s)
- Matthew C Mishkind
- Departments of Family Medicine and Psychiatry, Johnson Depression Center, University of Colorado School of Medicine, 13199 East Montview Boulevard, Suite 330, Aurora, CO 80045, USA.
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Maheu MM, Drude KP, Hertlein KM, Lipschutz R, Wall K, Hilty DM. Correction to: An Interprofessional Framework for Telebehavioral Health Competencies. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41347-019-00113-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Vakkalanka JP, Harland KK, Wittrock A, Schmidt M, Mack L, Nipe M, Himadi E, Ward MM, Mohr NM. Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study. J Epidemiol Community Health 2019; 73:1033-1039. [PMID: 31492762 PMCID: PMC7027382 DOI: 10.1136/jech-2019-212623] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/05/2019] [Accepted: 08/23/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the impact of telemedicine in clinical management and patient outcomes of patients presenting to rural critical access hospital emergency departments (EDs) with suicidal ideation or attempt. METHODS Retrospective propensity-matched cohort study of patients treated for suicidal attempt and ideation in 13 rural critical access hospital EDs participating in a telemedicine network. Patients for whom telemedicine was used were matched 1:1 to those who did not have telemedicine as an exposure (n=139 TM+, n=139 TM-) using optimal matching of propensity scores based on administrative data. Our primary outcome was ED length-of-stay (LOS), and secondary outcomes included admission proportion, use of chemical or physical restraint, 30 day ED return, involuntary detention orders, treatment/follow-up plan and 6-month mortality. Analyses for multivariable models were conducted using conditional linear and logistic regression clustered on matched pairs with purposeful selection of covariates. RESULTS Mean ED LOS was not associated with telemedicine consultation among all patients, but was associated with a 29.3% decrease in transferred patients (95% CI 11.1 to 47.5). The adjusted odds of hospital admission (either local or through transfer) was 2.35 (95% CI 1.10 to 5.00) times greater among TM+ patients compared with TM- patients. Involuntary hold placement was lower in those exposed to telemedicine (adjusted odds ratio (aOR): 0.48; 95% CI 0.23 to 0.97). We did not observe significant differences in other outcomes. CONCLUSION The role of telemedicine in influencing access, quality and efficiency of care in underserved rural hospitals is critically important as these networks become more prevalent in rural healthcare environments.
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Affiliation(s)
- Jayamalathi Priyanka Vakkalanka
- Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Karisa K Harland
- Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | | | | | - Luke Mack
- Avera eCARE, Sioux Falls, South Dakota, USA
| | | | - Elaine Himadi
- Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Marcia M Ward
- Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Nicholas M Mohr
- Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
- Division of Critical Care, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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Pierce BS, Perrin PB, McDonald SD. Path analytic modeling of psychologists’ openness to performing clinical work with telepsychology: A national study. J Clin Psychol 2019; 76:1135-1150. [DOI: 10.1002/jclp.22851] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
| | - Paul B. Perrin
- Psychology DepartmentVirginia Commonwealth University Virginia
| | - Scott D. McDonald
- Psychology DepartmentVirginia Commonwealth University Virginia
- Mental Health ServicesHunter Holmes McGuire VA Medical CenterRichmond Virginia
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45
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Shore JH, Goss CW, Dailey NK, Bair BD. Methodology for Evaluating Models of Telemental Health Delivery Against Population and Healthcare System Needs: Application to Telemental Healthcare for Rural Native Veterans. Telemed J E Health 2019; 25:628-637. [PMID: 30129880 DOI: 10.1089/tmj.2018.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Background: Rural American Indian and Alaska Native (AI/AN) Veterans face exceptional barriers to receiving quality mental healthcare. We aimed to identify models of in-person and telemental health service delivery with promise for adaptation and wide dissemination to rural AI/AN Veterans. Methods: Our method for matching specific populations with models of care includes (1) selecting frameworks that represent the healthcare organization's goals, (2) identifying relevant service delivery models for the target population(s), (3) assessing models against the selected frameworks, and (4) summarizing findings across models. We applied this approach to rural AI/AN Veteran populations. Results: Searches identified 13 current models of service delivery for rural AI/AN Veteran, rural AI/AN, and general rural Veteran populations. These models were assessed against four frameworks-the U.S. Department of Veterans Affairs' Office of Rural Health's Promising Practices, Veterans Health Administration's Guide to Mental Health Services, the Institute for Healthcare Improvement's Triple Aim Framework, and the American Indian Telemental Health Clinic framework. Discussion: The one model used for service delivery for rural AI/AN Veterans increases access and is patient-centered but lacks operational feasibility. Models for rural AI/ANs also increase access and are patient-centered but generally lack effectiveness evaluations. Models for rural Veterans demonstrate beneficial effects on mental health outcomes but do not emphasize cultural adaptations to diverse populations. Conclusions: Our approach to selecting models of service delivery considers the needs of operational partners as well as target populations and emphasizes large-scale implementation alongside effectiveness. Pending further testing, this approach holds promise for wider application.
