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Steidtmann D, McBride S, Mishkind M, Shore J. Examining Burnout and Perspective on Videoconferencing in the Mental Health Workforce. Telemed J E Health 2024; 30:1892-1895. [PMID: 38588556 DOI: 10.1089/tmj.2024.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Objective: To examine burnout and perspectives on videoconferencing over time for the mental health workforce. Methods: Members of an academic psychiatry department completed two anonymous surveys about virtual work and burnout 18 months apart (T1n = 274, response rate = 66.8%; T2n = 227, response rate = 36.7%). A subset completed the burnout subscale of the Stanford Professional Fulfillment Index (T1n = 145; T2n = 127). Results: Respondents were well satisfied with videoconferencing at both time points and satisfaction was higher at T2. Videoconferencing was not perceived to contribute to feelings of fatigue at either time point and burnout levels decreased from T1 to T2. Conclusions: Videoconferencing is well received by the mental health workforce and is not widely perceived to contribute to feelings of fatigue. Longer use of videoconferencing coincided with decreased levels of burnout. There are likely benefits to virtual work for the mental health workforce and virtual work may be protective from burnout.
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Affiliation(s)
- Dana Steidtmann
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Psychiatry, Helen and Arthur E. Johnson Depression Center, Aurora, Colorado, USA
- Brain and Behavior Innovation Center, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Samantha McBride
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Psychiatry, Helen and Arthur E. Johnson Depression Center, Aurora, Colorado, USA
| | - Matthew Mishkind
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Psychiatry, Helen and Arthur E. Johnson Depression Center, Aurora, Colorado, USA
- Brain and Behavior Innovation Center, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jay Shore
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
- Brain and Behavior Innovation Center, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA
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Gotra M, Lindberg K, Jasinski N, Scarisbrick D, Reilly S, Perle J, Miller L, Mahoney Iii J. Changes in the Clinical Practice of Mental Health Service Providers Throughout the COVID-19 Pandemic: Longitudinal Questionnaire Study. JMIR Form Res 2024; 8:e50303. [PMID: 38683653 PMCID: PMC11060325 DOI: 10.2196/50303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic impacted the practices of most mental health providers and resulted in a rapid transition to providing telemental health services, changes that were likely related to stay-at-home policies as well as increased need for services. OBJECTIVE The aim of this study was to examine whether these changes to practice have been sustained over time throughout the course of the COVID-19 pandemic and whether there are differences among mental health provider type and setting. We hypothesized that there would be an increase in the number of patients seen in person after the initial surge of the pandemic in spring 2020 and subsequent discontinuation of stay-at-home policies, though with continued implementation of telemental health services across settings. METHODS This study surveyed 235 of the 903 mental health providers who responded to a survey in spring 2020 (Time point 1) and at a 1-year follow-up in spring 2021 (Time point 2). Differences in practice adjustments, factors related to telemental health, and number of patients seen were examined across provider type (social worker, psychologist, neuropsychologist) and setting (academic medical center [AMC], community mental health, private practice, and Veterans Affairs hospital). RESULTS From Time point 1 to Time point 2, there was a small but significant increase in the overall number of providers who were implementing telehealth (191/235, 81% to 204/235, 87%, P=.01) and there was a significant decline in canceled or rescheduled appointments (25%-50% in 2020 to 3%-7% in 2021, P<.001). Psychologists and providers working at AMCs reported decreased difficulty with telehealth implementation (P<.001), and providers working at AMCs and in private practice settings indicated they were more likely to continue telehealth services beyond spring 2021 (P<.001). The percent of time working remotely decreased overall (78% to 59%, P<.001), which was most notable among neuropsychologists and providers working at an AMC. There was an overall increase in the average number of patients seen in person per week compared with earlier in the pandemic (mean 4.3 to 8.7, P<.001), with no change in the number of patients seen via telehealth (mean 9.7 to 9.9, P=.66). CONCLUSIONS These results show that the rapid transition to telemental health at the onset of the COVID-19 pandemic in spring 2020 was sustained over the next year, despite an overall increase in the number of patients seen in person. Although more providers reported returning to working on-site, over 50% of providers continued to use a hybrid model, and many providers reported they would be more likely to continue telemental health beyond spring 2021. This suggests the continued importance and reliance on telemental health services beyond the acute pandemic phase and has implications for future policies regulating the availability of telemental health services to patients.
