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Johnson EA, Strauch KA. A mixed-methods pilot examination of Montana, North Dakota nurse practitioner telepresence behaviors through web-camera eye-tracking and qualitative descriptive interviews. J Am Assoc Nurse Pract 2024; 36:270-278. [PMID: 37917096 DOI: 10.1097/jxx.0000000000000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND The use of telehealth for mental health-related encounters has increased exponentially since the COVID-19 pandemic. However, little is known how nurse practitioners (NPs) in rural areas establish connection and presence with patients through telehealth. PURPOSE To leverage web-camera eye-tracking technology coupled with qualitative interviews to better understand rural NPs' perceptions, beliefs, experiences, and visual cues of connection and presence during mental health-related telehealth encounters. METHODS This mixed-methods study employed web-camera eye-tracking technology to measure eye contact, facial/body movements with microexpressions, and auditory expressions during a simulated mental health-related telehealth visit. A qualitative descriptive methodology was used to conduct semistructured interviews with participants regarding utilization of telehealth in rural mental health care delivery. Sticky software, R, and STATA were used for the quantitative eye-tracking and demographic data analyses. Qualitative findings were analyzed using inductive thematic analysis. RESULTS Ten NPs participated in the eye-tracking aspect of the study; among them, three completed semistructured interviews. Eye-tracking areas of interest were significant for the number of fixations ( p = .005); number of visits ( p < .001); time until notice ( p < .001); and time viewed ( p < .001). The category Workflow had the greatest number of thematic units ( n = 21) derived from semistructured interviews. CONCLUSIONS Although an accessible means of obtaining data, web-camera eye tracking poses challenges with data usability. This prompts further attention to research, optimizing the telehealth milieu to lessen patient and provider frustrations with technological or environmental issues. IMPLICATIONS Nurse practitioners provide a key voice in the design and deployment of telehealth platforms congruent with the comprehensive assessment and presence of remote care delivery.
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Affiliation(s)
- Elizabeth A Johnson
- Mark & Robyn Jones College of Nursing, Montana State University, Bozeman, Montana
| | - Kimberly A Strauch
- Leonard A. Lauder Community Care Nurse Practitioner Program, The University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
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Bauer AG, Williams J, Hambrick E, Rempfer M, Bennett K, Christensen K, Berkley-Patton JY. Mental health attitudes, norms, beliefs, and experiences with care among young Black men: A theory of planned behavior assessment. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:653-660. [PMID: 37053405 PMCID: PMC10570394 DOI: 10.1037/tra0001462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
OBJECTIVE Young Black/African American men (YBM) are at greater risk for trauma and related mental health concerns compared to young non-Hispanic White men but are less likely to receive mental health care when needed. The current study used a Theory of Planned Behavior (TPB)-guided framework to qualitatively explore beliefs, norms, and intentions related to seeking mental health screening and linkage to care (LTC) among YBM exposed to trauma. METHOD Participants (N = 55, Mage = 23 years) were YBM aged 18-30 recruited from urban community settings in Kansas City, MO, between October 2018 and April 2019 for participation in focus groups. RESULTS Participants discussed lived experiences with trauma and mental health care, plus salient behavioral beliefs-both positive and negative. Key normative referents were significant others and family members, and participants endorsed greater motivation to seek care with their support. Control beliefs ranged from individual and interpersonal facilitators and barriers to more systemic factors (e.g., availability of providers, cost, lack of access, disparities in incarceration). CONCLUSIONS Tailored interventions are needed to promote engagement in mental health services among YBM, with strategies that recognize cultural contexts and ongoing needs for general well-being. Recommendations for providers and systems are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Alexandria G. Bauer
- Center of Alcohol & Substance Use Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, United States
| | - Joah Williams
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry Street, Kansas City, MO 64110, United States
| | - Erin Hambrick
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry Street, Kansas City, MO 64110, United States
| | - Melisa Rempfer
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry Street, Kansas City, MO 64110, United States
| | - Kymberly Bennett
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry Street, Kansas City, MO 64110, United States
| | - Kelsey Christensen
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108, United States
| | - Jannette Y. Berkley-Patton
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108, United States
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Kibbey MM, DiBello AM, Fedorenko EJ, Farris SG. Testing a brief, self-guided values affirmation for behavioral activation intervention during COVID-19. Cogn Behav Ther 2024:1-17. [PMID: 38593029 DOI: 10.1080/16506073.2024.2339315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
This pilot study tested a single-session digital values affirmation for behavioral activation (VABA) intervention. Hypotheses predicted the VABA intervention would be more effective than an active control condition in improving mood, decreasing COVID-19 fear/worry and depressive symptoms, and promoting positively reinforcing behaviors during early weeks of the COVID-19 pandemic. Participants were a diverse sample of undergraduate students (N = 296) under a state-wide lockdown. Students were randomized to either VABA, a 10-min values clarification and affirmation task, or Control, a time- and attention-matched task. Positive and negative affects were assessed pre- and post-intervention. At next-day follow-up, positive and negative affects were reassessed, as well as past 24-h behavioral activation and depressive symptoms. Within-group increases in positive affect were observed in both conditions (VABA d = 0.39; Control d = 0.19). However, VABA produced a significantly larger increase than Control (F[2] = 3.856, p = .022, d = 0.22). At 24-h follow-up, behavioral activation, which was significantly higher in VABA versus Control (t[294] = -5.584, p < .001, d = 0.65), predicted fewer depressive symptoms (R2 change = .019, β = -.134, p = .003). VABA is an ultra-brief intervention that appears to have acute effects on mood-enhancement and behavioral activation.
