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Andersen JA, Rowland B, Gloster E, McElfish PA. Telehealth Utilization During COVID-19 Among People with Diagnosed Mental Health Conditions. Telemed J E Health 2021; 28:743-746. [PMID: 34515529 PMCID: PMC9127827 DOI: 10.1089/tmj.2021.0356] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Despite the potential benefits and the demonstrated uptake throughout the coronavirus disease 2019 (COVID-19) pandemic, studies have found that telemental health is still underused. The objective of the study was to explore the associations between mental health diagnoses and telehealth utilization during the pandemic. Methods: The study utilized a cross-sectional survey among adult Arkansans (n = 754). Logistic regression was used to determine the association between a diagnosis of anxiety and/or depression and telehealth utilization. Results: Forty-two percent of respondents reported utilizing telehealth during the pandemic. Respondents with a diagnosis of anxiety and/or depression had three times greater odds of utilizing telehealth (odds ratio = 2.97) than those with no diagnoses. Discussion: Utilization of telehealth care during the COVID-19 pandemic was lower in our sample compared with other nationally representative surveys; however, utilization was higher among people with a diagnosis of anxiety and/or depression. Conclusions: The results indicate the need for outreach to increase telehealth utilization.
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Affiliation(s)
- Jennifer A Andersen
- College of Medicine, and University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Erin Gloster
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Pearl A McElfish
- College of Medicine, and University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
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102
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Singh S, Fletcher GG, Yao X, Sussman J. Virtual Care in Patients with Cancer: A Systematic Review. Curr Oncol 2021; 28:3488-3506. [PMID: 34590602 PMCID: PMC8482228 DOI: 10.3390/curroncol28050301] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 01/31/2023] Open
Abstract
Virtual care in cancer care existed in a limited fashion globally before the COVID-19 pandemic, mostly driven by geographic constraints. The pandemic has required dramatic shifts in health care delivery, including cancer care. We conducted a systematic review of comparative studies evaluating virtual versus in-person care in patients with cancer. Embase, APA PsycInfo, Ovid MEDLINE, and the Cochrane Library were searched for literature from January 2015 to 6 August 2020. We adhered to PRISMA guidelines and used the modified GRADE approach to evaluate the data. We included 34 full-text publications of 10 randomized controlled trials, 13 non-randomized comparative studies, and 5 ongoing randomized controlled trials. Evidence was divided into studies that provide psychosocial or genetic counselling and those that provide or assess medical and supportive care. The limited data in this review support that in the general field of psychological counselling, virtual or remote counselling can be equivalent to in-person counselling. In the area of genetic counselling, telephone counselling was more convenient and noninferior to usual care for all outcomes (knowledge, decision conflict, cancer distress, perceived stress, genetic counseling satisfaction). There are few data for clinical outcomes and supportive care. Future research should assess the role of virtual care in these areas. Protocol registration: PROSPERO CRD42020202871.
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Affiliation(s)
- Simron Singh
- Person-Centred Care, Ontario Health (Cancer Care Ontario), Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada;
| | - Glenn G. Fletcher
- Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada; (G.G.F.); (X.Y.)
| | - Xiaomei Yao
- Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada; (G.G.F.); (X.Y.)
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jonathan Sussman
- Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), Department of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada; (G.G.F.); (X.Y.)
- Correspondence: or ; Tel.: +1-905-387-9495
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103
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Williams D, Booth G, Cohen H, Gilbert A, Lucas A, Mitchell C, Mittal G, Patel H, Peters T, Phillips M, Rudge W, Zarnegar R. Rapid design and implementation of a virtual pain management programme due to COVID-19: a quality improvement initiative. Br J Pain 2021; 16:191-202. [PMID: 35425594 PMCID: PMC8998524 DOI: 10.1177/20494637211039252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The COVID-19 pandemic interrupted the delivery of face-to-face pain services including pain management programmes in the United Kingdom with considerable negative impact on patients with chronic musculoskeletal pain. We aimed to develop and implement a remotely delivered pain management programme (PMP) using video-conferencing technology that contains all the core components of a full programme: the ‘virtual PMP’ (vPMP). By reporting on the process of this development, we endeavour to help address the paucity of literature on the development of remote pain management programmes. Methods: The vPMP was developed by an inter-disciplinary group of professionals as a quality improvement (QI) project. The Model for Improvement Framework was employed with patient involvement at the design phase and at subsequent improvements. Improvement was measured qualitatively with frequent and repeated qualitative data collection leading to programme change. Quantitative patient demographic comparisons were made with a patient cohort who had been on a face-to-face PMP pathway. Results: Sixty-one patients on the PMP waiting list were contacted and 43 met the criteria for the programme. Fourteen patients participated in three vPMP cycles. Patient involvement and comprehensive stakeholder consultation were essential to a robust design for the first vPMP. Continued involvement of patient partners during the QI process led to rapid resolution of implementation problems. The most prominent issues that needed action were technical challenges including training needs, participant access to physical and technological resources, participant fatigue and concerns about adequate communication and peer support. Conclusion: This report demonstrates how a remotely delivered PMP, fully in line with national guidance, was rapidly developed and implemented in a hospital setting for patients with chronic musculoskeletal pain. We also discuss the relevance of our findings to the issues of cost, patient experience, patient preferences and inequities of access in delivering telerehabilitation for chronic pain.
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Affiliation(s)
- Deborah Williams
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Gregory Booth
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Helen Cohen
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Anthony Gilbert
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Andrew Lucas
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Chloe Mitchell
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Gayatri Mittal
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Hasina Patel
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Tamsin Peters
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Mia Phillips
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Will Rudge
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Roxaneh Zarnegar
- Physiotherapy Department, Royal National Orthopaedic Hospital, Stanmore, UK
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104
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Oudshoorn CEM, Frielink N, Riper H, Embregts PJCM. Experiences of therapists conducting psychological assessments and video conferencing therapy sessions with people with mild intellectual disabilities during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:350-358. [PMID: 37025338 PMCID: PMC10071960 DOI: 10.1080/20473869.2021.1967078] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/08/2021] [Accepted: 08/08/2021] [Indexed: 06/14/2023]
Abstract
Background. Due to the restrictive measures introduced to tackle the COVID-19 pandemic, therapists working with people with mild intellectual disabilities have had to use video conferencing to continue to conduct their psychological assessments and therapy sessions. This qualitative study explored therapists' experiences of using video conferencing during the initial lockdown period in the Netherlands. Method. In total, seven therapists working at a service organisation supporting people with intellectual disabilities participated in this qualitative study (M = 34.4 years; SD = 6.0, range: 26-42). The therapists documented their experiences via audio recordings, which were subsequently analysed using thematic analysis. Results. Five themes emerged: 1) An immediate transition to virtual working; 2) Developing virtual ways to support service users in both coping with COVID-19 related stress and with continuing therapy; 3) Lacking the appropriate equipment; 4) Limitations in virtually attuning to people with mild intellectual disabilities; and 5) Unforeseen opportunities for distance-based psychological assessments and therapy. Conclusions. This study provides valuable insights into the experiences of therapists using video conferencing to support people with mild intellectual disabilities during the COVID-19 pandemic. These insights can help inform clinical practice with respect to the use of video conferencing for psychological assessment and therapy with people with mild intellectual disabilities.
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Affiliation(s)
- Cathelijn E. M. Oudshoorn
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- ASVZ, Sliedrecht, The Netherlands
| | - Noud Frielink
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro & Developmental Psychology, VU Amsterdam, The Netherlands
| | - Petri J. C. M. Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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105
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Thomas N, McDonald C, de Boer K, Brand RM, Nedeljkovic M, Seabrook L. Review of the current empirical literature on using videoconferencing to deliver individual psychotherapies to adults with mental health problems. Psychol Psychother 2021; 94:854-883. [PMID: 33620133 PMCID: PMC8451850 DOI: 10.1111/papt.12332] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/02/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE The COVID-19 pandemic has resulted in a widespread adoption of videoconferencing as a communication medium in mental health service delivery. This review considers the empirical literature to date on using videoconferencing to deliver psychological therapy to adults presenting with mental health problems. METHOD Papers were identified via search of relevant databases. Quantitative and qualitative data were extracted and synthesized on uptake, feasibility, outcomes, and participant and therapist experiences. RESULTS Videoconferencing has an established evidence base in the delivery of cognitive behavioural therapies for post-traumatic stress disorder and depression, with prolonged exposure, cognitive processing therapy, and behavioural activation non-inferior to in-person delivery. There are large trials reporting efficacy for health anxiety and bulimia nervosa compared with treatment-as-usual. Initial studies show applicability of cognitive behavioural therapies for other anxiety and eating disorders and obsessive-compulsive spectrum disorders, but there has yet to be study of use in severe and complex mental health problems. Therapists may find it more difficult to judge non-verbal behaviour, and there may be initial discomfort while adapting to videoconferencing, but client ratings of the therapeutic alliance are similar to in-person therapy, and videoconferencing may have advantages such as being less confronting. There may be useful opportunities for videoconferencing in embedding therapy delivery within the client's own environment. CONCLUSIONS Videoconferencing is an accessible and effective modality for therapy delivery. Future research needs to extend beyond testing whether videoconferencing can replicate in-person therapy delivery to consider unique therapeutic affordances of the videoconferencing modality. PRACTITIONER POINTS Videoconferencing is an efficacious means of delivering behavioural and cognitive therapies to adults with mental health problems. Trial evidence has established it is no less efficacious than in-person therapy for prolonged exposure, cognitive processing therapy, and behavioural activation. While therapists report nonverbal feedback being harder to judge, and clients can take time to adapt to videoconferencing, clients rate the therapeutic alliance and satisfaction similarly to therapy in-person. Videoconferencing provides opportunities to integrate therapeutic exercises within the person's day-to-day environment.
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Affiliation(s)
- Neil Thomas
- National eTherapy CentreSwinburne University of TechnologyMelbourneVictoriaAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
- Alfred HospitalMelbourneVictoriaAustralia
| | - Caity McDonald
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Kathleen de Boer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Rachel M. Brand
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
- School of Health and Behavioural SciencesUniversity of the Sunshine CoastSippy DownsQldAustralia
| | - Maja Nedeljkovic
- National eTherapy CentreSwinburne University of TechnologyMelbourneVictoriaAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Liz Seabrook
- National eTherapy CentreSwinburne University of TechnologyMelbourneVictoriaAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
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106
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Krückl JS, Moeller J, Gaupp R, Meier CE, Roth CB, Lang UE, Huber CG. Implementing Home Office Work at a Large Psychiatric University Hospital in Switzerland During the COVID-19 Pandemic: Field Report. JMIR Ment Health 2021; 8:e28849. [PMID: 34115606 PMCID: PMC8412137 DOI: 10.2196/28849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic in 2020, psychiatric hospitals all over the world had to adapt their services to the prevailing governmental regulations. As a consequence, home office use and telepsychiatry boomed. OBJECTIVE The purpose of this study was to evaluate the potential of home office use, its adoption, and the association of home office use with employees' mental health in a large psychiatric university hospital in Switzerland. METHODS We obtained and analyzed home office implementation and use data from the psychiatric university hospital's information technology services. We also conducted a cross-sectional web-based survey to assess the employees' attitudes toward the clinic's crisis management during the COVID-19 pandemic in early 2020. Part of this web-based survey consisted of questions about home office use between March and June 2020, attitudes toward home office implementation, and mental health. Three mental health measures assessed depressive symptoms (Patient Health Questionnaire [PHQ]-2), anxiety (General Anxiety Disorder [GAD]-2), and stress factors (stress module of the PHQ-D); a cut-off score ≥3 was used for the PHQ-2 and GAD-2. RESULTS Of the 200 participating employees, 69 reported that they had worked from home at least partially (34.5%). Home office use differed significantly across professional groups (χ162=72.72, P≤.001, n=200). Employees experienced neither depressive symptoms (mean 0.76, SD 1.14) nor anxiety (mean 0.70, SD 1.03). The employees reported minor psychosocial stressors (mean 2.83, SD 2.92). The number of reported stress factors varied significantly across groups with different levels of home office use (χ42=9.72, P=.04). CONCLUSIONS In general, home office implementation appears to be feasible for large psychiatric hospitals, however, it is not equally feasible for all professional groups. Professional groups that require personal contact with patients and technical or manual tasks must work onsite. Further evaluation of home office use in psychiatric hospitals up to the development of clinics that function merely online will follow in future research. The situation created by the COVID-19 pandemic served as a stepping stone to promote home office use and should be used to improve employees' work-life balance, to save employers costs and foster other benefits.