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Affiliation(s)
- Milena Gotra
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | | | - Nicholas Jasinski
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - David Scarisbrick
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Shannon Reilly
- Department of Neurology, University of Virginia Health, Charlottesville, VA, United States
| | - Jonathan Perle
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - Liv Miller
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
| | - James Mahoney Iii
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, United States
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Yellowlees PM, Burke MM, Gonzalez AD, Fisher A, Chan SR, Hilty DM, McCarron RM, Scher LM, Sciolla AF, Shore J, Xiong G, Fine J, Bannister J, Iosif AM. Patient and Provider Satisfaction with Asynchronous Versus Synchronous Telepsychiatry in Primary Care: A Secondary Mixed-Methods Analysis of a Randomized Controlled Trial. Telemed J E Health 2024; 30:e1049-e1063. [PMID: 38011623 PMCID: PMC11035926 DOI: 10.1089/tmj.2023.0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Asynchronous telepsychiatry (ATP) consultations are a novel form of psychiatric consultation. Studies comparing patient and provider satisfaction for ATP with that for synchronous telepsychiatry (STP) do not exist. Methods: This mixed-methods study is a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial of ATP compared with STP. Patients and their PCPs completed satisfaction surveys, and provided unstructured feedback about their experiences with either ATP or STP. Differences in patient satisfaction were assessed using mixed-effects logistic regression models, and the qualitative data were analyzed using thematic analysis with an inductive coding framework. Results: Patient satisfaction overall was high with 84% and 97% of respondents at 6 months reported being somewhat or completely satisfied with ATP and STP, respectively. Patients in the STP group were more likely to report being completely satisfied, to recommend the program to a friend, and to report being comfortable with their care compared with ATP (all p < 0.05). However, there was no difference between the patients in ATP and STP in perceived change in clinical outcomes (p = 0.51). The PCP quantitative data were small, and thus only summarized descriptively. Conclusions: Patients expressed their overall satisfaction with both STP and ATP. Patients in ATP reported more concerns about the process, likely because feedback after ATP was slower than that after STP consultations. PCPs had no apparent preference for STP or ATP, and reported implementing the psychiatrists' recommendations for both groups when such recommendations were made, which supports our previous findings. Trial Registration: ClinicalTrials.gov NCT02084979; https://clinicaltrials.gov/ct2/show/NCT02084979.
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Affiliation(s)
- Peter M. Yellowlees
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Michelle M. Burke
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Alvaro D. Gonzalez
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Alice Fisher
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Steven R. Chan
- Stanford University School of Medicine, Stanford, California, USA
- Veterans Administration Palo Alto Healthcare System, Palo Alto, California, USA
| | | | - Robert M. McCarron
- Department of Psychiatry, University of California, Irvine, California, USA
| | - Lorin M. Scher
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Andres F. Sciolla
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Jay Shore
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA
| | - Glen Xiong
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Jeffrey Fine
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Jennifer Bannister
- Department of Psychiatry and Behavioral Sciences, University of California, Sacramento, California, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, California, USA
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Izuhara M, Matsui K, Okubo R, Yoshiike T, Nagao K, Kawamura A, Tsuru A, Utsumi T, Hazumi M, Sasaki Y, Takeda K, Komaki H, Oi H, Kim Y, Kuriyama K, Miyama T, Nakagome K. Association of COVID-19 preventive behavior and job-related stress with the sleep quality of healthcare workers one year into the COVID-19 outbreak: a Japanese cross-sectional survey. Biopsychosoc Med 2024; 18:8. [PMID: 38448990 PMCID: PMC10918958 DOI: 10.1186/s13030-024-00304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the association of COVID-19 preventive behavior and job-related stress with sleep quality among healthcare workers (HCWs). We conducted a cross-sectional survey using a questionnaire at the National Center of Neurology and Psychiatry, Tokyo, Japan. METHODS A total of 586 participants who completed the questionnaire were eligible for the study. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. We examined the level of engagement between poor sleep and COVID-19-related infection preventive behaviors, such as avoiding closed spaces, crowded places, and close contact (three Cs), a distance of at least one meter from others, wearing a face mask regularly, washing hands regularly, and working remotely, as well as job-related stress in the work environment, exposure to patients, potential risk of infection, fear of infecting others, need for social confinement, and financial instability. We conducted a hierarchical logistic regression analysis to examine the relationship between poor sleep and COVID-19 preventive behavior, job-related stress, and other covariates, including age, sex, and the Kessler Psychological Distress Scale (K6), which was used to measure non-specific psychological distress. RESULTS Poor sleep was observed in 223 (38.1%) participants. Adherence to COVID-19 preventive measures was relatively high: 84.1% of participants answered "always" for wearing a face mask regularly and 83.4% for washing hands regularly. In the multivariate logistic regression analysis, stress in the work environment (odds ratio [OR] = 2.09, 95% confidence interval [CI], 1.37-3.20; p < 0.001), financial instability (OR = 1.73, 95% CI, 1.12-2.67; p < 0.05), and low adherence to working remotely (OR = 1.65, 95% CI, 1.06-2.57; p < 0.05) were independently and significantly associated with poor sleep after controlling for the covariates. CONCLUSIONS One year into the COVID-19 pandemic, the poor sleep rates of HCWs remained high. These results emphasize the need to protect HCWs from work environment stress and financial concerns.