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Affiliation(s)
- Mindy M Kibbey
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Angelo M DiBello
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Erick J Fedorenko
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Samantha G Farris
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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Fisher OJ, McGrath K, Grogan C, Cockshaw W, Leggatt-Cook C. Care navigation addresses issues of tele-mental health acceptability and uptake in rural and remote Australian communities. PLoS One 2024; 19:e0298655. [PMID: 38574110 PMCID: PMC10994303 DOI: 10.1371/journal.pone.0298655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/30/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION People living in rural and remote areas face substantial barriers to accessing timely and appropriate mental health services. In the Bowen Basin region of Queensland, Australia, barriers include: limited local providers, long waiting lists, unreliable telecommunication, and reluctance to trial telehealth. Isaac Navicare is a new, community co-designed care navigation service which addresses these barriers by coupling care navigation with supported telehealth, and referrals to mental health providers and other supports. We aimed to understand the reach and effectiveness of Isaac Navicare in improving access to mental health services and address an evidence gap on strategies for improving telehealth acceptability. METHODS This mixed-methods implementation science evaluation used the RE-AIM Framework. It involved a client database review, survey and semi-structured interviews with service users during the 12-month pilot from November 2021. RESULTS 197 clients (128 adults, 69 minors) were referred to Navicare during the pilot. Half of adult clients were unemployed, meaning referral options were limited to low-cost or bulk-billed services. Participants described Navicare as supportive and effective in helping to access timely and appropriate mental health supports. Most clients who expressed a treatment modality preference selected face-to-face (n = 111, 85.4%), however most referrals were for telehealth (n = 103, 66.0%) due to a lack of suitable alternatives. The rapport and trust developed with the care navigator was critical for increasing willingness to trial telehealth. Barriers to telehealth included privacy issues, technical difficulties, unreliable internet/phone, and perceived difficulties developing therapeutic rapport. The supported telehealth site was under-utilised. The majority (88.3%, n = 182) of referrals to Navicare were from local health or community service providers or schools. DISCUSSION Coupling supportive, individualised care navigation with tele-mental health provider options resulted in increased uptake and acceptance of telehealth. Many barriers could be addressed through better preparation of clients and improving promotion and uptake of the supported telehealth site. CONCLUSION Attitudes towards telehealth have changed during the COVID-19 pandemic, however although the need exists, barriers remain to uptake. Telehealth alone is not enough. Coupling telehealth with other supports such as care navigation improves acceptance and uptake.
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Affiliation(s)
- Olivia J. Fisher
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kelly McGrath
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
- Isaac Navicare Hub, Wesley Research Institute, Moranbah, Queensland, Australia
| | - Caroline Grogan
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
| | - Wendell Cockshaw
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Chez Leggatt-Cook
- Family and Disability Services, UnitingCare Queensland, Brisbane, Queensland, Australia
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Dowell A, Stubbe M, Dunlop A, Fedchuck D, Gardiner T, Garrett S, Gordon S, Hilder J, Mathieson F, Tester R. Evaluating Success and Challenges of a Primary Care Youth Mental Health Programme Using Complexity, Implementation Science, and Appreciative Inquiry. Cureus 2024; 16:e58870. [PMID: 38800160 PMCID: PMC11116841 DOI: 10.7759/cureus.58870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Background Using an innovative framework of complexity and implementation science, with underpinning core values of appreciative inquiry (CIS-A), this paper describes the evaluation of a pilot service in New Zealand aiming to deliver integrated psychological therapy services within primary care, to young people (aged 18-24) experiencing mild to moderate mental distress. Method Using mixed quantitative and qualitative methods and multiple data sources, there was a strong focus on local innovation and co-design with service users, young people and multiple care providers. Data is drawn from service users, stakeholders and providers of the service in three areas of the lower North Island of New Zealand. Results The Piki pilot provided a significant and innovative enhancement of mental health care to this population. The service supported 5307 individuals with a range of therapy options, with the majority having between one and three therapy sessions. From 730 service users who completed a survey, 591 (81%) were 'very satisfied' with the service provided. The CIS-A framework was used successfully to provide rapid feedback and encourage adaptation to evolving issues. These included unexpected workload pressures, changes to therapy delivery, the integration of co-design and prioritising the needs of vulnerable groups. There was a successful incorporation of youth/service user input to co-design the programme, introduction of a peer-to-peer support service, and integration of a digital resource platform. The framework was also used to address challenges encountered and to support necessary adaptations in response to the COVID-19 pandemic. Conclusions We describe the use of an embedded evaluation to support and inform the implementation of a novel and innovative youth mental health programme. Complexity and implementation science, underpinned by the core values of appreciative inquiry (CIS-A), were successfully utilised providing potential learning that can be applied locally, nationally and internationally. This study has a focus on youth mental health but the principles and utility of applying a complexity and implementation science approach have application in many different health care settings. The use of a framework such as CIS-A can support complex innovation and implementation and can be used to enable rapid course correction and turn 'hindsight to foresight'.
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Affiliation(s)
- Anthony Dowell
- Primary Health Care and General Practice, University of Otago, Wellington, NZL
| | - Maria Stubbe
- Primary Health Care and General Practice, University of Otago, Wellington, NZL
| | - Abigail Dunlop
- Primary Health Care and General Practice, University of Otago, Wellington, NZL
| | - Dasha Fedchuck
- Psychological Medicine, University of Otago, Wellington, NZL
| | - Tracey Gardiner
- Psychological Medicine, University of Otago, Wellington, NZL
| | - Sue Garrett
- Primary Health Care and General Practice, University of Otago, Wellington, NZL
| | - Sarah Gordon
- Psychological Medicine, University of Otago, Wellington, NZL
| | - Jo Hilder
- Primary Health Care and General Practice, University of Otago, Wellington, NZL
| | - Fiona Mathieson
- Psychological Medicine, University of Otago, Wellington, NZL
| | - Rachel Tester
- Primary Health Care and General Practice, University of Otago, Wellington, NZL
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Katsumata Y, Hachisuka H, Sago N, Shimizu Y, Oikawa K, Horii S, Kimata S. Use of Telephone Crisis Hotline by Callers with Suicidality in Japan during the COVID-19 Pandemic. Arch Suicide Res 2024; 28:716-721. [PMID: 37038717 DOI: 10.1080/13811118.2023.2199807] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE The purpose of this study was to clarify changes over time in suicidal tendencies among crisis hotline service users in Japan before and during the COVID-19 pandemic. METHOD We analyzed telephone consultation data from January 2017 to June 2021 held by Inochi No Denwa, a leading organization providing a telephone crisis hotline in Japan. The number of monthly consultations by gender and the monthly counts of consultations identified by counselors as suicidal were collected, and we calculated trends over time in the proportion of suicidal calls by month using Joinpoint regression analysis. RESULTS The results indicated that the use of telephone crisis hotlines by suicidal callers increased significantly in Japan during the second wave of the pandemic in June to October 2020. These trends were also observed for both male and female users, although the increase began 1 month earlier for females than for males. CONCLUSION Previous studies reported that mental health deteriorated and suicide risk increased significantly during the second wave of COVID-19 in Japan. These trends are consistent with the present findings, suggesting increased use of the crisis hotline by individuals at high suicide risk.