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Affiliation(s)
- Jana Sophia Krückl
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Julian Moeller
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Rainer Gaupp
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Christoph E Meier
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Carl Bénédict Roth
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Undine Emmi Lang
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Christian G Huber
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
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107
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Bellanti DM, Kelber MS, Workman DE, Beech EH, Belsher BE. Rapid Review on the Effectiveness of Telehealth Interventions for the Treatment of Behavioral Health Disorders. Mil Med 2021; 187:e577-e588. [PMID: 34368853 DOI: 10.1093/milmed/usab318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/16/2021] [Accepted: 07/14/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The Psychological Health Center of Excellence conducted a rapid review of the literature to investigate the effectiveness of behavioral health treatments (i.e., evidence-based psychotherapy and psychiatry) delivered in person compared to telehealth (TH; i.e., video teleconference and telephone). MATERIALS AND METHODS The rapid review methods included a systematic search of a single database (PubMed), hand-searching of relevant systematic reviews, dual screening, single-person data abstraction verified by a second person, and dual risk of bias assessment. Due to heterogeneity across studies, no quantitative analyses were conducted. RESULTS Twenty-two randomized controlled trials (RCTs), eight of which were non-inferiority trials, evaluated the effectiveness of TH via telephone or video teleconferencing compared to in-person (IP) delivery for patient populations with posttraumatic stress disorder, depression, and mixed diagnoses. The majority of RCTs and all but one of the eight non-inferiority trials found that clinical outcomes did not differ between TH and IP treatment delivery. Two studies found that subgroups with higher symptom severity (hopelessness and anxiety disorders, respectively) in the TH group had worse treatment-related outcomes than IP participants with similar symptom profiles. The majority of studies found no significant differences in satisfaction with care, quality of the therapeutic alliance, or study discontinuation between TH and IP groups. CONCLUSION Based on evidence from 22 RCTs, the use of TH platforms, including video conference and telephone modalities, generally produces similar outcomes as face-to-face provision of psychotherapy and psychiatry services.
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Affiliation(s)
- Dawn M Bellanti
- Psychological Health Center of Excellence (PHCoE), Research Branch, Research & Development Division (J-9), Defense Health Agency, Silver Spring, MD 20910, USA
| | - Marija S Kelber
- Psychological Health Center of Excellence (PHCoE), Research Branch, Research & Development Division (J-9), Defense Health Agency, Silver Spring, MD 20910, USA
| | - Don E Workman
- Veterans Health Administration, Office of Research Development, Washington, DC 20402, USA
| | - Erin H Beech
- Psychological Health Center of Excellence (PHCoE), Research Branch, Research & Development Division (J-9), Defense Health Agency, Silver Spring, MD 20910, USA
| | - Brad E Belsher
- Phoenix VA Health Care System, Carl T Hayden Veterans Medical Center, Phoenix, AZ 85012, USA
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108
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Biancalani G, Franco C, Guglielmin MS, Moretto L, Orkibi H, Keisari S, Testoni I. Tele-psychodrama therapy during the COVID-19 pandemic: Participants' experiences. ARTS IN PSYCHOTHERAPY 2021; 75:101836. [PMID: 34305221 PMCID: PMC8294105 DOI: 10.1016/j.aip.2021.101836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/12/2021] [Accepted: 07/18/2021] [Indexed: 01/07/2023]
Abstract
Italy was severely hit by the COVID-19 pandemic. In early March 2020, a series of legislative decrees have been issued, establishing the restrictions that all Italian citizens are required to respect, according to which it is strictly forbidden to leave the house if not for reasons of necessity, health, or work. This qualitative study investigated which aspects clients find helpful or hindering in shifting to group tele-psychodrama due to the COVID-19 pandemic, after participation in an in-person psychodrama group. Participants were 15 adults who were members of a pre-existing in-person psychodrama group that shifted to a tele-psychodrama group format facilitated by two psychodrama therapists. The Client Change Interview was used at the end of the tele-psychodrama as a post-treatment assessment. All the interviews were transcribed and then underwent a thematic analysis. The analysis yielded six shared themes: the role of tele-psychodrama sessions during COVID-19 pandemic; perceived effectiveness of tele-psychodrama; main advantages of tele-psychodrama; limitations encountered during the online intervention; the termination of tele-psychodrama; and the relationship with the therapist. The findings provide preliminary evidence for the clinical practice of tele-psychodrama and lays the groundwork for further studies that can contribute to the use of electronic platforms in psychodrama interventions.
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Affiliation(s)
- Gianmarco Biancalani
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | - Chiara Franco
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | | | | | - Hod Orkibi
- Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Shoshi Keisari
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy
| | - Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, Padova, Italy.,Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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109
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Barnett P, Goulding L, Casetta C, Jordan H, Sheridan-Rains L, Steare T, Williams J, Wood L, Gaughran F, Johnson S. Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews. J Med Internet Res 2021; 23:e26492. [PMID: 34061758 PMCID: PMC8335619 DOI: 10.2196/26492] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/30/2021] [Accepted: 04/30/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Telemental health care has been rapidly adopted for maintaining services during the COVID-19 pandemic, and a substantial interest is now being devoted in its future role. Service planning and policy making for recovery from the pandemic and beyond should draw on both COVID-19 experiences and the substantial research evidence accumulated before this pandemic. OBJECTIVE We aim to conduct an umbrella review of systematic reviews available on the literature and evidence-based guidance on telemental health, including both qualitative and quantitative literature. METHODS Three databases were searched between January 2010 and August 2020 for systematic reviews meeting the predefined criteria. The retrieved reviews were independently screened, and those meeting the inclusion criteria were synthesized and assessed for risk of bias. Narrative synthesis was used to report these findings. RESULTS In total, 19 systematic reviews met the inclusion criteria. A total of 15 reviews examined clinical effectiveness, 8 reported on the aspects of telemental health implementation, 10 reported on acceptability to service users and clinicians, 2 reported on cost-effectiveness, and 1 reported on guidance. Most reviews were assessed to be of low quality. The findings suggested that video-based communication could be as effective and acceptable as face-to-face formats, at least in the short term. Evidence on the extent of digital exclusion and how it can be overcome and that on some significant contexts, such as children and young people's services and inpatient settings, was found to be lacking. CONCLUSIONS This umbrella review suggests that telemental health has the potential to be an effective and acceptable form of service delivery. However, we found limited evidence on the impact of its large-scale implementation across catchment areas. Combining previous evidence and COVID-19 experiences may allow realistic planning for the future implementation of telemental health.
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Affiliation(s)
- Phoebe Barnett
- Centre for Outcomes Research and Effectiveness, Division of Psychology and Language Sciences, University College London, London, United Kingdom.,NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Lucy Goulding
- King's Improvement Science, Centre for Implementation Science, King's College London, London, United Kingdom
| | - Cecilia Casetta
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom
| | - Harriet Jordan
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Trust, London, United Kingdom
| | - Luke Sheridan-Rains
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Thomas Steare
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Julie Williams
- Centre for Implementation Science, Health Service and Population Research Department, King's College London, London, United Kingdom
| | - Lisa Wood
- Division of Psychiatry, University College London, London, United Kingdom
| | - Fiona Gaughran
- NIHR Applied Research Collaboration, King's College London, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Trust, London, United Kingdom
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom.,Camden and Islington NHS Foundation Trust, London, United Kingdom
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110
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Oudshoorn CEM, Frielink N, Nijs SLP, Embregts PJCM. Psychological eHealth interventions for people with intellectual disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:950-972. [PMID: 33704872 PMCID: PMC8359285 DOI: 10.1111/jar.12877] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of eHealth, which has accelerated in the wake of the COVID-19 pandemic, could contribute to the access to tailor-made psychological interventions for people with intellectual disabilities. METHOD A scoping review was conducted on peer-reviewed studies between 1996-2019. RESULTS Thirty-three studies reported on the use of psychological eHealth interventions focused on mental health problems and/or challenging behaviour. The vast majority of these studies reported on interventions that were delivered at the individual level. The context in which these interventions were delivered varied, primarily ranging from the home setting to residential settings, as well as day or activity centres and schools. The studies described various types of interventions: telehealth interventions, computerized cognitive behavioural therapy, and interventions focused on (social) learning principles targeting challenging behaviour. CONCLUSIONS eHealth provides new opportunities for both therapists and lay-therapists to deliver psychological interventions. Future studies should focus on the effectiveness of psychological eHealth interventions.
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Affiliation(s)
- Cathelijn E. M. Oudshoorn
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
- ASVZSliedrechtThe Netherlands
| | - Noud Frielink
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Sara L. P. Nijs
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Petri J. C. M. Embregts
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
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111
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Smith K, Moller N, Cooper M, Gabriel L, Roddy J, Sheehy R. Video counselling and psychotherapy: A critical commentary on the evidence base. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kate Smith
- Division of Health Sciences Abertay University Dundee UK
| | - Naomi Moller
- Department of Psychology University of the West of England Bristol UK
| | - Mick Cooper
- Department of Psychology Roehampton University London UK
| | - Lynne Gabriel
- Faculty of Health and Life Sciences York St John University York UK
| | - Jeannette Roddy
- University of Salford School of Nursing Midwifery and Social Work Manchester UK
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112
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Pruitt Z, Chapin KP, Eakin H, Glover AL. Telehealth During COVID-19: Suicide Prevention and American Indian Communities in Montana. Telemed J E Health 2021; 28:325-333. [PMID: 34085870 PMCID: PMC8968828 DOI: 10.1089/tmj.2021.0104] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Public health measures that prevent the spread of COVID-19, such as social distancing, may increase the risk for suicide among American Indians due to decreased social connectedness that is crucial to wellbeing. Telehealth represents a potential solution, but barriers to effective suicide prevention may exist. Materials and Methods: In collaboration with Tribal and Urban Indian Health Center providers, this study measured suicide prevention practices during COVID-19. A 44-item Likert-type, web-based survey was distributed to Montana-based professionals who directly provide suicide prevention services to American Indians at risk for suicide. Descriptive statistics were calculated for survey items, and Mann–Whitney U tests examined the differences in telehealth use, training, skills among Montana geographic areas, and barriers between providers and their clients/patients. Results: Among the 80 respondents, two-thirds agreed or strongly agreed that American Indians experienced greater social disconnection since the COVID-19 pandemic began. Almost 98% agreed that telehealth was needed, and 93% were willing to use telehealth for suicide prevention services. Among current users, 75% agreed telehealth was effective for suicide prevention. Over one-third of respondents reported using telehealth for the first time during COVID-19 pandemic, and 30% use telehealth at least “usually” since the COVID-19 pandemic began, up from 6.3%. Compared with their own experiences, providers perceive their American Indian client/patients as experiencing greater barriers to telehealth. Discussion: Telehealth was increasingly utilized for suicide prevention during the COVID-19 pandemic. Opportunities to improve telehealth access should be explored, including investments in telehealth technologies for American Indians at risk for suicide.