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Affiliation(s)
- Muneto Izuhara
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kentaro Matsui
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ryo Okubo
- Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Aoi Kawamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Ayumi Tsuru
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Megumi Hazumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yohei Sasaki
- Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuyoshi Takeda
- Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Hirofumi Komaki
- Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Hideki Oi
- Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yoshiharu Kim
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
| | - Takeshi Miyama
- Department of Surgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuyuki Nakagome
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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Lum J, Sadej I, Pizer SD, Yee C. Telehealth Access and Substitution in the VHA. J Gen Intern Med 2024; 39:44-52. [PMID: 38393611 PMCID: PMC10937886 DOI: 10.1007/s11606-023-08465-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/06/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND In response to COVID-19, the Veterans Health Administration (VHA) expanded telehealth availability, allowing veterans to receive care at home. We explore the extent of substitution of telehealth for in-person care among medical centers (facilities), providers, and patients. We explore the extent to which patient preferences drive telehealth utilization, and compare access to care (as measured by waiting times) for telehealth and in-person visits. METHODS We use VHA electronic health records to identify scheduled outpatient mental health (MH) appointments from January 2019 through February 2023 focusing on care delivered by social workers, psychologists, and psychiatrists. For each quarter, we compute the proportion of completed appointments that were delivered via phone or video by each facility, provider, and patient and show the changes in these proportions before, during, and after the onset of COVID-19. To explore patient preferences, we match providers of patients with high rates of telehealth utilization and examine the extent to which those providers deliver in-person care. To examine access to care, we compute waiting times for in-person, video, and phone new patient appointments. We investigate differences between urban and rural patients, and patients of different ages. KEY RESULTS Telehealth for MH grew dramatically in the VHA after the onset of COVID-19. While some facilities provided more telehealth than others, all facilities (as of early 2023) provided some telehealth MH services. Approximately 86% of individual providers provided telehealth, with 27% scheduling MH appointments almost exclusively as telehealth appointments and 59% providing a mix. Patients exhibited more polarization, with 36% scheduling only in-person visits for almost all their MH visits and 56% of them scheduling exclusively telehealth, and only 8% of them utilizing a mix of modalities. Of those who exclusively received telehealth care, a majority of them utilized video (80%) over phone (20%). Take-up of MH among younger patients was higher relative to older patients. Urban patients used telehealth more than rural patients. Patient preferences rather than provider preferences drove utilization of patients who almost exclusively utilized telehealth. Between April 2021 and February 2023, the average difference in waiting time for in-person and video appointments was less than 1 day, with comparable appointment volumes, suggesting that the supply of and demand for in-person and video were not different enough to merit waiting longer. Telehealth was chosen over in-person more among urban and younger patients, as older and rural patients exhibited higher willingness to wait for in-person over video appointments. By contrast, appointment volumes and waiting times for phone appointments were lower across all groups, suggesting that phone may not be as substitutable for in-person visits in MH. CONCLUSIONS We find that the VHA has made telehealth widely available, providing access to many veterans. While telehealth utilization has increased, face-to-face care persists for MH services, suggesting that one modality may not serve all purposes and preferences for care. Patient preferences drive the modality decision among those who exclusively use MH care via telehealth. For those who persist in mostly utilizing in-person care, there may be various factors influencing those preferences such as issues with limited internet connectivity, language barriers, and digital literacy, especially for older and rural patients who utilize in-person care more than those who are younger and more urban. Further investigation is required to investigate the optimal mix of modalities which may allow for potential increases in patient satisfaction, quality of care, and clinic efficiency.
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Affiliation(s)
- Jessica Lum
- VA Boston Healthcare System, Boston, MA, USA.
| | - Izabela Sadej
- VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University of Public Health, Boston, MA, USA
| | - Steven D Pizer
- VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University of Public Health, Boston, MA, USA
| | - Christine Yee
- VA Boston Healthcare System, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University of Public Health, Boston, MA, USA
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Wilczewski H, Ong T, Ivanova J, Soni H, Barrera JF, Cummins MR, Welch BM, Bunnell BE. Telemedicine from Home or the Office: Perceptions of Mental Health Providers. Telemed J E Health 2024; 30:422-429. [PMID: 37466479 PMCID: PMC10877387 DOI: 10.1089/tmj.2023.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction: The COVID-19 pandemic led to a rapid transition to telemedicine for mental health care and redefined many providers' work environments and practices. The purpose of the study was to investigate the impact of work location on telemental health (TMH) benefits, disruptions, and concerns to further understand the rapid implementation of telemedicine for mental health treatment. Methods: A sample of 175 practicing TMH providers completed an online survey between July and August 2020. Providers answered questions about personal demographics and practice characteristics. Next, they answered questions about benefits, disruptions, and concerns regarding the use of telemedicine in their practice. Chi-square and independent samples t-test were conducted to identify work location differences for personal demographics and clinical practice characteristics. Three multivariate analyses of covariance were conducted to examine overall differences in perceptions of telemedicine benefits, concerns, and disruptions based on work location while covarying for provider race, ethnicity, percentage of caseload seen through telemedicine, practice type, specialty, and primary method of reimbursement. Results: TMH providers who primarily work from an office reported more benefit of reduced costs/overhead (ηp2 = 0.039), less benefit of limiting the spread of the virus (ηp2 = 0.028), and more concern about reimbursement (ηp2 = 0.046) than those who primarily work from home. We observed no difference in disruptions, patient access to care, quality of care, and work-life balance. Discussion: Exploration into work location of TMH providers aids in understanding of clinical workflows and provider wellbeing. Our findings suggest that telemedicine may be easily integrated into different types of clinical workflows and work locations.
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Affiliation(s)
| | - Triton Ong
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
| | - Julia Ivanova
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
| | - Hiral Soni
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
| | - Janelle F. Barrera
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
| | - Mollie R. Cummins
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- College of Nursing and Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
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Landers J, Madden E, Furlong W. Social Workers' Experiences of Support in the Workplace during the COVID-19 Pandemic. SOCIAL WORK 2023; 68:267-276. [PMID: 37468436 DOI: 10.1093/sw/swad030] [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: 05/11/2022] [Revised: 08/18/2022] [Accepted: 12/01/2022] [Indexed: 07/21/2023]
Abstract
This qualitative study included in-depth semistructured interviews with 17 social workers from across the state of Texas that took place during the summer of 2021. The purpose of this study was to describe social workers' experiences of workplace support during the COVID-19 pandemic and provide implications for how to improve support in the workplace. The interviews were analyzed using a phenomenological approach to describe the main themes of the participants' experiences. The findings combined with current literature suggest that following the pandemic and in the case of similar prolonged disasters organizational leaders should consider supporting their social work staff by clearly communicating protocol changes, providing more autonomy and flexible work arrangements, increasing time off and financial support, and providing tangible assistance such as technological support. Leaders should also consider their social work staff's emotional well-being following the pandemic by providing therapeutic resources and bonding opportunities for staff to promote a more resilient team-like culture in the workplace.
