1
|
Hobbs JA, Cowley DS, Crapanzano KA, Soman A, Camp ME, Houston LJ, New AS, Young JQ, Idicula SA, Brown GP, De Golia SG. Charting the Course for the Future of Psychiatric Residency Education: Guiding Considerations. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024:10.1007/s40596-024-01977-9. [PMID: 38710981 DOI: 10.1007/s40596-024-01977-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Affiliation(s)
| | | | | | | | - Mary E Camp
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - L Joy Houston
- Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Antonia S New
- The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Q Young
- Northwell Health and the Zucker School of Medicine, Hempstead, NY, USA
| | | | - Gregory P Brown
- Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, USA
| | | |
Collapse
|
2
|
Sheriff R, Hong JSW, Henshall C, D'Agostino A, Tomassi S, Stein HC, Cerveri G, Cibra C, Bonora S, Giordano B, Smith T, Phiri P, Asher C, Elliot K, Zangani C, Ede R, Saad F, Smith KA, Cipriani A. Evaluation of telepsychiatry during the COVID-19 pandemic across service users, carers and clinicians: an international mixed-methods study. BMJ MENTAL HEALTH 2023; 26:e300646. [PMID: 37567731 PMCID: PMC10577786 DOI: 10.1136/bmjment-2022-300646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/14/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Worldwide uptake of telepsychiatry accelerated during the COVID-19 pandemic. OBJECTIVE To conduct an evaluation of the opinions, preferences and attitudes to telepsychiatry from service users, carers and clinicians in order to understand how telepsychiatry can be best used in the peri/post-COVID-19 era. METHODS This mixed-methods, multicentre, international study of telepsychiatry was set in two sites in England and two in Italy. Survey questionnaires and focus group topic guides were co-produced for each participant group (service users, carers and clinicians). FINDINGS In the UK, 906 service users, 117 carers and 483 clinicians, and in Italy, 164 service users, 56 carers and 72 clinicians completed the surveys. In all, 17 service users/carers and 14 clinicians participated in focus groups. Overall, telepsychiatry was seen as convenient in follow-ups with a specific purpose such as medication reviews; however, it was perceived as less effective for establishing a therapeutic relationship or for assessing acutely disturbed mental states. In contrast to clinicians, most service users and carers indicated that telepsychiatry had not improved during the COVID-19 pandemic. Most service users and carers reported that the choice of appointment modality was most often determined by the service or clinician. CONCLUSION AND RELEVANCE There were circumstances in which telepsychiatry was seen as more suitable than others and clear differences in clinician, carer and service user perspectives on telepsychiatry. CLINICAL IMPLICATIONS All stakeholders should be actively engaged in determining a hybrid model of care according to clinical features and service user and carer preferences. Clinicians should be engaged in training programmes on telepsychiatry.
Collapse
Affiliation(s)
- Rebecca Sheriff
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - James S W Hong
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
| | - Catherine Henshall
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Armando D'Agostino
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Simona Tomassi
- Psychiatric Unit 1, Azienda ULSS 9 Scaligera, Verona, Italy
| | | | | | - Chiara Cibra
- Department of Psychiatry and Addiction, ASST Lodi, Lodi, Italy
| | - Stefano Bonora
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Barbara Giordano
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Tanya Smith
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Peter Phiri
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Carolyn Asher
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK
| | - Kathryn Elliot
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK
| | - Caroline Zangani
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
| | - Roger Ede
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Fathi Saad
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Katharine Alison Smith
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
| | - Andrea Cipriani
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
| |
Collapse
|
3
|
Cassity-Caywood W, Griffiths A, Woodward M, Hatfield A. The Benefits and Challenges of Shifting to Telehealth During COVID-19: Qualitative Feedback from Kentucky's Sexual Violence Resource Centers and Children's Advocacy Centers. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023; 8:87-99. [PMID: 36597503 PMCID: PMC9801142 DOI: 10.1007/s41347-022-00296-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
The onset of the COVID-19 pandemic presented novel challenges for service providers addressing mental health issues with a large shift to the utilization of telehealth. While previous research has examined the benefits and challenges of providing mental health and crisis services remotely through telehealth, little research exists examining the use of telehealth in children's advocacy centers (CACs) and sexual violence resource centers (SVRCs). CACs and SVRCs are multi-disciplinary agencies taking a holistic approach to addressing interpersonal violence, making them unique in that they provide a range of direct services beyond mental health counseling (e.g., legal advocacy, medical exams, and prevention education) but all geared toward public health and safety. The current study explored the experiences of direct service providers in Kentucky CACs and SVRCs and their opinions about the most significant challenges and benefits of adapting their practices at the onset of the COVID-19 pandemic. A total of 118 providers participated in the study, and 88 reported using telehealth (defined as communicating with clients via technology such as videoconferencing, phone calls, or email) since the onset of COVID-19. Qualitative data from those 88 respondents regarding the challenges and benefits of using telehealth were collected and coded using a thematic content analysis. 78.6% of the sample indicated that they served primarily rural areas. Benefits noted included increasing treatment access, increasing treatment flexibility, and advancing continuity of care, while challenges included difficulties with technology, client engagement, privacy, and logistical challenges. Responses highlighted that telehealth presented both a number of advantages and difficulties and that more formal guidance for providers at CACs and SVRCs was desired.