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Cook-Cottone C, Harriger JA, Tylka TL, Wood-Barcalow NL. Virtually possible: strategies for using telehealth in eating disorder treatment learned from the COVID-19 pandemic. Eat Disord 2024; 32:99-119. [PMID: 37772856 DOI: 10.1080/10640266.2023.2261762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
The COVID-19 pandemic resulted in an abrupt shift from in-person to virtual treatment, and clinicians continue to offer telehealth due to its advantages. Telehealth may be a viable, effective, and safe treatment modality for many clients with eating disorders. We consider contemporary issues regarding the use of telehealth in eating disorder treatment and identify strategies to enhance its delivery. First, we emphasize key factors when choosing therapy delivery (telehealth, in-person, or hybrid). Second, we address telehealth-specific planning, preparation, safety, and privacy considerations. Third, we discuss how eating disorder assessment and evidence-based interventions can be adapted for telehealth delivery. Fourth, we raise telehealth-specific challenges related to group-based delivery and the therapeutic alliance offering alternative avenues for connection and engagement. We conclude with a discussion of how additional research is needed to refine the presented strategies, develop new strategies, and assess their efficacy and effectiveness.
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Affiliation(s)
- Catherine Cook-Cottone
- Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York
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Punzalan JK, Guingona M, Gregorio E, Ferraren J, Sta Elena MA, Valaquio M, Arnuco FD, Punzalan MG, Arciaga R, Woolley T, Kunting A, Miravite DA, Cristobal F. Telehealth program for symptomatic COVID-19 patients in Mindanao, Philippines: a whole-of-system, pragmatic interventional study on patient monitoring from isolation facilities to community reintegration. Int J Equity Health 2024; 23:20. [PMID: 38310299 PMCID: PMC10838445 DOI: 10.1186/s12939-024-02115-5] [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] [Received: 09/04/2023] [Accepted: 01/19/2024] [Indexed: 02/05/2024] Open
Abstract
The COVID-19 pandemic is impacting individuals and society's physical and mental health. Despite the lack of any definite and effective therapeutic regimen, public health measures such as quarantine and isolation have been instituted to contain this pandemic. However, these mitigating measures have also raised issues regarding isolated patients' mental and psychological well-being. Several stakeholders were engaged in this approach, including the university, the local health office, the tertiary hospital, and the local communities. This intervention addresses concerns regarding the health status of isolated individuals due to COVID-19 infection, making the program available to anyone who agrees to participate. This was done through telehealth services delivered via phone calls and SMS. The university provided technical support and telehealth manpower through medical students. The local health unit manages the isolation facilities, while the referral hospital offers specialty care for isolated patients through teleconsultation. Finally, the local community is the one that reintegrates discharged patients into their communities. Three hundred forty-four (344) participants were provided seven sessions on telehealth education and tracking of their COVID-19 prescribed practices and mental health. The mean age of the patients was 37 years; half were females, and 15% had comorbidities. Regarding their mental health status, the level of depression dropped from 6% to 1% (p<0.0001), the level of anxiety dropped from 12% to 2% (p<0.0001), and the level of stress dropped from 3% to 0% (p<0.0001) from the first day of admission to 2 weeks after discharge. Moreover, a general trend of statistically significant increase in various practices was noted: wearing face masks, physical distancing, disinfecting frequently held objects, hand hygiene, and self-monitoring for COVID-19 symptoms. Those with progressing symptoms of COVID-19 were referred immediately to the referral hospital. There were also no reports of complications of co-morbidities during their stay in the isolation facilities or social isolation upon community reintegration. The study concludes that telehealth services have the potential to address many challenges in providing continuous healthcare services to isolated patients until they are reintegrated into their community. Furthermore, a whole-of-society approach is necessary to provide holistic care to patients affected by the pandemic.
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Affiliation(s)
- Jaime Kristoffer Punzalan
- Ateneo de Zamboanga University, Zamboanga City, Philippines.
- Zamboanga City Medical Center, Zamboanga City, Philippines.
| | | | - Elgie Gregorio
- Zamboanga City Medical Center, Zamboanga City, Philippines
| | | | | | | | | | - Mary Germeyn Punzalan
- Ateneo de Zamboanga University, Zamboanga City, Philippines
- Zamboanga City Medical Center, Zamboanga City, Philippines
| | | | | | - Afdal Kunting
- Zamboanga City Medical Center, Zamboanga City, Philippines
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Hersch E, Cohen KA, Saklecha A, Williams KD, Tan Y, Lattie EG. Remote-delivered services during COVID-19: A mixed-methods survey of college counseling center clinicians. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:423-431. [PMID: 35259062 PMCID: PMC9848410 DOI: 10.1080/07448481.2022.2038178] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 01/16/2022] [Accepted: 01/30/2022] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has drastically increased use of remote-delivered mental health services. This study identifies advantages and limitations of remote-delivered services on college campuses to inform mental health delivery post-pandemic. Methods: Clinicians (n = 30) were asked to evaluate COVID-19's impact on their work, environment, and wellness in an online survey. Qualitative data was coded using a thematic analysis approach, while quantitative data was analyzed using descriptive statistics. Results: Many clinicians reported benefits of remote services, including increased accessibility, greater convenience, no change in therapeutic alliance, and decreased stress for clinicians. Clinicians also experienced challenges such as social isolation, technological difficulties, and personal/family concerns. Clinicians envisioned a hybrid service combining online and in-person activities post-pandemic. Conclusions: Overall, remote-delivered mental health services on college campuses have potential in increasing treatment quality while highlighting a necessity for further research in hybrid mental health delivery. Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2038178 .
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Affiliation(s)
- Emily Hersch
- Department of Psychiatry & Behavioral Sciences, Northwestern University, Chicago, IL, USA
| | - Katherine A. Cohen
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Anjay Saklecha
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | | | - Yuxi Tan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Emily G. Lattie
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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Looi JCL, Allison S, Bastiampillai T, Kisely S, Pring W. Medicare Benefits Schedule (MBS) Review Advisory Committee post-implementation review of MBS telehealth items: abolition of initial telehealth consultations for non-general practitioner specialists. AUST HEALTH REV 2024; 48:34-36. [PMID: 38245912 DOI: 10.1071/ah23237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
In 2022, the Australian Federal Minister for Health and Aged Care commissioned the Medicare Benefits Schedule (MBS) Review Advisory Committee (MRAC) to conduct a post-implementation review of MBS telehealth services, including settings of video and telephone consultations. The MRAC has made a series of administrative recommendations for telehealth practice that appear at cross-purposes to the evidence-base on medical consultations and that would limit patient access to medical specialist assessment in Australia. These recommendations particularly underestimate the role of telehealth in rural and remote Australia and did not take into account high patient satisfaction with telehealth assessment and treatment during the ongoing coronavirus disease 2019 (COVID-19) pandemic. They also appear to contradict the Medical Board of Australia's guidance on telehealth. On this basis, the recommendations for telehealth principles and abolition of reimbursement for telehealth for all initial non-general practitioner medical specialist consultations should be withdrawn.