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Affiliation(s)
- Jillian Landers
- PhD, LMSW, is a postdoctoral research fellow, Diana R. Garland School of Social Work, Baylor University, 811 Washington Avenue, Waco, TX 76701, USA
| | - Elissa Madden
- PhD, MSW, is associate professor, Diana R. Garland School of Social Work, Baylor University, Waco, TX, USA
| | - Wesley Furlong
- MSW, is a PhD candidate, Diana R. Garland School of Social Work, Baylor University, Waco, TX, USA
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Morreale M, Cohen I, Van Wert M, Beccera A, Miller L, Narrow W, Schweizer B, Straub J, Zandi P, Ruble A. Determinants of experience & satisfaction in telehealth psychiatry during the COVID-19 pandemic for patients & providers. Front Psychiatry 2023; 14:1237249. [PMID: 37720903 PMCID: PMC10502508 DOI: 10.3389/fpsyt.2023.1237249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction The objective of this study was to characterize the experiences and overall satisfaction of patients and providers with the March 2020 transition to telehealth in a psychiatric setting (telepsychiatry). The study also investigated how socio-demographic and clinical characteristics impact an individual's experiences and satisfaction with telepsychiatry. Methods Responses were collected from 604 patients and 154 providers engaged in clinical care at one of three participating Johns Hopkins Medicine outpatient psychiatric clinics between January 2020-March 2021. Survey data were collected by self-report via Qualtrics or telephone follow-up. Results Respondents were predominately female and White. Over 70% of patients and providers were generally satisfied with telepsychiatry. However, providers were more likely to favor in-person care over telepsychiatry for post-pandemic care 48% to 17% respectively, while 35% rated both modalities equivalently. Patients were more evenly divided with 45% preferring telepsychiatry compared to 42% for in-person care, and only 13% rating them equivalently. Among providers, technical difficulties were significantly associated with both less satisfaction and lower preference for telepsychiatry [odds ratio for satisfaction (ORS) = 0.12; odds ratio for preference (ORP) = 0.13]. For patients, factors significantly associated with both lower satisfaction and lower preference for telepsychiatry included technical difficulties (ORS = 0.20; ORP = 0.41), unstable access to the internet (ORS = 0.46; ORP = 0.50), worsening depression (ORS = 0.38; ORP = 0.36), and worsening anxiety (ORS = 0.41; ORP = 0.40). Factors associated with greater satisfaction and higher preference for telepsychiatry among patients included higher education (ORS = 2.13; ORP = 1.96) and a decrease in technical difficulties over time (ORS = 2.86; ORP = 2.35). Discussion Patients and providers were satisfied with telepsychiatry. However, there were greater differences between them in preferences for continuing to use telepsychiatry post-pandemic. These findings highlight factors that influence patient and provider preferences and should be addressed to optimize the use of telepsychiatry in the future.
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Affiliation(s)
- Michael Morreale
- Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Ilana Cohen
- Johns Hopkins Resident Outpatient Continuity Clinic, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Michael Van Wert
- Johns Hopkins Bayview Community Psychiatry Program, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Alexis Beccera
- Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Leslie Miller
- Johns Hopkins Bayview Community Psychiatry Program, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - William Narrow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Community Psychiatry Program, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Barbara Schweizer
- Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jason Straub
- Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Peter Zandi
- Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Anne Ruble
- Johns Hopkins Resident Outpatient Continuity Clinic, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
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Crocker KM, Gnatt I, Haywood D, Butterfield I, Bhat R, Lalitha ARN, Jenkins ZM, Castle DJ. The impact of COVID-19 on the mental health workforce: A rapid review. Int J Ment Health Nurs 2023; 32:420-445. [PMID: 36461629 PMCID: PMC9878253 DOI: 10.1111/inm.13097] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic led to significant adaptations to healthcare. Provision of mental healthcare in a changing environment presented healthcare workers with unique challenges and demands, including changes in workload and expectations. To inform current and future healthcare service responses, and adaptations, the current review aimed to collate and examine the impact of the pandemic on mental healthcare workers (MHWs). We conducted a rapid systematic review to examine the overall impact of the COVID-19 pandemic on MHWs. Searches were conducted in Ovid Medline and PsycInfo and restricted to articles published from 2020. Inclusion criteria specified articles written in English, published in peer-reviewed journals, and that examined any outcome of the impact of COVID-19 on MHWs; 55 articles fulfilled these criteria. Outcomes were categorized into 'work-related outcomes' and 'personal outcomes'. Mental healthcare workers worldwide experienced a range of work-related and personal adversities during the pandemic. Key work-related outcomes included increased workload, changed roles, burnout, decreased job satisfaction, telehealth challenges, difficulties with work-life balance, altered job performance, vicarious trauma and increased workplace violence. Personal outcomes included decreased well-being, increased psychological distress and psychosocial difficulties. These outcomes differed between inpatient, outpatient and remote settings. The COVID-19 pandemic significantly altered the delivery of mental healthcare and MHWs experienced both work-related and personal adversities during the COVID-19 pandemic. With the continuation of changes introduced to healthcare in the initial stages of the pandemic, it will be important to maintain efforts to monitor negative outcomes and ensure supports for MHWs, going forward.