Collapse
Affiliation(s)
- Whitney Cassity-Caywood
- Department of Community Leadership and Human Services, Murray State University, Murray, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA.,Paducah Regional Campus, Murray State University, 4430 Sunset Ave, Paducah, KY 42001 USA
| | - Austin Griffiths
- The Department of Social Work Program, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
| | - Matthew Woodward
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
| | - Alecia Hatfield
- Department of Psychology, Western Kentucky University, Bowling Green, KY USA.,Lifeskills Center for Child Welfare Education and Research, Western Kentucky University, Bowling Green, KY USA
| |
Collapse
|
4
|
Lal S, Abdel-Baki A, Lee H. Telepsychiatry services during COVID-19: A cross-sectional survey on the experiences and perspectives of young adults with first-episode psychosis. Early Interv Psychiatry 2022; 17:368-377. [PMID: 35731034 PMCID: PMC9350121 DOI: 10.1111/eip.13332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/21/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Limited evidence exists on the implementation of telepsychiatry within the context of early intervention services for psychosis, the need for which has become even more relevant during the COVID-19 pandemic. To address this gap, we investigated the experiences and perspectives of young adults recovering from a first-episode psychosis (FEP) following their use of telepsychiatry services (i.e. use of video conferencing technology to deliver mental health services to patients in real time). METHODS A cross-sectional online survey study was implemented between November 19th , 2020 and March 9th , 2021 with young adults recruited from a specialized program for FEP located in an urban Canadian setting. Data were analysed using descriptive statistics, exploratory (Fisher's exact test), and content analysis. RESULTS Among 51 participants (mean age = 26.0, SD = 4.7; 56.9% female), the majority were satisfied with the service (91%, 46/51), perceived that the platform was easy to use (90%, 46/51) and felt secure in terms of confidentiality (82%, 42/51). Satisfaction was related to perceptions regarding ease of use, image quality, and employment/studying status. Several partially or totally agreed that the presence of a third party was essential to login during the first few sessions (35%, 18/51), and some needed technical support (24%, 12/51) throughout the sessions. CONCLUSIONS This study shows that telepsychiatry is feasible and acceptable to implement for patients in the early phase of psychosis recovery. It also highlights the importance of making technical support available, especially in the first few times of using the service, and addressing patient concerns regarding confidentiality, even when using secured health technologies.