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Affiliation(s)
- Jeffrey C L Looi
- Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Building 4, Level 2, PO Box 11, Garran, Canberra, ACT 2605, Australia; and Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Stephen Allison
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; and College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Tarun Bastiampillai
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; and College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; and Department of Psychiatry, Monash University, Wellington Road, Clayton, Vic., Australia
| | - Steve Kisely
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; and School of Medicine, The University of Queensland, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Qld, Australia; and Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - William Pring
- Delmont Private Hospital, Glen Iris, Vic., Australia; and Department of Psychiatry, Monash University, Clayton, Vic., Australia
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O'Connell M, Gluskin B, Parker S, Burke PJ, Pluhar E, Guss CE, Shrier LA. Adapting a Counseling-Plus-mHealth Intervention for the Virtual Environment to Reduce Sexual and Reproductive Health Risk Among Young Women with Depression. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:196-208. [PMID: 36881344 PMCID: PMC9989584 DOI: 10.1007/s11121-023-01506-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 03/08/2023]
Abstract
MARSSI (Momentary Affect Regulation - Safer Sex Intervention) is a counseling-plus-mobile health (mhealth) intervention to reduce sexual and reproductive health (SRH) risks for women with depression and high-risk sexual behavior. Due to the COVID-19 pandemic limiting in-person care, we sought to develop the counseling and mhealth app onboarding for virtual implementation. A team with SRH, adolescent medicine, motivational interviewing, cognitive behavioral therapy, and technology expertise adapted the counseling through an iterative consensus process. We identified essential aspects of the counseling, specified the content so the counseling could be delivered in person or virtually with fidelity, and considered best practices for telehealth for the focus population. Virtual counseling retained key elements from in-person counseling while including enhancements with engaging visual and audio-video aids. Instructions and programming were developed to support virtual counseling delivery and onboarding for the mhealth app component of MARSSI. After testing the virtual format in mock sessions, we implemented a small-scale feasibility study in an adolescent medicine clinic with women with depressive symptoms and high-risk sexual behavior age 18-24 years (N = 9). Participants experienced minimal technical difficulties and expressed satisfaction with the virtual format, and all were able to complete app onboarding successfully. Expanding delivery options for SRH interventions to include virtual can improve access, particularly for populations with psychological and environmental barriers to care.
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Affiliation(s)
- Maddie O'Connell
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Brittany Gluskin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Sarah Parker
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, MA, USA
| | - Pamela J Burke
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Emily Pluhar
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
| | - Carly E Guss
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Türk A, Ünsal E, Engin E, Kayahan B. Return to Community Mental Health Centers after the Pandemic: A Qualitative Study on Turkish Patients' Subjective Experiences. Niger J Clin Pract 2023; 26:1792-1799. [PMID: 38158344 DOI: 10.4103/njcp.njcp_739_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 09/22/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Community mental health centers (CMHCs) are important institutions for individuals with chronic mental illness. During the COVID-19 period, patients with mental health could not optimally access care in CMHCs. AIM To explore the experiences of patients using a CMHC after its closure due to the COVID-19 pandemic. PATIENTS AND METHODS This was a descriptive qualitative study that included 16 patients with mental disorders who regularly used CMHCs during the pre-pandemic period. Their data were collected between March 2022 and August 2022 using face-to-face, in-depth semi-structured interviews. All interviews were recorded and the content analysis method was used to analyze the data. RESULTS The age range of the 16 study participants was 29-53 years with a mean age of 40.8 ± 6.5 years. Nine (56.3%) participants were men, and 7 (43.7%) were women. Ten (62.5%) participants had schizophrenia, whereas 6 (37.5%) had bipolar disorder. According to content analysis, the five main themes that emerged based on the statements of participants were the effects of change, difficulties experienced, support needs, coping experiences, and suggestions. The results showed that although patients using CMHCs are struggling with the adverse consequences of the pandemic process, they also have difficulty managing their diseases and daily life due to their inability to access psychosocial services in the CMHCs. CONCLUSION The patients reported their negative experiences and need for support during the pandemic. The study highlights the need to adequately accommodate mental health services delivery during future pandemics that may impose movement restrictions.
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Affiliation(s)
- A Türk
- Mental Health Nursing Department, Ege University Faculty of Nursing, Turkey
| | - E Ünsal
- Mental Health Nursing Department, Ege University Faculty of Nursing, Turkey
| | - E Engin
- Mental Health Nursing Department, Ege University Faculty of Nursing, Turkey
| | - B Kayahan
- Department of Mental Health and Diseases, Community Mental Health, Ege University Faculty of Medicine, Turkey
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Galvez SJ, Altice FL, Meteliuk A, Ivasiy R, Machavariani E, Farnum SO, Fomenko T, Islam Z, Madden LM. High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine. Front Public Health 2023; 11:1231581. [PMID: 38098837 PMCID: PMC10720365 DOI: 10.3389/fpubh.2023.1231581] [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: 05/30/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
Background The COVID-19 pandemic resulted in marked disruptions in healthcare delivery in Ukraine related to emergency guidance in response to treating opioid use disorder (OUD). Patients with OUD, a group with high levels of comorbid medical and psychiatric disorders, and prescribed opioid agonist therapies (OAT) were rapidly shifted to take-home dosing if they were deemed clinically stable. The impact of these shifts on patient stress and related substance use during the pandemic, however, is unknown. Methods In early May 2020, 269 randomly selected OAT patients in Ukraine were surveyed to assess their stress level and substance use using the validated Perceived Stress Scale and examined correlates of severe perceived stress. Results Overall, 195 (72.5%) met criteria for moderate to severe levels of stress, which was independently correlated with having started OAT within the past 12 months (aOR: 1.33; 95%CI: 1.15-1.55), living in a large metropolitan area (aOR: 1.31; 95%CI: 1.18-1.46), having been asked by others to share their medication (aOR: 1.13; 95%CI: 1.02-1.25), and having an increase of over 10 min in transportation time to get to treatment (aOR: 1.16; 95%CI: 1.04-1.29). Twenty seven (10%) patients felt at high risk of relapse, while 24 (8.9%) patients reported purchasing drugs. Conclusion During a time of great uncertainty soon after emergency guidance to the COVID-19 pandemic, there was extraordinary high levels of perceived stress reported. In response to emergency guidance, OAT patients should be screened for perceived stress and certain subgroups should be targeted for additional psychosocial support.