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Affiliation(s)
- Zachary Pruitt
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Kate P Chapin
- Center for Children, Families, and Workforce Development, University of Montana Missoula, Missoula, Montana, USA
| | - Haley Eakin
- Center for Children, Families, and Workforce Development, University of Montana Missoula, Missoula, Montana, USA
| | - Annie L Glover
- Center for Children, Families, and Workforce Development, University of Montana Missoula, Missoula, Montana, USA
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113
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Lutz W, Edelbluth S, Deisenhofer AK, Delgadillo J, Moggia D, Prinz J, Schwartz B. The Impact of Switching from Face-to-Face to Remote Psychological Therapy during the COVID-19 Pandemic. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:285-286. [PMID: 33845476 PMCID: PMC8089400 DOI: 10.1159/000515543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany,*Wolfgang Lutz,
| | | | | | - Jaime Delgadillo
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Danilo Moggia
- Department of Psychology, University of Trier, Trier, Germany
| | - Jessica Prinz
- Department of Psychology, University of Trier, Trier, Germany
| | - Brian Schwartz
- Department of Psychology, University of Trier, Trier, Germany
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114
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Cozzolino M, Celia G, Girelli L, Limone P. Effects of the Brain Wave Modulation Technique Administered Online on Stress, Anxiety, Global Distress, and Affect During the First Wave of the COVID-19 Pandemic: A Randomized Clinical Trial. Front Psychol 2021; 12:635877. [PMID: 34093317 PMCID: PMC8170086 DOI: 10.3389/fpsyg.2021.635877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
This study aims to evaluate the effects of an innovative mind-body practice named the brain wave modulation technique (BWM-T) on stress, anxiety, global distress, and affect. The technique was administered online through a web-based video conferencing platform. The intervention started on week four of the first quarantine in Italy (week commencing 30th March 2020), for a duration of 4 weeks and ended before lockdown measures were loosened. 310 people participated in the study, mean age 28.73 years old (SD = 9.16), 77.8% women. Of these, about half were randomly assigned to the experimental group and the other half served as controls. Participants completed online psychological tests before and after the intervention. 266 people (144 experimental, 122 controls) completed the post-intervention tests. Consistent with our hypothesis, the study's findings indicate a reduction in the levels of stress, anxiety, global distress, and negative affect in the experimental group, compared to the control group. Moreover, the experimental group also showed higher levels of positive affect, compared to controls after the intervention. The present findings add to the current literature in suggesting that the BWM-T reduced stress not only when administered face-to face but also when administered online during the COVID-19 pandemic. Moreover, we also noted that the BWM-T has an effect on anxiety, global distress, and affect, which we had not investigated in previous studies.
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Affiliation(s)
- Mauro Cozzolino
- Department of Humanities, Philosophy and Education, University of Salerno, Fisciano, Italy
| | - Giovanna Celia
- Department of Economics, Management and Territory, University of Foggia, Foggia, Italy
| | - Laura Girelli
- Department of Humanities, Philosophy and Education, University of Salerno, Fisciano, Italy
| | - Pierpaolo Limone
- Department of Economics, Management and Territory, University of Foggia, Foggia, Italy
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115
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Skorburg JA, Yam J. Is There an App for That?: Ethical Issues in the Digital Mental Health Response to COVID-19. AJOB Neurosci 2021; 13:177-190. [PMID: 33989127 DOI: 10.1080/21507740.2021.1918284] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Well before COVID-19, there was growing excitement about the potential of various digital technologies such as tele-health, smartphone apps, or AI chatbots to revolutionize mental healthcare. As the SARS-CoV-2 virus spread across the globe, clinicians warned of the mental illness epidemic within the coronavirus pandemic. Now, funding for digital mental health technologies is surging and many researchers are calling for widespread adoption to address the mental health sequelae of COVID-19. Reckoning with the ethical implications of these technologies is urgent because decisions made today will shape the future of mental health research and care for the foreseeable future. We contend that the most pressing ethical issues concern (1) the extent to which these technologies demonstrably improve mental health outcomes and (2) the likelihood that wide-scale adoption will exacerbate the existing health inequalities laid bare by the pandemic. We argue that the evidence for efficacy is weak and that the likelihood of increasing inequalities is high. First, we review recent trends in digital mental health. Next, we turn to the clinical literature to show that many technologies proposed as a response to COVID-19 are unlikely to improve outcomes. Then, we argue that even evidence-based technologies run the risk of increasing health disparities. We conclude by suggesting that policymakers should not allocate limited resources to the development of many digital mental health tools and should focus instead on evidence-based solutions to address mental health inequalities.
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116
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Ter Heide FJJ, de la Rie S, de Haan A, Boeschoten M, Nijdam MJ, Smid G, Wind T, Mooren T. Wellbeing and clinical videoconferencing satisfaction among patients in psychotrauma treatment during the coronavirus pandemic: cross-sectional study. Eur J Psychotraumatol 2021; 12:1906021. [PMID: 34025924 PMCID: PMC8118435 DOI: 10.1080/20008198.2021.1906021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The coronavirus pandemic appears to put psychiatric patients with pre-existing symptomatology at risk of symptom increase, but evidence is scarce. While the pandemic and stringent governmental measures have accelerated the use of clinical videoconferencing (VCT), patient satisfaction with VCT is unclear. Objective: Aim of the study was to assess the wellbeing of patients in psychotrauma treatment during the coronavirus pandemic and to evaluate their use of and satisfaction with VCT. Method: This study used data from a routine outcome monitoring assessment completed by patients in treatment at a specialized psychotrauma institute and administered before the easing of governmental measures in June 2020. Wellbeing (Brief Symptom Inventory, Cantril Ladder, perceived stress level, and symptom change), VCT use and VCT satisfaction, and their association with demographic variables (gender, age, education level, and refugee status) were analysed. Results: Of the 318 respondents (response rate 64.5%), 139 (43.7%) reported a symptom increase, which was associated with a higher coronavirus-related stress level and general psychopathology as well as lower life satisfaction. There were significant effects of age and education level on wellbeing. VCT was reported to have been used by 228 (71.7%) patients. VCT satisfaction ratings were higher among women and those with lower levels of stress (r = -.20, p < .01) and general psychopathology (r = .21, p < .01). No difference in treatment satisfaction was found between patients who used VCT versus those who did not (mean difference = -.09 95% CI: -.79 to .62, p = .81). Conclusions: The coronavirus pandemic has aggravated mental health complaints according to a substantial percentage of patients in psychotrauma treatment. Although VCT was found to be acceptable, face-to-face treatment may remain necessary for specific target groups with limited access to VCT (such as refugees) and patients with high levels of general psychopathology.
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Affiliation(s)
| | | | | | | | - Mirjam J Nijdam
- ARQ Centrum'45, Diemen/Oegstgeest, The Netherlands.,Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Geert Smid
- ARQ Centrum'45, Diemen/Oegstgeest, The Netherlands.,University of Humanistic Studies, Utrecht, The Netherlands
| | - Tim Wind
- ARQ Centrum'45, Diemen/Oegstgeest, The Netherlands
| | - Trudy Mooren
- ARQ Centrum'45, Diemen/Oegstgeest, The Netherlands
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117
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Barth J, Canella C, Oehler M, Witt CM. Digital Consultations During COVID-19: A Multiperspective Mixed-Methods Study in an Integrative Medicine Setting in Switzerland. J Altern Complement Med 2021; 27:569-578. [PMID: 33960805 DOI: 10.1089/acm.2020.0539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: We evaluated digital consultations at a University Hospital in Switzerland within an integrative medicine outpatient setting. Patients' and treatment providers' (physicians and therapists) evaluated digital conversation-based consultations as well as the digital delivery of practical exercises. Methods: Digital consultations between March 15, 2020 and April 30, 2020 were identified. Between June and July 2020, patients and treatment providers completed online questionnaires addressing challenges and advantages of their digital consultations. Both groups documented their satisfaction and working alliance (Working Alliance Inventory). In addition, semistructured qualitative interviews with treatment providers were conducted. Findings: A total of 82 online surveys (response rate 47%) about the digital consultations were available for analyses, with 60 patients correctly identifying at least one treatment provider, and 9 interviews were performed. Patients and treatment providers overall evaluated the new setting of digital consultation as feasible and an efficient consultation format. Interestingly, the working alliance was rated as good. Technical problems were mentioned as the main challenge and the delivery of practical exercises in digital consultations was seen more challenging than having digital conversation-based consultations. Conclusion: Digital consultations were established with overall positive evaluations and with a good working alliance between patients and providers. For the delivery of practical exercises it might be required to develop more innovative digital settings to overcome shortcomings of the digital format. Hybrid settings that combine the best of both settings could be a good option for future in postpandemic times.
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Affiliation(s)
- Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Claudia Canella
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Manuela Oehler
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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118
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Classen B, Tudor K, du Preez E, Day E, Ioane J, Rodgers B. An Integrative Review of Contemporary Perspectives on Videoconference-Based Therapy-Prioritising Indigenous and Ethnic Minority Populations in the Global South. ACTA ACUST UNITED AC 2021; 6:545-558. [PMID: 33898737 PMCID: PMC8058578 DOI: 10.1007/s41347-021-00209-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/14/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022]
Abstract
An integrative literature review was undertaken as a means of drawing together contemporary perspectives on the outcomes and affordances of videoconference-based therapy. This review was conducted in a way which placed emphasis on the need for mental healthcare strategies which are mindful of the cultural and social needs of indigenous and ethnic minority populations, particularly those situated in the Global South. The review was undertaken using an inverse funnelling approach which sought to prioritise literature on videoconference-based therapy literature which specifically focused on indigenous and ethnic minority populations. A series of general and population specific searches across relevant health databases were supplemented by a simultaneous search of Google Scholar. The PICOS search tool was used in developing the search terms, and data was processed using an inductive approach to thematic analysis. A final dataset of 43 articles were included in the review. This body of literature encompassed an international range of studies and included perspectives informed by quantitative, qualitative and mixed methods research. Four key themes were identified across the reviewed literature: indigenous and ethnic minority populations, therapeutic relationships, clinical outcomes and technical and logistical considerations. Based on our findings, there is reason to believe that videoconference-based therapy can be made to be just as effective as offline, face-to-face modes of delivery. However, research into the efficacy, impact and cultural implications of this technology in relation to indigenous and ethnic minority populations represents a significant gap within contemporary literature.
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Affiliation(s)
- Ben Classen
- Auckland University of Technology, Auckland, New Zealand
| | - Keith Tudor
- Auckland University of Technology, Auckland, New Zealand
| | | | - Elizabeth Day
- Auckland University of Technology, Auckland, New Zealand
| | - Julia Ioane
- Auckland University of Technology, Auckland, New Zealand
| | - Brian Rodgers
- Auckland University of Technology, Auckland, New Zealand
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119
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Mousing CA, Sørensen D. Living with the risk of being infected: COPD patients' experiences during the coronavirus pandemic. J Clin Nurs 2021; 30:1719-1729. [PMID: 33616300 PMCID: PMC8014212 DOI: 10.1111/jocn.15727] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 12/15/2022]
Abstract
Aims To explore the existential significance of living with the risk of being infected with coronavirus in patients with COPD. Background Distancing measures aim to break the coronavirus transmission chains. Physical separation from social networks and social isolation are correlated with anxiety and depression. People with a chronic obstructive lung disease are particularly vulnerable due to the increased risk of a serious course of illness, so therefore many of them choose self‐isolation to protect themselves from COVID‐19. Design A qualitative exploratory study using individual semi‐structured interviews. Methods From June–September 2020, 13 participants were recruited through advertisements on Facebook as a convenience sample for semi‐structured individual interviews. The interviews took place through virtual platforms or in physical meetings. Data were analysed using Ricoeur's phenomenological approach, involving naïve reading, a structural analysis and a critical interpretation strategy. The study has been reported in line with COREQ guidelines. Findings Living with the threat of being infected with coronavirus has greatly affected everyday life for patients with COPD. The nagging fear of coronavirus as a death threat was a dominant feeling, together with anxiety, loneliness and hope. With self‐isolation, followed concerns of being forgotten and thoughts of the future, balancing between fearing the worst, and hoping the best. Conclusions Patients with moderate to severe COPD feel compelled to self‐isolate, as they fear dying from COVID‐19. The study revealed a need for proactive contact with health professionals to calm the patients' feelings of deprivation, loneliness, hopelessness and anxiety. Relevance to clinical practice Information about the patient's perspective may be used to develop targeted interventions aimed at giving adequate information, supporting hope, implementing digital or virtual solutions to keep in contact and avoid the feeling of being alone and forgotten during a pandemic crisis.