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Affiliation(s)
- Kaitlyn M Crocker
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Inge Gnatt
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Darren Haywood
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Ingrid Butterfield
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Ravi Bhat
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
| | | | - Zoe M Jenkins
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Castle
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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10
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Griffith B, Archbold H, Sáez Berruga I, Smith S, Deakin K, Cogan N, Tanner G, Flowers P. Frontline experiences of delivering remote mental health supports during the COVID-19 pandemic in Scotland: innovations, insights and lessons learned from mental health workers. PSYCHOL HEALTH MED 2023; 28:964-979. [PMID: 36408950 DOI: 10.1080/13548506.2022.2148698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
COVID-19 restrictions drove rapid adaptations to service delivery and new ways of working within Scotland's mental health sector. This study explores mental health workers' (MHWs') experiences of delivering their services remotely. Twenty participants, who had worked in mental health professions in the National Health Service (NHS) in Scotland throughout the COVID-19 pandemic, took part in online semi-structured interviews. Data was transcribed then analysed using an inductive thematic analysis. Two major themes are reported: (1) 'Improved Flexibility for both MHWs and Service Users' and (2) 'Teletherapies Challenge Therapeutic Boundaries'. In relation to (1) virtual platforms were seen as vital in maintaining patient care throughout the COVID-19 pandemic and a valuable resource for service users (SUs) who had previously struggled with mobility or social anxieties when accessing face-to-face services. Some MHWs' also noted benefits for their productivity and comfort. Regarding (2) MHWs highlighted that whilst conducting teletherapies from home, work-life boundaries became blurred and, in some instances, typically comforting spaces became associated with the traumatic content discussed by SUs. These stressors seemed to be compounded by MHWs' isolation, as they were less able to draw upon their colleagues for support. Further, confidentiality could not be assured, as MHWs and SUs alike had to accommodate their family members. These findings highlight important insights from MHWs in adapting to rapid changes in mental health working practices, particularly in relation to the challenges of delivering quality, safe and equitable services and the increased use of teletherapies. Such insights are vital in informing service developments and supporting future pandemic preparedness across a range of healthcare contexts and countries seeking to adopt hybrid models of mental health service delivery.
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Affiliation(s)
- Bethany Griffith
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Heather Archbold
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Isabel Sáez Berruga
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Samantha Smith
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Karen Deakin
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Nicola Cogan
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Gary Tanner
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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11
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Palmer CS, Brown Levey SM, Kostiuk M, Zisner AR, Tolle LW, Richey RM, Callan S. Virtual Care for Behavioral Health Conditions. Prim Care 2022; 49:641-657. [PMID: 36357068 PMCID: PMC9581698 DOI: 10.1016/j.pop.2022.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christina S. Palmer
- Department of Family Medicine, University of Colorado School of Medicine,Corresponding author
| | | | | | - Aimee R. Zisner
- Department of Family Medicine, University of Colorado School of Medicine
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12
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The Good, The Bad, The Uncertain: Diverse Provider Experiences with Telemental Health During COVID-19. Psychiatr Q 2022; 93:753-774. [PMID: 35689752 PMCID: PMC9187881 DOI: 10.1007/s11126-022-09990-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
This study assessed mental health provider attitudes and perceptions of telemental health (TMH) prior to and during the COVID-19 Pandemic. The study expands on earlier work by providing a more detailed qualitative analysis of provider perceptions of TMH, including its efficacy, advantages, and limitations. The current study is part of a larger mixed methods project utilizing a repeated cross-sectional design. An online survey was administered to a sample of 1,448 mental health providers. Of the survey participants, 934 offered narrative responses to open-ended questions and were included in the present study. Qualitative data was analyzed using a coding team and the Consensual Qualitative Research paradigm. Providers described both positive and negative feelings about using TMH during the COVID-19 Pandemic. Several advantages were identified, with providers clearly appreciating the role of TMH in allowing them to work continuously and safely during the public health emergency. An array of negative views and concerns were also expressed, including that TMH may not be optimal or effective in certain settings or situations. A portion of respondents also indicated a preference for face-to-face care and illuminated ways they found TMH lacking or limited.