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Affiliation(s)
- Samy J. Galvez
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States
| | - Frederick L. Altice
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States
- Division of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
- APT Foundation, New Haven, CT, United States
| | - Anna Meteliuk
- Alliance for Public Health of Ukraine, Kyiv, Ukraine
| | - Roman Ivasiy
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States
| | - Eteri Machavariani
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States
| | | | | | - Zahedul Islam
- Alliance for Public Health of Ukraine, Kyiv, Ukraine
| | - Lynn M. Madden
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, United States
- APT Foundation, New Haven, CT, United States
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Tamming T, Otake Y, Aburahma S, Tan M, Shishtawi A, El-Daour Y, Hamad K, Seita A. Mental health of health professionals and their perspectives on mental health services in a conflict-affected setting: a qualitative study in health centres in the Gaza Strip during the COVID-19 pandemic. BMJ Open 2023; 13:e066552. [PMID: 37648388 PMCID: PMC10471847 DOI: 10.1136/bmjopen-2022-066552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/22/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES To explore how primary care health professionals perceive their own mental health in a conflict-affected setting during and beyond the COVID-19 pandemic and to explore their perspectives on mental health services. METHODS The Gaza Strip faces a chronic humanitarian crisis and is suffering from the consequences of the COVID-19 pandemic; United Nations Relief and Works Agency (UNRWA) health centres were used to recruit participants for this study. Semistructured interviews were conducted with 29 health professionals in UNRWA health centres who were sampled using maximum variation sampling. Transcripts were translated, double checked and analysed via thematic analysis. RESULTS From the analysis, a thematic map was developed showing how health professionals perceive their mental health impacts. This included difficulties due to the COVID-19 pandemic, as well as the socioeconomic processes stemming from the on-going conflict.Another thematic map was developed showing the perceived strengths and challenges of the health services. The strengths included positive impact of the services to the service users and health professionals. In terms of challenges, health professionals identified socioeconomic processes and aspects of remote service provision during COVID-19. CONCLUSIONS Based on the findings, we suggest that an improved signposting mechanism should be developed to address many of the challenges that emergencies bring about; in particular, this could support the health professionals' mental health, as well as improve the response to patients' socioeconomic challenges. We further suggest recommendations for improving mental health services when delivered remotely to increase their resiliency during various emergencies.
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Affiliation(s)
- Teisi Tamming
- Department of Health, United Nations Relief and Works Agency for Palestine Refugees in the Near East Jordan, Amman, Jordan
| | - Yuko Otake
- School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK
| | - Safa'a Aburahma
- Department of Health, United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza, Palestine
| | - Mengxin Tan
- Department of Health, United Nations Relief and Works Agency for Palestine Refugees in the Near East Jordan, Amman, Jordan
| | - Anas Shishtawi
- Department of Health, United Nations Relief and Works Agency for Palestine Refugees in the Near East Jordan, Amman, Jordan
| | - Yahya El-Daour
- Department of Health, United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza, Palestine
| | - Khalil Hamad
- Department of Health, United Nations Relief and Works Agency for Palestine Refugees in the Near East, Gaza, Palestine
| | - Akihiro Seita
- Department of Health, United Nations Relief and Works Agency for Palestine Refugees in the Near East Jordan, Amman, Jordan
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15
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Nakhostin Ansari N, Bahramnezhad F, Anastasio AT, Hassanzadeh G, Shariat A. Telestroke: A Novel Approach for Post-Stroke Rehabilitation. Brain Sci 2023; 13:1186. [PMID: 37626542 PMCID: PMC10452418 DOI: 10.3390/brainsci13081186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/01/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Despite the tremendous technologic advancements of recent years, the prevalence of stroke has increased significantly worldwide from 1990 to 2019 (a 70 [...].
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Affiliation(s)
- Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran P.O. Box 14155-6559, Iran;
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran P.O. Box 14155-6559, Iran
| | - Fatemeh Bahramnezhad
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran P.O. Box 14197-3317, Iran;
| | | | - Gholamreza Hassanzadeh
- Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran P.O. Box 14618-84513, Iran;
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran P.O. Box 14176-13151, Iran
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran P.O. Box 55469-14177, Iran
| | - Ardalan Shariat
- Department of Digital Health, School of Medicine, Tehran University of Medical Sciences, Tehran P.O. Box 14618-84513, Iran;
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McKenna S, Piper S, Capon W, Crowley A, Lira L, LaMonica HM, Chong MK, Scott E, Hickie I, Iorfino F. The Polarization of Clinician and Service Staff Perspectives After the Use of Health Information Technology in Youth Mental Health Services: Implementation and Evaluation Study. JMIR Hum Factors 2023; 10:e42993. [PMID: 37490321 PMCID: PMC10410532 DOI: 10.2196/42993] [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: 09/27/2022] [Revised: 03/30/2023] [Accepted: 04/30/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Highly personalized care is substantially improved by technology platforms that assess and track patient outcomes. However, evidence regarding how to successfully implement technology in real-world mental health settings is limited. OBJECTIVE This study aimed to naturalistically monitor how a health information technology (HIT) platform was used within 2 real-world mental health service settings to gain practical insights into how HIT can be implemented and sustained to improve mental health service delivery. METHODS An HIT (The Innowell Platform) was naturally implemented in 2 youth mental health services in Sydney, Australia. Web-based surveys (n=19) and implementation logs were used to investigate staff attitudes toward technology before and after implementation. Descriptive statistics were used to track staff attitudes over time, whereas qualitative thematic analysis was used to explore implementation log data to gain practical insights into useful implementation strategies in real-world settings. RESULTS After the implementation, the staff were nearly 3 times more likely to agree that the HIT would improve care for their clients (3/12, 25% agreed before the implementation compared with 7/10, 70% after the implementation). Despite this, there was also an increase in the number of staff who disagreed that the HIT would improve care (from 1/12, 8% to 2/10, 20%). There was also decreased uncertainty (from 6/12, 50% to 3/10, 30%) about the willingness of the service to implement the technology for its intended purpose, with similar increases in the number of staff who agreed and disagreed with this statement. Staff were more likely to be uncertain about whether colleagues in my service are receptive to changes in clinical processes (not sure rose from 5/12, 42% to 7/10, 70%). They were also more likely to report that their service already provides the best mental health care (agreement rose from 7/12, 58% to 8/10, 80%). After the implementation, a greater proportion of participants reported that the HIT enabled shared or collaborative decision-making with young people (2/10, 20%, compared with 1/12, 8%), enabled clients to proactively work on their mental health care through digital technologies (3/10, 30%, compared with 2/12, 16%), and improved their response to suicidal risk (4/10, 40% compared with 3/12, 25%). CONCLUSIONS This study raises important questions about why clinicians, who have the same training and support in using technology, develop more polarized opinions on its usefulness after implementation. It seems that the uptake of HIT is heavily influenced by a clinician's underlying beliefs and attitudes toward clinical practice in general as well as the role of technology, rather than their knowledge or the ease of use of the HIT in question.