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Affiliation(s)
- Camilla Askov Mousing
- Research Centre for Health and Welfare Technology, Centre for Research in Clinical Nursing, VIA University College and Regional Hospital Central Jutland, Viborg, Denmark.,Research Centre for Health and Welfare Technology, Programme of Rehabilitation, VIA University College, Aarhus, Denmark
| | - Dorthe Sørensen
- Research Centre for Health and Welfare Technology, Programme of Rehabilitation, VIA University College, Aarhus, Denmark
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120
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de Boer K, Muir SD, Silva SSM, Nedeljkovic M, Seabrook E, Thomas N, Meyer D. Videoconferencing psychotherapy for couples and families: A systematic review. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:259-288. [PMID: 33837968 DOI: 10.1111/jmft.12518] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
The delivery of videoconferencing psychotherapy (VCP) has been found to be an efficacious, acceptable and feasible treatment modality for individual therapy. However, less is known about the use of VCP for couple and family therapy (CFT). The focus of this systematic review was to examine the efficacy, feasibility and acceptability of using VCP as a treatment delivery modality for CFT. A systematic search was conducted, data relating to efficacy, feasibility and acceptability were extracted from included studies. The search returned 7,112 abstracts, with 37 papers (0.005%) included. The methods of the review were pre-registered (PROSPERO; CRD42018106137). VCP for CFT was demonstrated to be feasible and acceptable. A meta-analysis was not conducted; however, results from the included studies indicate that VCP is an efficacious delivery method for CFT. Recommendations for future research and implications regarding clinical practice are made, which may be of interest to practitioners given the COVID-19 pandemic.
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Affiliation(s)
- Kathleen de Boer
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Samuel D Muir
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - S Sandun M Silva
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Maja Nedeljkovic
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Elizabeth Seabrook
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Neil Thomas
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Denny Meyer
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
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121
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Tönnies J, Hartmann M, Wensing M, Szecsenyi J, Peters-Klimm F, Brinster R, Weber D, Vomhof M, Icks A, Friederich HC, Haun MW. Mental Health Specialist Video Consultations Versus Treatment-as-Usual for Patients With Depression or Anxiety Disorders in Primary Care: Randomized Controlled Feasibility Trial. JMIR Ment Health 2021; 8:e22569. [PMID: 33709931 PMCID: PMC7998325 DOI: 10.2196/22569] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/13/2020] [Accepted: 01/29/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Most people affected by depression or anxiety disorders are treated solely by their primary care physician. Access to specialized mental health care is impeded by patients' comorbidity and immobility in aging societies and long waiting times at the providers' end. Video-based integrated care models may leverage limited resources more efficiently and provide timely specialized care in primary care settings. OBJECTIVE The study aims to evaluate the feasibility of mental health specialist video consultations with primary care patients with depression or anxiety disorders. METHODS Participants were recruited by their primary care physicians during regular practice visits. Patients who had experienced at least moderate symptoms of depression and/or anxiety disorders were considered eligible for the study. Patients were randomized into 2 groups receiving either treatment-as-usual as provided by their general practitioner or up to 5 video consultations conducted by a mental health specialist. Video consultations focused on systematic diagnosis and proactive monitoring using validated clinical rating scales, the establishment of an effective working alliance, and a stepped-care algorithm within integrated care adjusting treatments based on clinical outcomes. Feasibility outcomes were recruitment, rate of loss to follow-up, acceptability of treatment, and attendance at sessions. Effectiveness outcomes included depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), burden of specific somatic complaints (Somatic Symptom Disorder-B Criteria Scale-12), recovery (Recovery Assessment Scale-German [RAS-G]), and perception of chronic illness care (Patient Assessment of Chronic Illness Care), which were measured at baseline and 16 weeks postallocation by assessors blinded to the group allocation. RESULTS A total of 50 patients with depression and/or anxiety disorders were randomized, 23 in the intervention group and 27 in the treatment-as-usual group. The recruitment yield (number randomized per number screened) and the consent rate (number randomized per number eligible) were 69% (50/73) and 86% (50/58), respectively. Regarding acceptability, 87% (20/23) of the participants in the intervention group completed the intervention. Of the 108 planned video consultations, 102 (94.4%) were delivered. Follow-up rates were 96% (22/23) and 85% (23/27) for the intervention and control groups, respectively. The change from baseline scores at postmeasurement for the No Domination by Symptoms domain of recovery (RAS-G) was somewhat higher in the intervention group than in the control group (Mann-Whitney U test: rank-biserial r=0.19; 95% CI -0.09 to 0.46; P=.18). We did not detect any notable differences between the intervention and control groups in terms of other effectiveness outcomes. We did not observe any serious adverse events related to the trial. CONCLUSIONS The intervention and study procedures were found to be feasible for patients, primary care practice staff, and mental health specialists. A sufficiently powered pragmatic trial on mental health specialist video consultations should be conducted to investigate their effectiveness in routine care. TRIAL REGISTRATION German Clinical Trials Register DRKS00015812; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015812.
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Affiliation(s)
- Justus Tönnies
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Frank Peters-Klimm
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Regina Brinster
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Dorothea Weber
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Markus Vomhof
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Heinrich-Heine-University, Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Heinrich-Heine-University, Düsseldorf, Düsseldorf, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Markus W Haun
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
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122
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Markowitz JC, Milrod B, Heckman TG, Bergman M, Amsalem D, Zalman H, Ballas T, Neria Y. Psychotherapy at a Distance. Am J Psychiatry 2021; 178:240-246. [PMID: 32972202 DOI: 10.1176/appi.ajp.2020.20050557] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The 2020 COVID-19 pandemic has abruptly overwhelmed normal life. Beyond the fear and fatality of the virus itself comes a likely wave of psychiatric disorders. Simultaneously, social distancing has changed overnight how psychiatrists and other mental health professionals must treat patients. Telepsychotherapy, until now a promising but niche treatment, has suddenly become treatment as usual. This article briefly reviews the limited clinical evidence supporting different modes of telepsychotherapy, then focuses on how remote therapy affects clinicians and their patients.
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Affiliation(s)
- John C Markowitz
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
| | - Barbara Milrod
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
| | - Timothy G Heckman
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
| | - Maja Bergman
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
| | - Doron Amsalem
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
| | - Hemrie Zalman
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
| | - Thomas Ballas
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
| | - Yuval Neria
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Markowitz, Neria); New York State Psychiatric Institute, New York (Markowitz, Bergman, Amsalem, Zalman, Neria); Department of Psychiatry, Weill Cornell Medical College, New York (Milrod); College of Public Health, University of Georgia, Athens (Heckman); School of Psychology, Fairleigh Dickinson University, Teaneck, N.J. (Ballas)
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123
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Ghaneirad E, Groba S, Bleich S, Szycik GR. [Use of outpatient psychotherapy via video consultation]. PSYCHOTHERAPEUT 2021; 66:240-246. [PMID: 33642699 PMCID: PMC7898015 DOI: 10.1007/s00278-021-00497-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 11/29/2022]
Abstract
Hintergrund Aufgrund der Hygienemaßnahmen während der Coronapandemie Anfang 2020 war Präsenzpsychotherapie vielerorts in Deutschland nicht mehr oder nur eingeschränkt möglich. Psychotherapie via Videokonferenz trat als alternative Versorgungsmöglichkeit an diese Stelle. Fragestellung Die vorliegende Studie beschäftigt sich mit der Frage der tatsächlichen Nutzung dieser Art von Psychotherapie während des Lockdowns. Material und Methode Durch Befragung von Behandlern in der psychotherapeutischen Ausbildungsambulanz der Medizinischen Hochschule Hannover bezüglich ihrer Erfahrung sowie Erfahrung ihrer Patienten mit der Nutzung der Videosprechstunde während laufender Richtlinienpsychotherapie konnten Daten von 338 Patienten erhoben werden. Die Daten enthalten Angaben u. a. zur Annahme oder zur Ablehnung des Angebots der Videosprechstunde, zu Gründen der Ablehnung oder zu technischen Problemen bei der Durchführung. Ergebnisse Die präsentierten Daten zeigen, dass 35 % der Patienten von der Videosprechstunde nicht erreicht werden konnten. Circa die Hälfte der Patienten aus dieser Gruppe konnte aufgrund mangelnder technischer Ausstattung diese Therapieform nicht nutzen. Die andere Hälfte wünschte keine Therapie mithilfe der Videosprechstunde, obwohl die technischen Voraussetzungen dazu vorhanden waren. In der Gruppe der Nutzer der Videosprechstunde wurden in 31 % der Fälle die Sitzungen durch technische Störungen beeinträchtigt, und in weiteren 10 % der Fälle führten die Störungen sogar zur vorzeitigen Beendigung der Sitzung. Die vorgestellten Daten machen deutlich, dass mit steigendem Alter und sinkendem Bildungsniveau die Nutzung der Therapie über Videosprechstunde signifikant abnimmt. Schlussfolgerung Die Ergebnisse der vorliegenden Studie zeigen, dass trotz der Verbreitung der Videosprechstunde ein beträchtlicher Anteil der Patienten durch das Angebot nicht erreicht wird und somit im Fall weiterer Lockdowns Spezialangebote für diese Gruppe erwogen werden sollten. Die Autoren empfehlen Unterstützung durch Krankenkassen für Patienten, die über keine technischen Voraussetzungen verfügen. Patienten, die sich auf diese Form der Behandlung nicht einlassen wollten, brauchen therapeutisch motivierende Unterstützung. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s00278-021-00497-3) enthält folgendes Zusatzmaterial: Fragebogen zur Nutzung der Videosprechstunde in der ambulanten Psychotherapie. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.
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Affiliation(s)
- Erfan Ghaneirad
- Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Stefanie Groba
- Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Stefan Bleich
- Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Gregor R Szycik
- Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Deutschland.,Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Zentrum für Seelische Gesundheit, Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland
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Jayawardana D, Gannon B. Use of telehealth mental health services during the COVID-19 pandemic. AUST HEALTH REV 2021; 45:442-446. [PMID: 33583488 DOI: 10.1071/ah20325] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/29/2020] [Indexed: 01/22/2023]
Abstract
During the COVID-19 pandemic, specific mental health telehealth services in Australia have been an important source of help for the increasingly stressed population. This study examined trends in the uptake of telehealth items for mental health during the first 6 months of the COVID-19 pandemic using administrative Medicare data. During the peak of the pandemic there was a 50% reduction in the in-person consultations for mental health but also a substantial increase in uptake largely of the newly introduced temporary Medicare Benefits Schedule telehealth services. Further, the use of telehealth varied across age, gender and state/territory. These findings have important implications for the allocation of resources for telehealth, both now, and into the post-COVID-19 era.