Collapse
Affiliation(s)
- Shalini Lal
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada.,Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, Quebec, Canada.,Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montréal, Quebec, Canada.,ACCESS Open Minds, Douglas Mental Health University Institute, Montréal, Quebec, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry, Centre Hospitalier Université de Montréal (CHUM), Montreal, Quebec, Canada.,Axe Neurosciences, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
| | - Hajin Lee
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada.,Youth Mental Health and Technology Lab, Health Innovation and Evaluation Hub, University of Montréal Hospital Research Centre, Montréal, Quebec, Canada
| |
Collapse
|
5
|
Orsolini L, Bellagamba S, Marchetti V, Menculini G, Tempia Valenta S, Salvi V, Volpe U. A Preliminary Italian Cross-Sectional Study on the Level of Digital Psychiatry Training, Knowledge, Beliefs and Experiences among Medical Students, Psychiatry Trainees and Professionals. Healthcare (Basel) 2022; 10:healthcare10020390. [PMID: 35207004 PMCID: PMC8871870 DOI: 10.3390/healthcare10020390] [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: 12/14/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic led to the implementation of digital psychiatry (DP), resulting in the need for a new skilled healthcare workforce. The purpose of this study was to investigate the level of training, knowledge, beliefs, and experiences of young mental health professionals and medical students in DP. An ad hoc cross-sectional survey was administered and descriptive analyses, Student’s t and ANOVA tests were conducted, together with an exploratory factor analysis, bivariate correlations and linear regression. Most of the sample (N = 239) declared that DP was never discussed within their academic training (89.1%), mainly revealing an overall lack of knowledge on the issue. Nevertheless, subjects mostly declared that DP represents a valuable therapeutic tool in mental health (80%) and that their training should include this topic (54.4%). Moreover, most subjects declared that digital interventions are less effective than face-to-face ones (73.2%), despite the emerging evidence that being trained in DP is significantly associated with the belief that digital and in-person interventions are comparable in their effectiveness (p ≤ 0.05). Strong positive correlations were found between the knowledge score (KS) and perceived significance index (PSI) (r = 0.148, p < 0.001), and KS and Digital Psychiatry Opinion (DPO) index (r = 0.193, p < 0.001). PSI scores statistically significantly predicted KS total scores (F(1, 237) = 5.283, R2 = 0.022, p = 0.022). KS scores statistically significantly predicted DPO total scores (F(1, 237) = 9.136, R2 = 0.037, p = 0.003). During the current pandemic, DP represented an ideal response to the forced physical distancing by ensuring the advantage of greater access to care. However, this kind of intervention is still uncommon, and mental health professionals still prove to be skeptical. The lack of formal training on DP during the academic years could be a limiting factor.
Collapse
Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Silvia Bellagamba
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Virginia Marchetti
- School of Medicine and Surgery, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, 06100 Perugia, Italy;
| | - Silvia Tempia Valenta
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Virginio Salvi
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
- Correspondence:
| |
Collapse
|
6
|
Column on Telebehavioral Health Education, Training, and Competency Development: Current and Future Impact of the COVID-19 Pandemic. ACTA ACUST UNITED AC 2021; 6:561-566. [PMID: 34277930 PMCID: PMC8270767 DOI: 10.1007/s41347-021-00219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 06/19/2021] [Accepted: 06/30/2021] [Indexed: 10/26/2022]
Abstract
The COVID-19 pandemic in 2020 has resulted in many worldwide rapid and major changes in how behavioral health education, training, supervision, and service delivery are being done and will have significant long-term implications for the future of telebehavioral health (TBH). Mandates for social distancing during the pandemic necessitated urgently changing from in-person forms of education, training, supervision, and service delivery to uses of telecommunications, often with minimal preparation. This column on telebehavioral health education, training, supervision, and competencies presents some examples of how organizations, programs, and practitioners generally successfully adapted and responded to these sudden circumstances. How some of the major barriers to the adoption of telebehavioral services in the USA were quickly changed, and considerations for the future education, training, and service delivery of telebehavioral health are identified.
Collapse
|
7
|
A Survey Comparing Adult and Child Psychiatry Trainees, Faculty, and Program Directors' Perspectives About Telepsychiatry: Implications for Clinical Care and Training. ACTA ACUST UNITED AC 2021; 6:338-347. [PMID: 33501373 PMCID: PMC7820828 DOI: 10.1007/s41347-020-00187-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/21/2020] [Accepted: 12/02/2020] [Indexed: 11/18/2022]
Abstract
Telepsychiatry’s effectiveness is well established, and interest in it is growing, despite few residency/fellowship core curricula and rotations. A link to a cross-sectional survey was sent via national organization listservs for psychiatry residents, fellows, faculty, and program directors to complete. The survey queried demographics, clinical experience, and views/concerns about telepsychiatry. Descriptive statistics and other analyses compared groups to assess the impact of amount clinical experience and psychiatric specialty (general vs. child and adolescent psychiatry), on interest, and views/concerns about the practice of telepsychiatry. All respondents (N = 270; child psychiatry N = 89) have limited clinical experience with telepsychiatry (46% overall; 49% of non-child had none versus 40% child). Trainees (N = 123; child N = 43) expressed less interest than others. All respondents expressed worry about ability to do a physical exam, connectivity, medico-legal issues, and fit for diverse populations. Child respondents expressed less concern than others, but they reported more worry about loss of nonverbal cues. Clinical experience with telepsychiatry in the range of 6–20 h appears to build interest and allay concerns, though 1–5 h also may have a positive impact. More research is needed to assess clinical experience, interest, and concerns for adult and child psychiatry trainees and clinicians. Replicable, curricular interventions appear to be indicated.
Collapse
|