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Affiliation(s)
- Sarah McKenna
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Sarah Piper
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - William Capon
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | | | - Lucas Lira
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Haley M LaMonica
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Min Kyung Chong
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Elizabeth Scott
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Ian Hickie
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Frank Iorfino
- Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Camperdown, Australia
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Subotic-Kerry M, Braund TA, Gallen D, Li SH, Parker BL, Achilles MR, Chakouch C, Baker S, Werner-Seidler A, O'Dea B. Examining the impact of a universal positive psychology program on mental health outcomes among Australian secondary students during the COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2023; 17:70. [PMID: 37308960 DOI: 10.1186/s13034-023-00623-w] [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] [Received: 01/02/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND This study aimed to examine the impact of a web-based positive psychology program delivered universally to secondary school students during school closures caused by the COVID-19 pandemic in New South Wales, Australia. METHODS Using a quasi-experimental design conducted in 2020, 438 students aged 12-15 years (73% male) from 4 secondary schools were invited to complete the 'Bite Back Mental Fitness Challenge'. This web-based program consisted of 7 self-directed modules that targeted 5 key domains of positive psychology. Self-reported symptoms of anxiety and depression and help-seeking intentions for mental health were assessed at baseline prior to school closures (February to March 2020) and at post-test after the return to school (July to August 2020). At post-test, students also reported on their perceived changes in mental health and help-seeking behavior for mental health during the pandemic. Completion of the program modules was recorded. RESULTS A total of 445 students consented and 336 (75.5%) completed both assessments. On average, participants completed 2.31 modules (SD: 2.38, range: 0 to 7). There was no change in symptoms of anxiety and depression or help-seeking intentions between baseline and post-test, with no significant effects for gender and history of mental illness. Students who were symptomatic for anxiety and depression at baseline reported lower symptoms at post-test, but this change was not significant. Ninety-seven students (27.5%) reported that their mental health had worsened during the pandemic, and a significant increase in anxiety and depressive symptoms was found in this subsample at post-test. Only 7.7% of students reported a change in their help-seeking behavior, with increased mental health support sought from the Internet, parents, and friends. CONCLUSIONS The universal delivery of a web-based positive psychology program during school closures did not appear to be associated with improved mental health symptoms; however, completion of the modules was low. Different effects may emerge when selectively delivered to students with mild or greater symptoms. The findings also suggest that broader measures of mental health and wellbeing, including perceived change, are key to the mental health surveillance of students during periods of remote learning.
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Affiliation(s)
- Mirjana Subotic-Kerry
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia.
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Taylor A Braund
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Dervla Gallen
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Sophie H Li
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Belinda L Parker
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Melinda R Achilles
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Cassandra Chakouch
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Simon Baker
- Orygen, University of Melbourne, Melbourne, VIC, Australia
| | - Aliza Werner-Seidler
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Bridianne O'Dea
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Goh ZZS, Chan LG, Lai JY, Lee J, Lee ES, Soon WSW, Toh A, Griva K. Impact of COVID-19 on mental health and social service provision in Singapore: Learnings from a descriptive mixed-methods study for future resource planning. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:239-248. [PMID: 38904521 DOI: 10.47102/annals-acadmedsg.2022332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction COVID-19 restrictions and lockdown measures have led to impact on the mental health and social service delivery, including the rapid adoption of digital solutions to mental healthcare delivery in Singapore. This study aims to rapidly document the quantitative and qualitative impact of the pandemic restrictions on mental health and social services. Method This descriptive mixed-methods study consisted of a survey arm and a qualitative arm. Providers and clients from eligible mental health organisations and social service agencies were recruited. The respondents completed a survey on changes to their service delivery and the extent of impact of the pandemic on their clients. In-depth interviews were also conducted with representatives of the organisations and clients. Results There were 31 organisation representatives to the survey, while 16 providers and 3 clients participated in the in-depth interviews. In the survey arm, all representatives reported pivoting to remote means of delivering care during the lockdown. An increase in new client referrals and more domestic violence were reported from primary and community health partners respondents who made up 55.5% of health partners respondents. Three distinct response themes were recorded in the in-depth interviews: impact on clients, impact on service provision and impact on mental health landscape. Conclusion Two key findings are distilled: (1) mental health and social services have been challenged to meet the evolving demands brought about by the pandemic; (2) more societal attention is needed on mental health and social services. The findings indicate a necessary need for extensive studies on COVID-19 that can inform policies to build a more pandemic-resilient nation.
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Affiliation(s)
| | - Lai Gwen Chan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Psychiatry, Tan Tock Seng Hospital, Singapore
| | | | - Jimmy Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Institute of Mental Health, Singapore
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- National Healthcare Group Polyclinics, Singapore
| | | | - Adrian Toh
- Department of Psychology, National University of Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Herrmann WJ, Buspavanich P, Oeser P, Berger M, Lech S, Gellert P. [Changes in the provision of primary care and psychotherapy in Germany during the first two lockdowns in 2020 and 2021: A two-wave survey giving consideration to gender identity and sexual orientation]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023; 177:26-34. [PMID: 36964120 PMCID: PMC10032457 DOI: 10.1016/j.zefq.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/21/2022] [Accepted: 01/23/2023] [Indexed: 03/24/2023]
Abstract
INTRODUCTION Measures against the COVID-19 pandemic led to restrictions in ambulatory health care in Germany. While the restrictions have been described from claims data, the patients' perspective has been missing. Lesbian, gay, bisexual, trans-, inter- and asexual persons (LGBTIA) might have been particularly affected by these restrictions because of their vulnerability. Thus, our research questions were: 1) How did the restrictions during the pandemic influence primary care and psychotherapy in Germany from the patients' perspective? 2) Are there differences between LGBTIA and cis-heterosexual persons regarding these restrictions? METHODS We conducted an online survey with two survey waves in March/April 2020 and January/February 2021. Sampling was conducted via multiplicators and via snowball sampling. Amongst others, the survey contained open-ended questions regarding primary care and psychotherapy. From the answers of the first survey wave we constructed quantitative items for the second survey wave. Descriptive and inferential statistical analysis was conducted, including linear regression with R. RESULTS 6,784 participants took part in the survey (2,641 in the first survey wave), 5,442 of whom identified as LGBTIA. Categories of changes in primary care were: no health care utilization, no changes in primary care, insecurity regarding primary care, and changes in primary care which could be less frequent utilization, differing procedures or changes in ways of communication. In the second wave, LGBTIA participants rated the worsening of primary care during the pandemic as being more pronounced. Regarding psychotherapy, the change can be described as no change in care, changes in the form of therapy, treatment in emergencies only and a longer break from psychotherapy. There was no different rating by LGBTIA persons compared to cis-heterosexual persons in the second survey wave. Telephone and video consultations were more common in psychotherapy than in primary care. DISCUSSION LGBTIA persons were oversampled, so the sample included more people from urban areas than the German population. Due to the online survey form, older people were underrepresented relative to their numbers in the general German population. CONCLUSION With respect to future pandemics GENERAL practitioners in primary care must be prepared that psychotherapy might be paused and delayed for some time. Video and telephone consultations should be offered to overcome pandemic-related restrictions in the future. General practitioners should know the gender identity and sexual orientation of their patients in order to proactively address health care barriers.