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Affiliation(s)
- Danusha Jayawardana
- Centre for the Business and Economics of Health, Level 5, Sir Llew Edwards Building, University of Queensland, St Lucia, Qld 4072, Australia; and Corresponding author.
| | - Brenda Gannon
- Centre for the Business and Economics of Health, Level 5, Sir Llew Edwards Building, University of Queensland, St Lucia, Qld 4072, Australia; and School of Economics, Level 6, Colin Clark Building, University of Queensland, St Lucia, Qld 4072, Australia.
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125
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Al-Alawi M, McCall RK, Sultan A, Al Balushi N, Al-Mahrouqi T, Al Ghailani A, Al Sabti H, Al-Maniri A, Panchatcharam SM, Al Sinawi H. Efficacy of a Six-Week-Long Therapist-Guided Online Therapy Versus Self-help Internet-Based Therapy for COVID-19-Induced Anxiety and Depression: Open-label, Pragmatic, Randomized Controlled Trial. JMIR Ment Health 2021; 8:e26683. [PMID: 33512323 PMCID: PMC7886373 DOI: 10.2196/26683] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to a notable increase in psychological distress, globally. Oman is no exception to this, with several studies indicating high levels of anxiety and depression among the Omani public. There is a need for adaptive and effective interventions that aim to improve the elevated levels of psychological distress due to the COVID-19 pandemic. OBJECTIVE This study aimed to comparatively assess the efficacy of therapist-guided online therapy with that of self-help, internet-based therapy focusing on COVID-19-induced symptoms of anxiety and depression among individuals living in Oman during the COVID-19 pandemic. METHODS This was a 6-week-long pragmatic randomized controlled trial involving 60 participants who were recruited from a study sample surveyed for symptoms of anxiety or depression among the Omani public amid the COVID-19 pandemic. Participants in the intervention group were allocated to receive 1 online session per week for 6 weeks from certified psychotherapists in Oman; these sessions were conducted in Arabic or English. The psychotherapists utilized cognitive behavioral therapy and acceptance and commitment therapy interventions. Participants in the control group received an automatic weekly newsletter via email containing self-help information and tips to cope with distress associated with COVID-19. The information mainly consisted of behavioral tips revolving around the principles of cognitive behavioral therapy and acceptance and commitment therapy. The primary outcome was measured by comparing the change in the mean scores of Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scale from the baseline to the end of the study (ie, after 6 sessions) between the two groups. The secondary outcome was to compare the proportions of participants with depression and anxiety between the two groups. RESULTS Data from 46 participants were analyzed (intervention group n=22, control group n=24). There was no statistical difference in the baseline characteristics between both groups. Analysis of covariance indicated a significant reduction in the GAD-7 scores (F1,43=7.307; P=.01) between the two groups after adjusting for baseline scores. GAD-7 scores of participants in the intervention group were considerably more reduced than those of participants in the control group (β=-3.27; P=.01). Moreover, a greater reduction in mean PHQ-9 scores was observed among participants in the intervention group (F1,43=8.298; P=.006) than those in the control group (β=-4.311; P=.006). Although the levels of anxiety and depression reduced in both study groups, the reduction was higher in the intervention group (P=.049) than in the control group (P=.02). CONCLUSIONS This study provides preliminary evidence to support the efficacy of online therapy for improving the symptoms of anxiety and depression during the COVID-19 crisis in Oman. Therapist-guided online therapy was found to be superior to self-help, internet-based therapy; however, both therapies could be considered as viable options. TRIAL REGISTRATION ClinicalTrials.gov NCT04378257; https://clinicaltrials.gov/ct2/show/NCT04378257.
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Affiliation(s)
- Mohammed Al-Alawi
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | | | - Naser Al Balushi
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | | | | | | | | | - Hamed Al Sinawi
- Department of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman
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Yaffa S, Adi EL, Itai P, Marit JM, Doron G, Daniel S. Treatment of eating disorders in adolescents during the COVID-19 pandemic: a case series. J Eat Disord 2021; 9:17. [PMID: 33568207 PMCID: PMC7874990 DOI: 10.1186/s40337-021-00374-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) are among the most difficult psychiatric disorders to treat in normal conditions. They are likely even more difficult to manage in at-risk conditions such as the COVID-19 pandemic. Currently there is limited evidence about the particular needs and recommended treatment of adolescents with EDs during the COVID-19 outbreak, in particular regarding the use of telemedicine and the involvement of the family in long distance-treatment. AIMS We sought to discuss the advantages and problems associated with the use of multi-professional long-distance telemedicine treatment in the management of adolescents with EDs and their families during the COVID-19 outbreak. METHODS We gathered data about the treatment of adolescents with EDs in our pediatric ED-treatment center in Israel during the COVID-19 outbreak in the first 10 months of 2020, and compared it to the respective period in the past five years (2015-2019). Second, we described the management of four young females with anorexia nervosa (AN), treated in the ambulatory, daycare and inpatient facilities of our center during the COVID-19 pandemic. FINDINGS Slightly less patients were treated in our center during the COVID-19 pandemic than in the respective period in the past five years. These patients received at that time considerably more treatment sessions from all treatment providers (psychiatrists, clinical nutritionists and psychotherapists). This was related, in part, to the extensive use of telemedicine during that period (more than as third of all sessions were carried out with telemedicine in comparison to no use of long-distance treatment in the previous years). The condition of the four adolescents with AN was compromised at the start of the COVID-19 quarantine. The use of multi-disciplinary long-distance telemedicine treatment resulted in an improvement in the condition in three of the four adolescents, living in well-organized families, with the motivation and ability to adjust to the new conditions, but not in one adolescent whose family experienced more problems. These families might require the use of face-to-face interventions even during pandemic conditions. CONCLUSION The choice of the mode of treatment for adolescents with EDs during pandemic times (telemedicine vs. face-to-face) should consider the functioning of the family.
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Affiliation(s)
- Serur Yaffa
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Enoch-Levy Adi
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Pessach Itai
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Joffe-Milstein Marit
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Gothelf Doron
- Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Stein Daniel
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.
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Lüchau EC, Jepsen C, Grønning A, Hvidt EA. Reciprocal dynamics between patients' choice of place and how they experience video consultations: A qualitative study. Digit Health 2021; 7:20552076211052158. [PMID: 34733540 PMCID: PMC8559177 DOI: 10.1177/20552076211052158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/22/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To analyse the reciprocal dynamics between patients' choice of place and how they experience video consultations (VCs) with the general practitioner. METHODS Qualitative, semi-structured interviews with 27 Danish patients were conducted over a period of 9 months, from February to October 2020. Interviews were analysed using thematic analysis. The analysis was guided by Nelly Oudshoorn's concept of technogeography of care. RESULTS The following three themes were identified in the data: VC-home dynamics: balancing boundaries; VC-workplace dynamics: logistical considerations; and VC-body image dynamics: on-screen exposure. CONCLUSIONS Taking human geography and science and technology studies as our analytical point of departure, we used the concept of technogeography of care and demonstrated how the reciprocal dynamics between patients' choice of place and how they experience VC made boundaries fluid and complex between different contexts and places, such as the home, the workplace and the clinic. These boundaries were negotiated differently by the patients depending on their need for privacy, convenience and support. Additionally, VC reconfigured patients' and general practitioners' roles, increasing patients' responsibility in securing an appropriate health care setting.
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Affiliation(s)
- Elle C. Lüchau
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Carole Jepsen
- Department for the Study of Culture, University of Southern Denmark, Odense, Denmark
| | - Anette Grønning
- Department for the Study of Culture, University of Southern Denmark, Odense, Denmark
| | - Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department for the Study of Culture, University of Southern Denmark, Odense, Denmark
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128
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Khan MI, Saleem HAR, Anwar MF, Chang YC. Novel Coronavirus and Emerging Mental Health Issues—A Timely Analysis of Potential Consequences and Legal Policies Perspective. FUDAN JOURNAL OF THE HUMANITIES AND SOCIAL SCIENCES 2021; 14. [PMCID: PMC7841381 DOI: 10.1007/s40647-020-00313-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The present outbreak of coronavirus disease 2019 (COVID-19) has swiftly crossed borders, and inflicted the global mental health issues. It is also affecting peoples’ daily behaviours, economics, prevention strategies and decision-making among policymakers, healthcare organisations and medical centres that may unintentionally weaken COVID-19 control strategies and lead to increased morbidity, as well as mental health care needs globally. Ultimately, this outbreak is leading to further health complications worldwide, such as stress, fear of the unknown, anger, anxiety, denial, depression symptoms, and insomnia. Notwithstanding all the resources used to counter the spread of the virus, further universal strategies are desirable to address the associated mental health problems. The present study uses the qualitative means to investigate the potential impact of COVID-19, the consequences and legal aspects, then recommend policy implications, in an attempt to cover any apparent loopholes. It presents a unique analysis of its kind on the policy and legal aspects of the ongoing pandemic, as regards mental health. It concludes that there is an acute need to prioritising the health care and curative issues, strengthen awareness and address the psychological syndromes or similar complications afflicting members of the general public during this pandemic.
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Affiliation(s)
- Mehran Idris Khan
- School of Law, Dalian Maritime University, Dalian, 116026 Liaoning Province China
- Business Administration Department, Faculty of Management Sciences, ILMA University, Karachi, 75190 Sindh Province Pakistan
| | | | - Muhammad Fahad Anwar
- Department of Law, University of Sahiwal, Sahiwal, 57000 Punjab Province, Pakistan
| | - Yen-Chiang Chang
- School of Law, Dalian Maritime University, Dalian, 116026 Liaoning Province China
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EÉk N, Romberg K, Siljeholm O, Johansson M, Andreasson S, Lundgren T, Fahlke C, Ingesson S, Bäckman L, Hammarberg A. Efficacy of an Internet-Based Community Reinforcement and Family Training Program to Increase Treatment Engagement for AUD and to Improve Psychiatric Health for CSOs: A Randomized Controlled Trial. Alcohol Alcohol 2020; 55:187-195. [PMID: 31912156 PMCID: PMC7082489 DOI: 10.1093/alcalc/agz095] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 10/09/2019] [Accepted: 10/24/2019] [Indexed: 12/04/2022] Open
Abstract
Aims Community Reinforcement Approach and Family Training (CRAFT) is a support program for concerned significant others (CSOs) to identified persons (IPs) with alcohol use disorders, with the purpose of engaging IPs to treatment and to improve CSO functioning. The purpose of the present study was to investigate the efficacy of an internet-based version of CRAFT (iCRAFT). Methods Randomized controlled trial comparing iCRAFT with a wait-list (WL) condition with a nation-wide uptake in Sweden. A total of 94 CSOs to a treatment refusing IP, who described the IP according to DSM-IV criteria for alcohol dependence or abuse, were included in the study. iCRAFT consisted of five weekly administered therapist-guided modules with the following content: (a) improve CSOs’ own mental health, (b) improve the CSOs skills in asking the IP to seek treatment, (c) positive communication skills training, (d) contingency management of IP drinking behavior. Main outcome measure was IPs initiative to seek treatment measured at 24 weeks. Secondary outcomes were IP’s daily alcohol consumption, CSOs mental health, quality of life and relational satisfaction. Results Of 94 participants, 15 CSOs reported IP treatment initiative during the study period. Of these, 10 belonged to the iCRAFT condition and five to the WL condition. The difference between conditions was nonsignificant, and the results were inconclusive. Participants in iCRAFT showed short-term improvements regarding depressive symptoms, quality of life and relational happiness. Conclusion This study was unable to demonstrate substantial changes in the iCRAFT program regarding IP treatment seeking or CSO mental health.