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Affiliation(s)
- Jay H Shore
- Veterans Rural Health Resource Center-Salt Lake City, Veterans Health Administration Office of Rural Health, Salt Lake City, Utah
| | - Cynthia W Goss
- Veterans Rural Health Resource Center-Salt Lake City, Veterans Health Administration Office of Rural Health, Salt Lake City, Utah
| | - Nancy K Dailey
- Veterans Rural Health Resource Center-Salt Lake City, Veterans Health Administration Office of Rural Health, Salt Lake City, Utah
| | - Byron D Bair
- Veterans Rural Health Resource Center-Salt Lake City, Veterans Health Administration Office of Rural Health, Salt Lake City, Utah
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Ralston AL, Andrews AR, Hope DA. Fulfilling the promise of mental health technology to reduce public health disparities: Review and research agenda. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/cpsp.12277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mahmoud H, Vogt EL, Sers M, Fattal O, Ballout S. Overcoming Barriers to Larger-Scale Adoption of Telepsychiatry. Psychiatr Ann 2019. [DOI: 10.3928/00485713-20181228-02] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Noori T, Mehraeen E, Safdari R, Ahmadi M, Bahaadinbeigy K, Farzi J. Identifying and validating requirements of telemental health services for Iranian veterans. J Family Med Prim Care 2019; 8:1216-1221. [PMID: 31041276 PMCID: PMC6482756 DOI: 10.4103/jfmpc.jfmpc_324_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: The ability of timely access to mental health care is very important for combat veterans that are facing many barriers such as living in rural and remote areas and the lack of integration. Telemental health services improve the veterans’ health situation by providing mental health care from a distance. We aimed to identify the telemental health service requirements for Iranian veterans and validate them from the perspective of the statistical population. Methods: This descriptive cross-sectional study was conducted in 2018. In the first phase, a review was conducted in relevant databases, such as PubMed, Scopus, Ovid, Ebsco, and Web of Science. In the second phase, veterans, mental health providers, and telemedicine experts were consulted to validating of the identified telemental health service requirements by a researcher-made questionnaire. Analysis of collecting data was done using SPSS software. Results: By full-text reviewing of 15 related articles, the identified elements were justified in 2 main categories and 24 subcategories including telemental health services (17 items) and telemental health requirements (7 items). According to the findings, the highest score was related to “save health-care costs” (4.47) and “reduce transportation-related problems” (4.47). Moreover, the “feasible alternative to face-to-face care” (2.22) obtained the lowest score from the perspective of the statistical population. Conclusion: Due to the importance of accessibility and patient-based mental health services, more studies are needed to investigate the point of views of patients and specialists to better understand the concerns and barriers to the implementation and use of telemental health services.