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Affiliation(s)
- Wolfram J Herrmann
- Charité - Universitätsmedizin Berlin, Institut für Allgemeinmedizin, Berlin, Deutschland.
| | - Pichit Buspavanich
- Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Deutschland; Charité - Universitätsmedizin Berlin, Geschlechterforschung in der Medizin (GIM) & Institut für Sexualwissenschaft und Sexualmedizin, Berlin, Deutschland; Medizinische Hochschule Brandenburg CAMPUS GmbH, Fehrbelliner Straße 38, 16816 Neuruppin, Deutschland
| | - Philip Oeser
- Charité - Universitätsmedizin Berlin, Institut für Allgemeinmedizin, Berlin, Deutschland
| | - Maximilian Berger
- Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Deutschland
| | - Sonia Lech
- Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Deutschland; Charité - Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin, Deutschland
| | - Paul Gellert
- Charité - Universitätsmedizin Berlin, Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Berlin, Deutschland
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Rinn R, Gao L, Schoeneich SM, Dahmen A, Anand-Kumar V, Becker P, Lippke S. A Scoping Review of Digital Interventions that Treat Post-/Long-COVID. J Med Internet Res 2023; 25:e45711. [PMID: 36943909 PMCID: PMC10131666 DOI: 10.2196/45711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/28/2023] [Accepted: 03/10/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Patients with Post-/Long-COVID need support, and health care professionals require evidence-based patient care. Digital interventions can meet these requirements, especially if personal contact is limited. OBJECTIVE We reviewed evidence-based digital interventions, to help manage physical and mental health, for patients with Post-/Long-COVID. METHODS A scoping review was carried out; summarizing novel digital health interventions for treating Post-/Long-COVID patients. Using the PICO scheme, original studies were summarized in which patients with Post-/Long-COVID symptoms used digital interventions to help aid recovery. RESULTS From all scanned articles, k = 8 original studies matched the inclusion criteria. Three were "pre-test" studies. Three describe the implementation of a tele-rehabilitation program, one is a Post-/Long-COVID program, and one study describes the results of qualitative interviews with patients who used an online peer support group. Following the PICO scheme, we categorized previous studies: studies varied in terms of (P) participants, ranging from adults in different countries, such as former hospitalized patients with COVID-19, to disadvantaged communities in the UK, as well as health-care workers. In addition, the studies included patients who had previously been infected with COVID-19, who had ongoing symptoms, and some studies focused on specific symptoms, some post-COVID-19 or long-term. Other studies included patients in online peer support groups. The (I) interventions also varied. Most interventions used a combination of psychological and physical exercises, but they varied in duration, frequency, and social dimensions. The reviewed studies investigated physical and mental health (C) conditions of patients with Post-/Long-COVID. Most studies reported (O) outcomes/ improvements in physiological health perception, some physical conditions, fatigue, and some psychological aspects such as depression. However, some studies found no improvements in bowel/bladder problems, concentration, short-term memory, unpleasant dreams, physical ailments, perceived bodily pain, emotional ailments, and perceived mental health. CONCLUSIONS More systematic research with larger sample sizes is required to overcome sampling bias and include the health care professionals' perspective as well as help patients mobilize support by health care professionals and social network partners. The evidence so far suggests that patients should be provided with digital interventions to manage symptoms and reintegrate into everyday life, including work. CLINICALTRIAL
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Affiliation(s)
- Robin Rinn
- Constructor University, Constructor University, Campus Ring 1, Bremen, DE
- Julius-Maximilians-Universität, Lehrstuhl für Psychologie 2, Röntgenring 10, Würzburg, DE
| | - Lingling Gao
- Constructor University, Constructor University, Campus Ring 1, Bremen, DE
| | | | - Alina Dahmen
- Klinikum Wolfsburg, Wolfsburg, DE
- Constructor University, Constructor University, Campus Ring 1, Bremen, DE
- Dr. Becker Klinikgruppe, Bad Windsheim, DE
| | | | | | - Sonia Lippke
- Constructor University, Constructor University, Campus Ring 1, Bremen, DE
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21
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Patrick AK, Ramsey KA, Essoe JKY, McGuire JF. Clinical Considerations for an Evidence-Based Assessment for Obsessive-Compulsive Disorder. Psychiatr Clin North Am 2023; 46:17-38. [PMID: 36740351 DOI: 10.1016/j.psc.2022.10.001] [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: 12/15/2022]
Abstract
Obsessive-compulsive disorder (OCD) is an impairing mental health disease, generally beginning in childhood, affecting up to ∼3% of the population. Using evidence-based assessments (EBAs) is the starting point for the accurate diagnosis and treatment of OCD. EBAs consist of structured and semistructured clinician-administered interviews, parent-report and child-report, and self-report for adults. This article details the practical application, psychometric properties, and limitations of available assessments to determine the presence of OCD and evaluate OCD symptom severity. The following reviews measurement of constructs relevant to OCD (ie, insight, family accommodation, impairment) and details considerations for best clinical interview practices.
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Affiliation(s)
- Ainsley K Patrick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA
| | - Kesley A Ramsey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA
| | - Joey K-Y Essoe
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA
| | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA.