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Affiliation(s)
- Niels EÉk
- Department of Psychology, University of Gothenburg, PO Box 500, SE405 30 Gothenburg, Sweden
| | - Karin Romberg
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, SE171 77 Stockholm, Sweden.,Stockholm Health Care Services , Stockholm County Council, Solnavägen 1E, SE113 65, Stockholm, Sweden
| | - Ola Siljeholm
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, SE171 77 Stockholm, Sweden.,Stockholm Health Care Services , Stockholm County Council, Solnavägen 1E, SE113 65, Stockholm, Sweden
| | - Magnus Johansson
- Department of Public Health Sciences, Karolinska Institutet, SE171 77 Stockholm, Sweden
| | - Sven Andreasson
- Department of Public Health Sciences, Karolinska Institutet, SE171 77 Stockholm, Sweden
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, SE171 77 Stockholm, Sweden.,Stockholm Health Care Services , Stockholm County Council, Solnavägen 1E, SE113 65, Stockholm, Sweden
| | - Claudia Fahlke
- Department of Psychology, University of Gothenburg, PO Box 500, SE405 30 Gothenburg, Sweden
| | - Stina Ingesson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, SE171 77 Stockholm, Sweden.,Stockholm Health Care Services , Stockholm County Council, Solnavägen 1E, SE113 65, Stockholm, Sweden
| | - Lisa Bäckman
- Sahlgrenska University Hospital, The Clinic for Addictions and Dependency, SE413 45, Gothenburg, Sweden
| | - Anders Hammarberg
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, SE171 77 Stockholm, Sweden.,Stockholm Health Care Services , Stockholm County Council, Solnavägen 1E, SE113 65, Stockholm, Sweden
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130
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Carlier NG, Powell S, El-Halawani M, Dixon M, Weber A. COVID-19 transforms art therapy services in the Arabian Gulf. INTERNATIONAL JOURNAL OF ART THERAPY 2020. [DOI: 10.1080/17454832.2020.1845759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Sara Powell
- ATIC Psychological & Counselling Center, Dubai, UAE
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Remote management of musculoskeletal pain: a pragmatic approach to the implementation of video and phone consultations in musculoskeletal practice. Pain Rep 2020; 5:e878. [PMID: 33344873 PMCID: PMC7743834 DOI: 10.1097/pr9.0000000000000878] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/24/2020] [Accepted: 11/02/2020] [Indexed: 11/26/2022] Open
Abstract
Video and phone consultations for musculoskeletal pain are effective, safe, and appreciated by patients. Implementation and execution require special consideration and such guidance is provided. Introduction: Remote consultations through phone or video are gaining in importance for the treatment of musculoskeletal pain across a range of health care providers. However, there is a plethora of technical options for practitioners to choose from, and there are various challenges in the adaptation of clinical processes as well as several special considerations regarding regulatory context and patient management. Practitioners are faced with a lack of high-quality peer-reviewed resources to guide the planning and practical implementation of remote consultations. Objectives: This Clinical Update seeks to provide practical guidance for the planning and implementation of remote consultations for the management and treatment of people with musculoskeletal pain. Methods: Recommendations are based on a brief overview of the relevant research regarding phone and video consultations for musculoskeletal practice and derived from the literature, relevant guidelines, and practical experience. Results: The technical feasibility of remote consultations for musculoskeletal complaints is good, patient satisfaction is high, and a growing body of evidence supports its comparative effectiveness to in-person consultations in some circumstances for improving pain and functioning. We consider in detail practical aspects such as the choosing of hardware and software, we touch on the legal and regulatory context, and we focus on the adaptation of clinical processes and communication. Conclusion: This Clinical Update draws together best-practice evidence in a practically applicable format, enabling therapists who are working with people with pain to directly apply this knowledge to their individual clinical settings and the requirements of their patients.
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132
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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: 14] [Impact Index Per Article: 3.5] [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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133
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Rapisarda F, Vallarino M, Cavallini E, Barbato A, Brousseau-Paradis C, De Benedictis L, Lesage A. The Early Impact of the Covid-19 Emergency on Mental Health Workers: A Survey in Lombardy, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228615. [PMID: 33233513 PMCID: PMC7699473 DOI: 10.3390/ijerph17228615] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 01/12/2023]
Abstract
Lombardy was the epicenter of the Covid-19 outbreak in Italy, and in March 2020 the rapid escalation in cases prompted the Italian Government to decree a mandatory lockdown and to introduce safety practices in mental health services. The general objective of the study is to evaluate the early impact of the Covid-19 emergency and quarantine on the well-being and work practices of mental health service personnel and professionals. Data were collected through an online survey of workers and professionals working with people with mental health problems in Lombardy in several outpatient and inpatient services. Their socio-demographic characteristics, professional background, description of working conditions during lockdown and psychological distress levels were collected. All analyses were performed on a sample of 241. Approximately, 31% of the participants obtained a severe score in at least one of the burnout dimensions, 11.6% showed moderate or severe levels of anxiety, and 6.6% had a moderate or severe level of depression. Different work conditions and patterns of distress were found for outpatient service workers and inpatient service workers. The overall impact of the Covid-19 emergency on mental health workers' level of distress was mild, although a significant number of workers experienced severe levels of depersonalization and anxiety. More research is needed to assess specific predictive factors.
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Affiliation(s)
- Filippo Rapisarda
- Research and Development Team, Sociosfera ONLUS SCS, Via Antonio Gramsci 8, 20831 Seregno, Italy
- Correspondence:
| | - Martine Vallarino
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (M.V.); (E.C.)
| | - Elena Cavallini
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (M.V.); (E.C.)
| | - Angelo Barbato
- IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Via Mario Negri 2, 20156 Milano, Italy;
| | - Camille Brousseau-Paradis
- Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l’Est-de-l’Île-de-Montréal, 7401 Rue Hochelaga, Montreal, QC H1N 3M5, Canada; (C.B.-P.); (L.D.B.); (A.L.)
| | - Luigi De Benedictis
- Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l’Est-de-l’Île-de-Montréal, 7401 Rue Hochelaga, Montreal, QC H1N 3M5, Canada; (C.B.-P.); (L.D.B.); (A.L.)
| | - Alain Lesage
- Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l’Est-de-l’Île-de-Montréal, 7401 Rue Hochelaga, Montreal, QC H1N 3M5, Canada; (C.B.-P.); (L.D.B.); (A.L.)
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El Hayek S, Nofal M, Abdelrahman D, Adra A, Al Harthi M, Al Shamli S, AlNuaimi N, Bensid L, Cheaito MA, Emberish AM, Larnaout A, Radwan A, Slaih M, Kobeissy F, Bizri M. Telepsychiatry in the Arab World: A Viewpoint Before and During COVID-19. Neuropsychiatr Dis Treat 2020; 16:2805-2815. [PMID: 33239877 PMCID: PMC7682595 DOI: 10.2147/ndt.s277224] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Telepsychiatry, a subset of telemedicine, has been increasingly studied to meet the growing demands for psychiatric care. The utility of telepsychiatry is relevant now more than ever as the world endures the COVID-19 global pandemic. This paper describes the prior state and the changes that the COVID-19 outbreak brought to telepsychiatry in a selected group of Arab countries of the Middle East and North Africa (MENA) region. PATIENTS AND METHODS We invited twelve early-career psychiatrists from different Arab nations to share information related to telepsychiatry in their respective countries before and during the COVID-19 pandemic. The information was collected using a semi-structured guide. This was complemented by a search for relevant articles in five search engines using terms such as "COVID-19," "telepsychiatry," and "Arab world". RESULTS Before the pandemic, digital mental health services were provided in several Arab countries, mainly through hotlines and messaging services. The COVID-19 pandemic has marked a major shift in digital psychiatric services in the Arab MENA world, through the transformation of many clinics and some hospitals into digital mental health systems. Many non-governmental organizations also started remote initiatives for psychological support and psychiatric counseling. Three main barriers of patient-related, healthcare-related, and system-related hurdles of using telepsychiatry emanated from the analysis. CONCLUSION The use of digital mental health services varies between different Arab countries. Even though some nations have laws that regulate the provision of such services, most struggle with multifactorial barriers. As affordable and attainable solutions cannot only rely on training and recruiting more psychiatrists, telepsychiatry would help meet the exceeding demands in the Arab world, particularly after the COVID-19 outbreak.
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Affiliation(s)
- Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | | | | | - Ali Adra
- Department of Psychiatry, Damascus University, Damascus, Syria
| | - Mansour Al Harthi
- Department of Psychiatry, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Siham Al Shamli
- Oman Medical Specialty Board, Psychiatry Program, Muscat, Sultanet of Oman
| | - Nawaf AlNuaimi
- Psychiatric Department, Al Ain Hospital, Abu Dhabi, United Arab Emirates
| | - Lynda Bensid
- Department a, University of Algiers, Drid Hocine Hospital Specialized in Psychiatry, Algiers, Algeria
| | - Mohamad Ali Cheaito
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Amine Larnaout
- Psychiatry Department D, Razi Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ahmed Radwan
- Mental Health Service, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Slaih
- National Center for Mental Health, Ministry of Health, Amman, Jordan
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maya Bizri
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
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Mendes-Santos C, Andersson G, Weiderpass E, Santana R. Mitigating COVID-19 Impact on the Portuguese Population Mental Health: The Opportunity That Lies in Digital Mental Health. Front Public Health 2020; 8:553345. [PMID: 33313033 PMCID: PMC7701327 DOI: 10.3389/fpubh.2020.553345] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 09/04/2020] [Indexed: 01/09/2023] Open
Abstract
COVID-19 mitigation measures present unprecedented challenges in mental healthcare delivery, posing high risk to the mental health of at-risk populations, namely patients diagnosed with COVID-19, frontline healthcare providers, and those submitted to quarantine or isolation measures, as well as the general population. Ensuring safe and equitable access to mental healthcare by these groups entails resorting to innovative psychosocial intervention strategies, such as digital mental health. In this perspective piece, we describe the impact of COVID-19 on the Portuguese population's mental health, present an overview on initiatives developed to address the challenges currently faced by the Portuguese mental healthcare system, and discuss how the timely implementation of a comprehensive digital mental health strategy, coupling research, education, implementation, and quality assessment initiatives, might buffer COVID-19's impact on the Portuguese society.
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Affiliation(s)
- Cristina Mendes-Santos
- Department of Culture and Society, Linköping University, Linköping, Sweden
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Fraunhofer Center for Assistive Information and Communication Solutions, Porto, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Psychiatry Section, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
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Abstract
This review highlights proposed pandemic-adjusted modifications in obstetric care, with discussion of risks and benefits based on available evidence. We suggest best practices for balancing community-mitigation efforts with appropriate care of obstetric patients.
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137
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Turkington R, Mulvenna M, Bond R, Ennis E, Potts C, Moore C, Hamra L, Morrissey J, Isaksen M, Scowcroft E, O'Neill S. Behavior of Callers to a Crisis Helpline Before and During the COVID-19 Pandemic: Quantitative Data Analysis. JMIR Ment Health 2020; 7:e22984. [PMID: 33112759 PMCID: PMC7652595 DOI: 10.2196/22984] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/16/2020] [Accepted: 09/29/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The World Health Organization declared the outbreak of COVID-19 to be an international pandemic in March 2020. While numbers of new confirmed cases of the disease and death tolls are rising at an alarming rate on a daily basis, there is concern that the pandemic and the measures taken to counteract it could cause an increase in distress among the public. Hence, there could be an increase in need for emotional support within the population, which is complicated further by the reduction of existing face-to-face mental health services as a result of measures taken to limit the spread of the virus. OBJECTIVE The objective of this study was to determine whether the COVID-19 pandemic has had any influence on the calls made to Samaritans Ireland, a national crisis helpline within the Republic of Ireland. METHODS This study presents an analysis of calls made to Samaritans Ireland in a four-week period before the first confirmed case of COVID-19 (calls=41,648, callers=3752) and calls made to the service within a four-week period after a restrictive lockdown was imposed by the government of the Republic of Ireland (calls=46,043, callers=3147). Statistical analysis was conducted to explore any differences between the duration of calls in the two periods at a global level and at an hourly level. We performed k-means clustering to determine the types of callers who used the helpline based on their helpline call usage behavior and to assess the impact of the pandemic on the caller type usage patterns. RESULTS The analysis revealed that calls were of a longer duration in the postlockdown period in comparison with the pre-COVID-19 period. There were changes in the behavior of individuals in the cluster types defined by caller behavior, where some caller types tended to make longer calls to the service in the postlockdown period. There were also changes in caller behavior patterns with regard to the time of day of the call; variations were observed in the duration of calls at particular times of day, where average call durations increased in the early hours of the morning. CONCLUSIONS The results of this study highlight the impact of COVID-19 on a national crisis helpline service. Statistical differences were observed in caller behavior between the prelockdown and active lockdown periods. The findings suggest that service users relied on crisis helpline services more during the lockdown period due to an increased sense of isolation, worsening of underlying mental illness due to the pandemic, and reduction or overall removal of access to other support resources. Practical implications and limitations are discussed.