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13
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Duden GS, Gersdorf S, Trautmann K, Steinhart I, Riedel-Heller S, Stengler K. LeiP#netz 2.0: mapping COVID-19-related changes in mental health services in the German city of Leipzig. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1531-1541. [PMID: 35333930 PMCID: PMC8949643 DOI: 10.1007/s00127-022-02274-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/08/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE The purpose of the study was to investigate the changes in psychosocial and psychiatric services in the German city of Leipzig during the COVID-19-pandemic. METHODS A participatory, mixed-methods study was used involving a quantitative online survey and qualitative semi-structured interviews with professionals. Quantitative findings were reported with descriptive statistics, and thematic analysis was conducted for qualitative data. RESULTS Fifty professionals from various mental health services participated in the survey and eleven professionals were interviewed. Quantitative findings showed that some services were closed intermittently and that there was a stiff increase in use of digital/telephonic service and a decrease in face-to-face services. Staff or funding did not change considerably during the pandemic. Psychosocial groups were suspended or reduced, while access to services became more difficult and professional training for staff was stopped. Thematic analysis of the interviews showed that professionals experienced different phases and levels of change during the pandemic, including changes on a structural level, on the users' level, and on the staff' level. Professionals particularly criticised the equivocality of COVID-19 regulations, a defective flow of information and lack of attention for mental healthcare in public policies. They also saw positive aspects, such as the capacity of users and the outpatient care system to adapt to the new situation. CONCLUSION This study suggests directions for policy and service development, such as communicating clearly in infection-control measures, fostering outpatient care and networks between services.
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Affiliation(s)
- Gesa Solveig Duden
- Leipzig Heart Institute GmbH, Leipzig, Germany.
- Community Psychology, University of Hagen (Fernuniversitaet), Hagen, Germany.
| | | | | | - Ingmar Steinhart
- Institute for Social Psychiatry, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Katarina Stengler
- Clinic for Psychiatry, Psychosomatics and Psychotherapy and Centre for Mental Health, Helios-Park-Hospital Leipzig, Leipzig, Germany
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14
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Daneshfar Z, Asokan-Ajitha A, Sharma P, Malik A. Work-from-home (WFH) during COVID-19 pandemic – A netnographic investigation using Twitter data. INFORMATION TECHNOLOGY & PEOPLE 2022. [DOI: 10.1108/itp-01-2021-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper aims to create a better understanding of the challenges posed by work from home (WFH) during the ongoing COVID-19 pandemic, to investigate the public sentiment toward this transition, and to develop a conceptual model incorporating the relationships among the factors that influence the effectiveness of WFH.Design/methodology/approachThis paper uses netnography method to collect data from the Twitter platform and uses Python programming language, Natural Language Processing techniques and IBM SPSS 26 to conduct sentiment analysis and directed content analysis on the data. The findings are combined with an extensive review of the remote work literature to develop a conceptual model.FindingsResults show the majority of tweets about WFH during the pandemic are positive and objective with technology and cyber security as the most repeated topics in the tweets. New challenges to WFH during pandemic include future uncertainty, health concerns, home workspaces, self-isolation, lack of recreational activities and support mechanisms. In addition, exhaustion and technostress mediate the relationship between the antecedents and outcomes of WFH during the ongoing COVID-19 pandemic. Finally, the fear of pandemic and coping strategies moderates these relationships.Originality/valueThis paper is one of the first efforts to comprehensively investigate the challenges of WFH during a crisis and to extend the remote work literature by developing a conceptual model incorporating the moderating effects of fear of pandemic and coping strategies. Moreover, it is the first paper to investigate the tweeting behavior of different user types on Twitter who shared posts about WFH during the ongoing pandemic.
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15
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Kisicki A, Becker S, Chaple M, Gustafson DH, Hartzler BJ, Jacobson N, Murphy AA, Tapscott S, Molfenter T. Behavioral healthcare organizations' experiences related to use of telehealth as a result of the COVID-19 pandemic: an exploratory study. BMC Health Serv Res 2022; 22:775. [PMID: 35698186 PMCID: PMC9189799 DOI: 10.1186/s12913-022-08114-y] [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: 10/12/2021] [Accepted: 05/19/2022] [Indexed: 11/12/2022] Open
Abstract
Background Due to the COVID-19 pandemic, healthcare providers were forced to shift many services quickly from in-person to virtual, including substance use disorder (SUD) and mental health (MH) treatment services. This led to a sharp increase in telehealth services, with health systems seeing patients virtually at hundreds of times the rate as before the onset of the COVID-19 pandemic. By analyzing qualitative data about SUD and MH care organizations’ experiences using telehealth, this study aims to elucidate emergent themes related to telehealth use by the front-line behavioral health workforce. Methods This study uses qualitative data from large-scale web surveys distributed to SUD and MH organizations between May and August 2020. At the end of these surveys, the following question was posed in free-response form: “Is there anything else you would like to say about use of telehealth during or after the COVID-19 pandemic?” Respondents were asked to answer on behalf of their organizations. The 391 responses to this question were analyzed for emergent themes using a conventional approach to content analysis. Results Three major themes emerged: COVID-specific experiences with telehealth, general experiences with telehealth, and recommendations to continue telehealth delivery. Convenience, access to new populations, and lack of commute were frequently cited advantages of telehealth, while perceived ineffectiveness of and limited access to technology were frequently cited disadvantages. Also commonly mentioned was the relaxation of reimbursement regulations. Respondents supported continuation of relaxed regulations, increased institutional support, and using a combination of telehealth and in-person care in their practices. Conclusions This study advanced our knowledge of how the behavioral health workforce experiences telehealth delivery. Further longitudinal research comparing treatment outcomes of those receiving in-person and virtual services will be necessary to undergird organizations’ financial support, and perhaps also legislative support, for virtual SUD and MH services.