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Valentine LM, Donofry SD, Sexton MB. Demographic and psychiatric predictors of engagement in psychotherapy services conducted via clinical video telehealth. J Telemed Telecare 2018; 26:113-118. [PMID: 30261806 DOI: 10.1177/1357633x18801713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Introduction Military veterans are at high risk for developing mental health problems. Unfortunately, veterans have relatively low rates of engagement in mental health services compared with non-veterans. In order to address barriers to mental health care services, the Veteran’s Health Administration (VHA) has implemented clinical video telehealth (CVT). Although the effectiveness of this technology appears promising, there is limited research evaluating rates of engagement in CVT mental health services or what factors may predict premature attrition from mental health care delivered via this format. Methods The present study aimed to investigate treatment engagement among veterans enrolled in psychotherapy delivered via CVT, as well as to explore the effects of various demographic and clinical characteristics on these outcomes. Participants were 250 veterans with consults placed to the CVT clinic at a large Midwestern VHA. To evaluate characteristics related to therapy retention, demographic and symptom profile information was gathered from a subset of 93 participants who attended at least one CVT psychotherapy appointment. Results Results indicated there were no significant demographic differences between veterans who attended at least one CVT appointment and those who did not attend at least one session. Demographic variables were not related to the number of CVT visits attended. Regarding psychological characteristics, veterans with anxiety disorders attended fewer CVT appointments overall than veterans with mood disorders and attendance at CVT was negatively correlated with anxiety severity. Discussion These findings have potential implications for providers working in CVT clinics as well as for future research in this area.
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Affiliation(s)
- Lisa M Valentine
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Shannon D Donofry
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Minden B Sexton
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,University of Michigan Medical School, Ann Arbor, Michigan, USA
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50
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Zapata AML, Beaudreau SA, O'Hara R, Bereknyei Merrell S, Bruce J, Garrison-Diehn C, Gould CE. Information-Seeking about Anxiety and Perceptions about Technology to Teach Coping Skills in Older Veterans. Clin Gerontol 2018; 41:346-356. [PMID: 28967837 DOI: 10.1080/07317115.2017.1359716] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We sought to learn where older veterans seek information about anxiety and coping. Due to increasing use of technology in health care, we also explored benefits and barriers of using technology to teach coping skills. METHODS Twenty veterans (mean age = 69.5 years, SD = 7.3) participated in semi-structured interviews in which we inquired about where they seek information about anxiety. We explored quantitative and qualitative differences for veterans with high versus low anxiety. In follow-up focus groups, we examined opinions about learning coping skills using technology. RESULTS Though veterans primarily named health care professionals as sources of information about anxiety, online searches and reading books were frequently mentioned. Reported benefits of using technology were convenience and standardized instruction of coping skills. Barriers included lack of interaction and frustration with technology usability. CONCLUSION Older veterans use multiple sources, heavily rely on interpersonal sources (e.g., professionals, friends), and employ varied search strategies regarding how to cope with anxiety. Using technology to teach coping skills was generally acceptable to older veterans. CLINICAL IMPLICATIONS Health care professionals could guide patients towards credible online and book sources. Providing instruction about using technology may help older adults use technology to learn coping skills.
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Affiliation(s)
- Aimee Marie L Zapata
- a Palo Alto Geriatric Research, Education, and Clinical Center , VA Palo Alto Health Care System , Palo Alto , California , USA.,b Pacific Graduate School of Psychology , Palo Alto University , Palo Alto , California , USA
| | - Sherry A Beaudreau
- c Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.,d Sierra Pacific Mental Illness Research, Education, and Clinical Center , VA Palo Alto Health Care System , Palo Alto , California , USA
| | - Ruth O'Hara
- c Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.,d Sierra Pacific Mental Illness Research, Education, and Clinical Center , VA Palo Alto Health Care System , Palo Alto , California , USA
| | - Sylvia Bereknyei Merrell
- e Department of Medicine, Division of General Medical Disciplines , Stanford University School of Medicine , Stanford , California , USA
| | - Janine Bruce
- f Department of Pediatrics, Division of General Pediatrics , Stanford University School of Medicine , Stanford , California , USA
| | - Christina Garrison-Diehn
- a Palo Alto Geriatric Research, Education, and Clinical Center , VA Palo Alto Health Care System , Palo Alto , California , USA.,c Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
| | - Christine E Gould
- a Palo Alto Geriatric Research, Education, and Clinical Center , VA Palo Alto Health Care System , Palo Alto , California , USA.,c Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
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