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Affiliation(s)
- Robin Turkington
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | - Maurice Mulvenna
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | - Raymond Bond
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | - Edel Ennis
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Courtney Potts
- School of Computing, Ulster University, Newtownabbey, United Kingdom
| | | | | | | | | | | | - Siobhan O'Neill
- School of Psychology, Ulster University, Coleraine, United Kingdom
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Smith BP, Coe E, Meyer EC. Acceptance and Commitment Therapy Delivered via Telehealth for the Treatment of Co-Occurring Depression, PTSD, and Nicotine Use in a Male Veteran. Clin Case Stud 2020. [DOI: 10.1177/1534650120963183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Symptoms of depression, posttraumatic stress, and substance use disorders commonly co-occur and are a tremendous health burden among the U.S. military veteran population. Acceptance and Commitment Therapy (ACT) is an evidence-based, transdiagnostic, integrated approach that has been used to treat these problems. Delivering psychotherapy via telehealth helps to break down barriers to care. This case study describes the application of ACT via telehealth with a male veteran with co-occurring symptoms of depression, PTSD and nicotine addiction. His depressive symptoms, PTSD symptoms, and nicotine use decreased substantially over the course of therapy. He demonstrated increased willingness to experience negatively evaluated internal experiences such as emotions and urges to use nicotine, defusion from self-critical and other unhelpful thoughts, more consistent engagement in values-consistent behaviors, and increased behavioral engagement in his social life. Treatment implications and unique aspects of the telehealth modality are discussed. Recommendations are made for training clinicians who may be considering providing services via telehealth or using ACT.
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Affiliation(s)
- Brandon P. Smith
- Baylor Scott & White Health, Waco, TX, USA
- Texas A&M University, College Station, TX, USA
| | | | - Eric C. Meyer
- Baylor Scott & White Health, Waco, TX, USA
- Texas A&M University Health Science Center, College Station, TX, USA
- Baylor University, Waco, TX, USA
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Gaebel W, Lukies R, Stricker J. COVID-19: сonsequences for mental health and the use of e-Mental health options. CONSORTIUM PSYCHIATRICUM 2020; 1:3-7. [PMID: 38680385 PMCID: PMC11047267 DOI: 10.17650/2712-7672-2020-1-1-3-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 05/01/2024] Open
Abstract
The current COVID-19 pandemic is associated with fear, insecurity, and perceived social isolation worldwide. In this editorial, we discuss the influence of the COVID-19 pandemic on mental health among the general population and among particularly vulnerable groups (e.g., people with pre-existing mental illness). Additionally, we explore the role of e-mental health options in times of social distancing. Preliminary empirical evidence indicates that a wide range of people have experienced mental health difficulties due to the COVID-19 pandemic and corresponding infection-control measures. E-mental health options are a feasible means of addressing psychological distress and mental illness during the pandemic. Thus, these options should be made available in a timely fashion. Future multidisciplinary research is needed to develop e-mental health strategies that specifically focus on the consequences of social isolation, economic hardship and fear of infection.
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Affiliation(s)
- Wolfgang Gaebel
- Department of Psychiatry, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University
- WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health
- LVR-Institute for Healthcare Research
| | | | - Johannes Stricker
- Department of Psychiatry, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University
- WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health
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van Dijk SDM, Bouman R, Folmer EH, den Held RC, Warringa JE, Marijnissen RM, Voshaar RCO. (Vi)-rushed Into Online Group Schema Therapy Based Day-Treatment for Older Adults by the COVID-19 Outbreak in the Netherlands. Am J Geriatr Psychiatry 2020; 28:983-988. [PMID: 32622730 PMCID: PMC7274959 DOI: 10.1016/j.jagp.2020.05.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/24/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Societal measures in context of the COVID-19 outbreak forced us to transform our schema therapy based day-treatment for older adults with chronic affective disorders and personality problems into an online program. The objective of this paper is to present first impressions of this transformation. METHODS Using over-the-phone instructions initially, all patients were able to participate with the online therapy program. To reduce screen-time for patients, the nonverbal therapies were shortened. Four patients, aged 64-70 years, started our online program. RESULTS Therapists were positive about the online capabilities and resilience of patients to adapt to the new situation. Prejudices on limited effectiveness of online psychotherapy were counteracted. Sending homework by email and mail seems to facilitate therapy adherence. Nonverbal therapy could be important to stimulate the online group process. CONCLUSION We were positively surprised by the online capabilities of our geriatric mental healthcare patients and encourage further formal effectiveness studies.
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Affiliation(s)
- Silvia Dian Maria van Dijk
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen (SDMVD, RB, EHF, RCDH, JEW, RMM, and RCOV), Groningen, the Netherlands.
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Humer E, Pieh C, Kuska M, Barke A, Doering BK, Gossmann K, Trnka R, Meier Z, Kascakova N, Tavel P, Probst T. Provision of Psychotherapy during the COVID-19 Pandemic among Czech, German and Slovak Psychotherapists. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4811. [PMID: 32635422 PMCID: PMC7370023 DOI: 10.3390/ijerph17134811] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 01/18/2023]
Abstract
Psychotherapists around the world are facing an unprecedented situation with the outbreak of the novel coronavirus disease (COVID-19). To combat the rapid spread of the virus, direct contact with others has to be avoided when possible. Therefore, remote psychotherapy provides a valuable option to continue mental health care during the COVID-19 pandemic. The present study investigated the fear of psychotherapists to become infected with COVID-19 during psychotherapy in personal contact and assessed how the provision of psychotherapy changed due to the COVID-19 situation and whether there were differences with regard to country and gender. Psychotherapists from three European countries: Czech Republic (CZ, n = 112), Germany (DE, n = 130) and Slovakia (SK, n = 96), with on average 77.8% female participants, completed an online survey. Participants rated the fear of COVID-19 infection during face-to-face psychotherapy and reported the number of patients treated on average per week (in personal contact, via telephone, via internet) during the COVID-19 situation as well as (retrospectively) in the months before. Fear of COVID-19 infection was highest in SK and lowest in DE (p < 0.001) and was higher in female compared to male psychotherapists (p = 0.021). In all countries, the number of patients treated on average per week in personal contact decreased (p < 0.001) and remote psychotherapies increased (p < 0.001), with more patients being treated via internet than via telephone during the COVID-19 situation (p < 0.001). Furthermore, female psychotherapists treated less patients in personal contact (p = 0.036), while they treated more patients via telephone than their male colleagues (p = 0.015). Overall, the total number of patients treated did not differ during COVID-19 from the months before (p = 0.133) and psychotherapy in personal contact remained the most common treatment modality. Results imply that the supply of mental health care could be maintained during COVID-19 and that changes in the provision of psychotherapy vary among countries and gender.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
| | - Martin Kuska
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
| | - Antonia Barke
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (B.K.D.); (K.G.)
| | - Bettina K. Doering
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (B.K.D.); (K.G.)
| | - Katharina Gossmann
- Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, 85072 Eichstätt, Germany; (A.B.); (B.K.D.); (K.G.)
| | - Radek Trnka
- Science and Research Department, Prague College of Psychosocial Studies, 14900 Prague, Czech Republic;
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Zdenek Meier
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Natalia Kascakova
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
- Psychiatric-Psychotherapeutic Outpatient Clinic, Pro mente sana, 81108 Bratislava, Slovakia
| | - Peter Tavel
- Olomouc University Social Health Institute (OUSHI), Palacky University Olomouc, 77111 Olomouc, Czech Republic; (Z.M.); (N.K.); (P.T.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (E.H.); (C.P.); (M.K.)
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Matheson BE, Bohon C, Lock J. Family-based treatment via videoconference: Clinical recommendations for treatment providers during COVID-19 and beyond. Int J Eat Disord 2020; 53:1142-1154. [PMID: 32533799 PMCID: PMC7323318 DOI: 10.1002/eat.23326] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 12/20/2022]
Abstract
The necessity to employ distance-based methods to deliver on-going eating disorder care due to the novel coronavirus (COVID-19) pandemic represents a dramatic and urgent shift in treatment delivery. Yet, TeleHealth treatments for eating disorders in youth have not been adequately researched or rigorously tested. Based on clinical experience within our clinic and research programs, we aim to highlight the common challenges clinicians may encounter in providing family-based treatment (FBT) via TeleHealth for children and adolescents with anorexia nervosa and bulimia nervosa. We also discuss possible solutions and offer practical considerations for providers delivering FBT in this format. Additional research in TeleHealth treatment for eating disorders in youth may lead to improved access, efficiency, and effectiveness of FBT delivered via videoconferencing.
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Affiliation(s)
- Brittany E. Matheson
- Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordCaliforniaUSA
| | - Cara Bohon
- Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordCaliforniaUSA
| | - James Lock
- Department of Psychiatry and Behavioral SciencesStanford University School of MedicineStanfordCaliforniaUSA
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Digital interventions in adult mental healthcare settings: recent evidence and future directions. Curr Opin Psychiatry 2020; 33:422-431. [PMID: 32427592 DOI: 10.1097/yco.0000000000000614] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Internet and mobile-based interventions (IMI) can be used as online delivered forms of psychotherapeutic mental health treatments. These interventions can be an effective as well as time and cost-efficient treatment with the potential to scale up mental healthcare. In this review, we map implementation possibilities into routine mental healthcare settings and provide the most recent evidence. RECENT FINDINGS Fourteen articles on digital mental healthcare approaches published in the last 18 months were included. Despite the limited number, the studies provide evidence for the effectiveness of IMI in treating inpatients and outpatients with various disorders in different mental healthcare settings. IMI were investigated as stand-alone interventions, in combination with other treatment forms (blended-care), or as aftercare. SUMMARY Although there is encouraging evidence for the effectiveness of IMI in mental healthcare settings, several limitations have to be considered. The small number of studies conducted within the healthcare system, especially with inpatient samples, calls for more collaboration between researchers and clinical practitioners to unravel barriers and develop efficient protocols for the integration into routine care. Nonetheless, IMI are a promising tool for the endeavour of closing the treatment gap and should, therefore, be further explored in varying settings.