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Affiliation(s)
- Abby Kisicki
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, 1513 University Ave., WI, 53706, Madison, USA.
| | - Sara Becker
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA
| | - Michael Chaple
- Division On Substance Use Disorders, New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA
| | - David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, 1513 University Ave., WI, 53706, Madison, USA
| | - Bryan J Hartzler
- Alcohol & Drug Abuse Institute, University of Washington, 1107 NE 45th Street, Suite 120, Seattle, WA, 98105, USA
| | - Nora Jacobson
- Institute for Clinical and Translational Research, Community Academic Partnerships Program, University of Wisconsin-Madison School of Nursing, 701 Highland Ave, Madison, WI, 53705, USA
| | - Ann A Murphy
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers, The State University of New Jersey, 675 Hoes Lane West, Piscataway, NJ, 08854, USA
| | - Stephanie Tapscott
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Rd., Atlanta, GA, 30322, USA
| | - Todd Molfenter
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, 1513 University Ave., WI, 53706, Madison, USA
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16
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Ong T, Wilczewski H, Soni H, Nisbet Q, Paige SR, Barrera JF, Welch BM, Bunnell BE. The Symbiosis of Virtual Reality Exposure Therapy and Telemental Health: A Review. FRONTIERS IN VIRTUAL REALITY 2022; 3:848066. [PMID: 37483657 PMCID: PMC10361704 DOI: 10.3389/frvir.2022.848066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Phobias and related anxiety are common and costly mental health disorders. Experts anticipate the prevalence of phobias will increase due to the COVID-19 pandemic. Exposure therapies have been established as effective and reliable treatments for anxiety, including recent innovations in virtual reality-based exposure therapy (VRET). With the recent advent of telemental health (TMH), VRET is poised to become mainstream. The combination of VRET and TMH has the potential to extend provider treatment options and improve patient care experiences. In this narrative review, we describe how recent events have accelerated VRET + TMH, identify barriers to VRET + TMH implementation, and discuss strategies to navigate those barriers.
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Affiliation(s)
- Triton Ong
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Hiral Soni
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | - Quinn Nisbet
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
| | | | - Janelle F. Barrera
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Innovation in Mental Health Lab, Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, United States
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me Inc., Rochester, NY, United States
- Biomedical Informatics Center, Public Health and Sciences, Medical University of South Carolina, Charleston, SC, United States
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17
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Benjenk I, Saliba Z, Duggal N, Albaroudi A, Posada J, Chen J. Impact of COVID-19 Mitigation Efforts on Adults With Serious Mental Illness: A Patient-Centered Perspective. J Nerv Ment Dis 2021; 209:892-898. [PMID: 34846356 PMCID: PMC8614196 DOI: 10.1097/nmd.0000000000001389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
ABSTRACT In response to COVID-19 mitigation policies, mental health and social service agencies have had to rapidly change their operations, creating challenges for patients with serious mental illness (SMI). This study aimed to explore the experiences of adults with SMI navigating these altered systems during the pandemic. In-depth interviews were conducted with 20 hospitalized adults with SMI in the fall of 2020; they were coded using thematic analysis. Most participants found the new systems effective at meeting their essential needs. However, several reported significant unmet needs, including inability to access mental health care and public benefits. These participants lacked identification documents, housing, and/or a personal device. Although none of the participants used telemedicine before COVID-19, most reported no or minimal problems with telemental health. Those reporting difficulties did not have personal devices, were receiving audio-only services, or viewed telemedicine as less personal or too distracting.
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Affiliation(s)
| | | | - Neel Duggal
- School of Medicine, George Washington University, Washington, DC
| | - Asmaa Albaroudi
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, Maryland
| | | | - Jie Chen
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, Maryland
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18
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COVID-19, Rural Communities, and Implications of Telebehavioral Health Services: Addressing the Benefits and Challenges of Behavioral Health Services via Telehealth in Nebraska. SOCIETIES 2021. [DOI: 10.3390/soc11040141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Telehealth has been in use, in various forms, for over a century and is growing increasingly more popular. The current research sought to examine the prevalence, benefits, and challenges of telehealth for behavioral and mental health services in the state of Nebraska with a particular focus on rural communities. The COVID-19 pandemic coincided with the research endeavors and impacted the questions that were asked related to the use of telebehavioral health. Specifically, the research included an investigation of the rates of use of telebehavioral health across agencies and whether/how the pandemic impacted the use of telehealth services. The research included an initial examination of more than 50 behavioral health agencies to assess overall utilization of telehealth. Researchers then conducted interviews with 15 practitioners to discuss the challenges and benefits associated with telehealth services. Key results suggest that implementation of telehealth in Nebraska has resulted in increased access to services among rural residents and has deeply impacted clinical practice. Additionally, clinicians identified specific benefits and challenges of telebehavioral health. It was also noted that the majority of clinicians plan to continue providing services via telehealth if the policies and regulations remain as they are post-COVID-19. Implications of this research highlight the efficiency and effectiveness of using telehealth to increase access.
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19
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Different patterns of human activities in nature during Covid-19 pandemic and African swine fever outbreak confirm direct impact on wildlife disruption. Sci Rep 2021; 11:20791. [PMID: 34675330 PMCID: PMC8531377 DOI: 10.1038/s41598-021-99862-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022] Open
Abstract
Implementation of various restrictions to eradicate viral diseases has globally affected human activity and subsequently nature. But how can the altered routines of human activity (restrictions, lockdowns) affect wildlife behaviour? This study compared the differences between human and wildlife occurrences in the study forest area with acreage of 5430.6 ha in 2018 (African swine fever outbreak, complete entrance ban), 2019 (standard pattern) and 2020 (COVID-19 restrictions) during the breeding season. The number of visitors was lower by 64% in 2018 (non-respecting of the entry ban by forest visitors) compared to standard 2019, while in 2020, the number of visitors increased to 151%. In the COVID-19 period, distinct peaks in the number of visitors were observed between 8-11 AM and 4-7 PM. The peaks of wildlife activity were recorded between 4-7 AM and 9-12 PM. Animals avoided the localities that were visited by humans during the people-influenced time (24 h after people visit), which confirmed the direct negative impact of human activities on wildlife.