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Hoffmann M, Wensing M, Peters-Klimm F, Szecsenyi J, Hartmann M, Friederich HC, Haun MW. Perspectives of Psychotherapists and Psychiatrists on Mental Health Care Integration Within Primary Care Via Video Consultations: Qualitative Preimplementation Study. J Med Internet Res 2020; 22:e17569. [PMID: 32554369 PMCID: PMC7333073 DOI: 10.2196/17569] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/18/2020] [Accepted: 04/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background Many patients with mental disorders remain untreated. Video-based mental health care demonstrates comparable effectiveness to face-to-face treatments and is a promising mode for delivering specialized care within primary care. Nevertheless, professionals struggle with implementing video consultations in their daily practice. Specifically, little is known about mental health specialists’ acceptance of mental health video consultations in routine practice. The PROVIDE (ImPROving cross-sectoral collaboration between primary and psychosocial care: An implementation study on VIDEo consultations) project aims to improve cross-sectoral collaboration between primary and psychosocial care through implementing video consultations in primary care. To increase the uptake of video consultations, it is crucial to account for necessary prerequisites and to tailor interventions to the needs of the target group prior to implementation. Objective The aim of this study was to explore the acceptance of video consultations embedded in primary care from the perspectives of mental health specialists in Germany. Methods We conducted a qualitative, exploratory, preimplementation study in urban and rural counties. We conducted three semistructured focus groups with 11 mental health specialists. We used qualitative content analysis combining an inductive-deductive approach, applying the Tailored Implementation in Chronic Diseases (TICD) framework to the text material, which comprises individual health professional factors; patient factors; professional interactions; incentives and resources; capacity for organizational change; social, political, and legal factors; and guideline factors. Results Against the background of long waiting times and a shortage of mental health specialists, especially in rural areas, participants valued video consultations as a potential means to improve access to mental health care. With respect to the TICD framework domains, the participants most often discussed individual health professional factors, followed by patient factors. All participants highlighted the importance of a trusting relationship between the patient and the therapist and doubted whether such a relationship could be established through video consultations (11/11, 100%). However, participants considered mental health specialist video consultations to be particularly suited for patients in rural areas, those with impaired mobility, and those who may otherwise remain untreated (6/11, 55%). Most participants expected video consultations to help the aforementioned patient groups avoid tedious searching for an available therapist and save on travel time and, therefore, improve access to specialized care for patients (7/11, 64%). Moreover, the participants expected video consultations to improve collaboration with the family physician (6/11, 55%). Finally, participants identified organizational aspects, such as reliable scheduling, the duration of the individual consultation (9/11, 82%), and reimbursement conditions (7/11, 67%), as key drivers for the acceptance and adoption of the model. Conclusions While mental health specialists expect video consultations to improve access to specialized care for some patients, they consistently wonder whether such consultations can establish a trusting patient-therapist relationship. When implementing video consultations, these concerns should be addressed by training providers in managing technology-based treatment settings, with extra consideration for fostering the patients’ and therapists’ engagement. Trial Registration German Clinical Trials Register DRKS00012487; https://tinyurl.com/uhg2one
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Affiliation(s)
- Mariell Hoffmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Frank Peters-Klimm
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
| | - Markus W Haun
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
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Fisher S, Guralnik T, Fonagy P, Zilcha-Mano S. Let’s face it: video conferencing psychotherapy requires the extensive use of ostensive cues. COUNSELLING PSYCHOLOGY QUARTERLY 2020. [DOI: 10.1080/09515070.2020.1777535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Shimrit Fisher
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Timur Guralnik
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Haun MW, Hoffmann M, Tönnies J, Dinger U, Hartmann M, Friederich HC. [Realtime video consultations by psychotherapists in times of the COVID-19 pandemic]. PSYCHOTHERAPEUT 2020; 65:291-296. [PMID: 32836895 PMCID: PMC7249972 DOI: 10.1007/s00278-020-00438-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Wegen der durch die „corona virus disease 2019“ (COVID-19) ausgelösten Pandemie und den resultierenden Beeinträchtigungen persönlicher (d. h. von Angesicht zu Angesicht stattfindender) Behandlung haben Videokonsultationen in der Erbringung von Gesundheitsleistungen massiv an Bedeutung zugenommen. Die meisten Psychotherapeuten haben allerdings bis dato wenig praktische Erfahrung in der Durchführung von Videokonsultationen, nicht zuletzt auch aufgrund bisher eingeschränkter Möglichkeiten zur Abrechnung mit den Kostenträgern. Der vorliegende Beitrag stellt (1) eine Übersicht über die Wirksamkeit per Videokonsultation durchgeführter psychotherapeutischer Interventionen bei depressiven und Angststörungen, (2) Empfehlungen zur spezifischen Gestaltung des Behandlungsrahmens sowie (3) erste Erfahrungen von Patienten und Psychotherapeuten aus einer deutschen Machbarkeitsstudie sowie mit dem Routineangebot im Krankenhaus während der COVID-19-Pandemie vor.
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Affiliation(s)
- Markus W Haun
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Deutschland
| | - Mariell Hoffmann
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Deutschland
| | - Justus Tönnies
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Deutschland
| | - Ulrike Dinger
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Deutschland
| | - Mechthild Hartmann
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Deutschland
| | - Hans-Christoph Friederich
- Klinik für Allgemeine Innere Medizin und Psychosomatik, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Deutschland
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147
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Shore JH, Schneck CD, Mishkind M, Caudill R, Thomas M. Advancing Treatment of Depression and Other Mood Disorders Through Innovative Models of Telepsychiatry. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:169-174. [PMID: 33162854 PMCID: PMC7587877 DOI: 10.1176/appi.focus.20190039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Rapid changes in health care technology are advancing mental health care. Telepsychiatry, in the form of live interactive videoconferencing, has demonstrated its ability to improve access to high-quality mental health care, specifically in the treatment of patients with depression and mood disorders. This article reviews the advances in telepsychiatry in the treatment of depression and mood disorders. Telepsychiatry is significantly reconfiguring the structures and models of psychiatric care delivery. Such changes include direct-to-home services, blending telepsychiatry with other technologies, and using a team-based care approach. This article also examines the evolving and innovative models of care, synthesizes literature and lessons learned about telehealth, and considers current and future pragmatic implications for the treatment of depression and mood disorders in various clinical settings. Telepsychiatry has an important and expanding role in addressing the individual and societal psychiatric burdens of depression and mood disorders.
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Affiliation(s)
- Jay H Shore
- Helen and Arthur E Johnson Depression Center, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora (Shore, Schneck, Mishkind, Thomas); AccessCare, Aurora, Colorado (Shore, Thomas); Department of Psychiatry and Behavioral Sciences, University of Louisville, School of Medicine, Louisville, Kentucky (Caudill)
| | - Christopher D Schneck
- Helen and Arthur E Johnson Depression Center, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora (Shore, Schneck, Mishkind, Thomas); AccessCare, Aurora, Colorado (Shore, Thomas); Department of Psychiatry and Behavioral Sciences, University of Louisville, School of Medicine, Louisville, Kentucky (Caudill)
| | - Matthew Mishkind
- Helen and Arthur E Johnson Depression Center, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora (Shore, Schneck, Mishkind, Thomas); AccessCare, Aurora, Colorado (Shore, Thomas); Department of Psychiatry and Behavioral Sciences, University of Louisville, School of Medicine, Louisville, Kentucky (Caudill)
| | - Robert Caudill
- Helen and Arthur E Johnson Depression Center, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora (Shore, Schneck, Mishkind, Thomas); AccessCare, Aurora, Colorado (Shore, Thomas); Department of Psychiatry and Behavioral Sciences, University of Louisville, School of Medicine, Louisville, Kentucky (Caudill)
| | - Marshal Thomas
- Helen and Arthur E Johnson Depression Center, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora (Shore, Schneck, Mishkind, Thomas); AccessCare, Aurora, Colorado (Shore, Thomas); Department of Psychiatry and Behavioral Sciences, University of Louisville, School of Medicine, Louisville, Kentucky (Caudill)
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148
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Wind TR, Rijkeboer M, Andersson G, Riper H. The COVID-19 pandemic: The 'black swan' for mental health care and a turning point for e-health. Internet Interv 2020; 20:100317. [PMID: 32289019 PMCID: PMC7104190 DOI: 10.1016/j.invent.2020.100317] [Citation(s) in RCA: 375] [Impact Index Per Article: 93.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tim R. Wind
- Foundation Centrum '45, Oegstgeest, The Netherlands
- partner in Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE Diemen, the Netherlands
| | - Marleen Rijkeboer
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Linköping University, Linköping, Sweden,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands,Department of Research and Innovation, GGZ in Geest/Amsterdam University Medical Center, VU University Medical Center, Amsterdam, Netherlands,Corresponding author at: Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, the Netherlands.
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149
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Ellis MJ, Boles S, Derksen V, Dawyduk B, Amadu A, Stelmack K, Kowalchuk M, Russell K. Evaluation of a pilot paediatric concussion telemedicine programme for northern communities in Manitoba. Int J Circumpolar Health 2020; 78:1573163. [PMID: 30714513 PMCID: PMC6366439 DOI: 10.1080/22423982.2019.1573163] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Pediatric concussion patients living in northern communities in Canada can face unique challenges accessing primary and specialized healthcare. In this study we report the clinical characteristics, healthcare utilization, outcomes and estimated cost avoidance associated with a pilot pediatric concussion telemedicine program established between a multi-disciplinary pediatric concussion program in Winnipeg, Manitoba and a hospital in Thompson, Manitoba. From October 1st- July 1st, 2018, 20 patients were evaluated; mean age 13.1 years, 15 (75%) males and 14 (70%) self-identified as Indigenous. Injury mechanisms included hockey (50%), falls (35%) and assaults (15%). Median time from referral to initial consultation was 2.0 days. After screening by the neurosurgeon, 90% of patients underwent initial consultation via real-time videoconferencing with 80% managed exclusively through telemedicine. At the end of the study, 90% met the criteria for clinical recovery, one remained in treatment and one was discharged to a headache neurologist. Sixty-six telemedicine encounters were completed including 57 videoconferencing appointments and 9 telephone follow-ups representing an estimated cost avoidance of $40,972.94. This study suggests telemedicine may be a useful approach to assist pediatric concussion programs with delivering timely, safe and cost-effective care to patients living in medically underserviced remote and northern communities in Canada.
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Affiliation(s)
- Michael J Ellis
- a Department of Surgery , University of Manitoba , Canada.,b Pediatrics and Child Health , University of Manitoba , Canada.,c Section of Neurosurgery , University of Manitoba , Canada.,d Pan Am Concussion Program , Winnipeg , Manitoba , Canada.,e Childrens Hospital Research Institute of Manitoba , Winnipeg , Manitoba , Canada.,f Canada North Concussion Network , Winnipeg , Manitoba , Canada
| | - Susan Boles
- g MBTelehealth, Manitoba eHealth , Winnipeg , Manitoba , Canada
| | - Vickie Derksen
- d Pan Am Concussion Program , Winnipeg , Manitoba , Canada
| | | | - Adam Amadu
- h Thompson General Hospital , Thompson , MB , Canada
| | - Karen Stelmack
- g MBTelehealth, Manitoba eHealth , Winnipeg , Manitoba , Canada
| | | | - Kelly Russell
- b Pediatrics and Child Health , University of Manitoba , Canada.,e Childrens Hospital Research Institute of Manitoba , Winnipeg , Manitoba , Canada.,f Canada North Concussion Network , Winnipeg , Manitoba , Canada
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150
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Zadka Ł, Olajossy M. COVID-19 Pandemic as the Beginning of a Golden Era for Telepsychiatry in Poland's Healthcare System. Front Psychiatry 2020; 11:555559. [PMID: 33519538 PMCID: PMC7838124 DOI: 10.3389/fpsyt.2020.555559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/11/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Łukasz Zadka
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Wroclaw, Poland.,Polish Psychiatric Association, Warsaw, Poland
| | - Marcin Olajossy
- Polish Psychiatric Association, Warsaw, Poland.,2nd Department of Psychiatry and Psychiatric Rehabilitation Medical University of Lublin, Medical University of Lublin, Lublin, Poland
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