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20
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Telepsychiatry to Provide Mental Health Support to Healthcare Professionals during the COVID-19 Crisis: A Cross-Sectional Survey among 321 Healthcare Professionals in France. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910146. [PMID: 34639447 PMCID: PMC8508285 DOI: 10.3390/ijerph181910146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 12/28/2022]
Abstract
Pandemics are difficult times for the mental health of healthcare professionals, who are more likely to present with PTSD-like symptoms. In the context of a highly contagious communicable disease, telemedicine is a useful alternative to usual care, and should be considered as a means to support healthcare professionals’ mental health. This is a multicenter (n = 19), cross-sectional study, based on a 27-item questionnaire, aiming to investigate the acceptability to healthcare workers of a telepsychiatry service as a means of providing mental health support during the COVID-19 pandemic. Between October and December 2020, 321 responses were received, showing that women, caregiving staff, and those directly involved in the care of COVID-19 patients are less favorable to the idea of receiving remote support. In our population, barriers were related to the clinical setting or ethics, and most of the respondents would not accept a drug prescription by telepsychiatry. Although telepsychiatry should be a part of the armamentarium of mental health management, it is not suitable as a stand-alone approach, and should be combined with conventional face-to-face consultations.
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21
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Tönnies J, Oeljeklaus L, Wensing M, Hartmann M, Friederich HC, Haun MW. Health policy experts' perspectives on implementing mental health specialist video consultations in routine primary care - a qualitative interview study. BMC Health Serv Res 2021; 21:713. [PMID: 34284786 PMCID: PMC8293503 DOI: 10.1186/s12913-021-06676-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/22/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Many patients with mental disorders are treated by their general practitioner (GP). Innovative technology-based integrated care models (e.g., mental health specialist video consultations) have been proposed to facilitate access to specialist services in primary care settings. While perspectives of patients and providers have been examined, there is little insight into the perspectives of health policy experts on such models. The purpose of this study was to examine the perspectives of health policy experts on (1) current challenges for continuity of care, (2) anticipated benefits and barriers for implementation of mental health specialist video consultations along with (3) practical and regulative preconditions for sustained implementation in primary care. METHODS In a cross-sectional qualitative study, we conducted 15 semi-structured interviews with health policy experts representing various stakeholders in the German health care system: health insurances, governmental bodies, clinicians' professional associations, and patient representatives. Following a critical realism approach, we applied a qualitative inductive content analysis to derive key themes from the material. RESULTS Health policy experts saw long waiting times for patients and a lack of collaboration between in- and outpatient mental health services as well as mental health specialists and GPs as main barriers for current continuity of care. Health policy experts also felt that video consultations bear great potential to foster coordinated care between GPs and specialists and ensure timely referral for severely burdened patients. Increased workload for the general practice staff to facilitate video consultations and difficulties in establishing reliable therapeutic alliances between patients and specialists via remote treatment were considered as major barriers. Health policy experts varied significantly in their level of knowledge concerning legal frameworks and regulations pertaining to video consultations. However, the implementation of appropriate reimbursement schemes and sufficient data protection were regarded as the major regulative challenges. CONCLUSIONS Health policy experts mostly consider mental health specialist video consultations as a promising way to overcome current challenges for the management of patients with mental disorders at the interface between primary and specialist care. To ensure sustained implementation, a multi-stakeholder approach accounting for the perspective of health policy experts, patients, and providers should be followed. TRIAL REGISTRATION German Clinical Trials Register DRKS00012487.
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Affiliation(s)
- Justus Tönnies
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Lydia Oeljeklaus
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Markus W Haun
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
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22
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Abstract
OBJECTIVE The main objective is to understand and characterize the impact of Covid-19 pandemic on mental health and psychosocial risks at work in professionally active adults. METHODS This specific work includes 4708 professionally active participants from all over the country, of which 3354 are women (71.2%), aged between 19 and 86 years, with an average age of 45.8 years (SD = 12.56). RESULTS The global impact of Covid-19 is explained by socio-demographic factors (sex, age, and education), by work-related and volume of work and health that is reflected in most symptoms. We found sex, age, education level, and professional area differences related to global impact of Covid-19. CONCLUSION The Covid-19 pandemic accounts for the challenge to identify the important factors to promote resilience of citizens, professionals, and organizations.
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Affiliation(s)
- Tania Gaspar
- CENC - Sleep Medicine Center (Ms Gaspar, Ms Paiva); Research Center Social Service and Social Intervention, Universidade Lusíada/CLISSIS (Ms Gaspar); ISAMB - Faculdade de Medicina (Ms Gaspar, Ms Paiva); CHRC - Comprehensive Health Research Center, Universidade Nova de Lisboa (Ms Paiva); FMH (Ms Matos), Research Center in Environmental Health, Universidade de Lisboa, Lisboa; Portugal
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