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22
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Lohaus T, Rogalla S, Thoma P. Use of Technologies in the Therapy of Social Cognition Deficits in Neurological and Mental Diseases: A Systematic Review. Telemed J E Health 2023; 29:331-351. [PMID: 35532968 DOI: 10.1089/tmj.2022.0037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: This article systematically reviews the effects of technology-based (TB) treatments on impaired social cognition (SC) in neurological and mental disorders. Methods: Strictly adhering to the PRISMA guidelines, a systematic search was carried out in PsycINFO, PubMed, and Web of Science (last search: April 22, 2021) to identify studies that, implementing a control group design, evaluated TB treatments targeting deficits in emotion recognition, Theory of Mind (ToM) and social behavior in adult patients with nondevelopmental and nonprogressive neurological or mental disorders. Risk of bias was assessed using the PEDro Scale, certainty assessment followed the GRADE approach. Results: Sixteen studies involving 857 patients, all focusing on psychotic disorders, were retrieved. The most pronounced effects were observed concerning emotion recognition with all studies revealing overall improvements. Regarding ToM and social behavior, results were mixed. However, the number of studies including outcome measures for these domains, is significantly lower compared to the domain of emotion recognition, limiting the validity of the results. Risk of bias and certainty assessment revealed further limitations of evidence. Conclusion: TB treatment achieves positive effects especially with regard to emotion recognition impairments, at least for patients with schizophrenia. Future research should expand the evaluation of TB training of other SC domains, ought to be carried out in more diverse patient populations, rely on different devices, and include follow-up measurements.
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Affiliation(s)
- Tobias Lohaus
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Sally Rogalla
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
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Kline ER, Thibeau H, Sanders AS, Davis BJ, Fenley A, McIntyre T, English K, Keshavan MS. The School of Hard Talks: A telehealth parent training group for caregivers of adolescents and young adults. Early Interv Psychiatry 2023; 17:244-251. [PMID: 35715966 PMCID: PMC10588675 DOI: 10.1111/eip.13321] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/19/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Abstract
AIM A large body of evidence demonstrates the importance of the family environment in the developmental trajectory of mental illness in young people. Caregiver communication skills training represents a potential model for influencing the outcomes of adolescents and young adults struggling with emerging mental health and behavioural difficulties. The aim of the current study is to describe the development of a telehealth group training intervention for caregivers of adolescents and young adults, and to report the results of a pilot feasibility-effectiveness study that took place in 2020-2021. METHODS The "School of Hard Talks" intervention consisted of 8 h of training in communication skills consistent with motivational interviewing techniques. All pilot study participants were assigned to receive the intervention. Outcomes of interest were family conflict, caregiver stress, caregiver self-efficacy and expressed emotion (EE). Participants were assessed three times: prior to the intervention, after the intervention and 12 weeks later. RESULTS A total of 62 participants enrolled in the study, of whom 49 completed the intervention. Large, significant improvements were observed over time in all four domains of interest. Qualitative feedback from parents was very positive and added context to quantitative observations. CONCLUSIONS The School of Hard Talks was a feasible and effective intervention targeting both caregiver wellbeing as well as important mechanisms of risk for youth psychopathology, namely family conflict and EE. Further research involving a larger sample and a control condition are needed to confirm these findings.
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Affiliation(s)
- Emily R. Kline
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Heather Thibeau
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - A. Simone Sanders
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Beshaun J. Davis
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Alicia Fenley
- Department of Psychology, Boston University, Boston, Massachusetts, USA
| | - Theresa McIntyre
- Children’s Behavioral Health Knowledge Center, Massachusetts Department of Mental Health, Boston, Massachusetts, USA
| | - Kelly English
- Children’s Behavioral Health Knowledge Center, Massachusetts Department of Mental Health, Boston, Massachusetts, USA
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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24
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Hao X, Qin Y, Lv M, Zhao X, Wu S, Li K. Effectiveness of telehealth interventions on psychological outcomes and quality of life in community adults during the COVID-19 pandemic: A systematic review and meta-analysis. Int J Ment Health Nurs 2023. [PMID: 36808863 DOI: 10.1111/inm.13126] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/09/2022] [Accepted: 01/24/2023] [Indexed: 02/22/2023]
Abstract
Physical distancing and contact restrictions have been implemented in most countries and territories due to the rapid spread of SARS-CoV-2. This has caused physical, emotional, and psychological distress for adults living in the community. Diversified telehealth interventions have been widely applied in health care and have proven to be cost-effective and well accepted by patients and health professionals. Currently, the effectiveness of telehealth interventions on psychological outcomes and quality of life among community adults during the COVID-19 pandemic remains unclear. A literature search was conducted using PubMed, PsycINFO, CINAHL, EMBASE, MEDLINE, and the Cochrane Library from 2019 to October 2022. Twenty-five randomized controlled trials with 3228 subjects were finally included in this review. Two independent reviewers performed the screening, extraction of key data points, and appraisal of the methodological quality. There were positive effects of telehealth interventions on anxiety, stress, loneliness, and well-being among community adults. Participants who were women or older adults were more likely to recover from negative emotions, increase well-being, and improve quality of life. The real-time and interactive interventions and remote cognitive-behavioural therapy (CBT) may be better choices during the COVID-19 pandemic. Based on the findings of this review, health professionals have more options and alternatives for delivering telehealth interventions in the future. Rigorously designed randomized controlled trials (RCTs) with higher statistical power and long-term follow-up should be conducted in the future to strengthen the currently weak evidence.
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Affiliation(s)
- Xiaonan Hao
- School of Nursing, Jilin University, Changchun, China
| | - Yuan Qin
- School of Nursing, Jilin University, Changchun, China
| | - Miaohua Lv
- School of Nursing, Jilin University, Changchun, China
| | - Xuetong Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Shuang Wu
- School of Nursing, Jilin University, Changchun, China
| | - Kun Li
- School of Nursing, Jilin University, Changchun, China
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25
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Kathiravan S, Chakrabarti S. Development of a protocol for videoconferencing-based exposure and response prevention treatment of obsessive-compulsive disorder during the COVID-19 pandemic. World J Psychiatry 2023; 13:60-74. [PMID: 36925949 PMCID: PMC10011942 DOI: 10.5498/wjp.v13.i2.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/01/2022] [Accepted: 12/06/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The existing literature indicates that psychotherapeutic treatment, especially exposure and response prevention (ERP) is efficacious in treating obsessive-compulsive disorder (OCD). The coronavirus disease 2019 pandemic adversely impacted many patients with OCD and disrupted their usual treatment. Moreover, the pandemic forced a global switch to telemental health (TMH) services to maintain the standards and continuity of care. Consequently, clinicians are increasingly using TMH-based psychotherapeutic treatments to treat OCD. However, several challenges have made it difficult for them to implement these treatments in the changed circumstances imposed by the pandemic.
AIM To describe the formulation, implementation, feasibility, and usefulness of videoconferencing-based ERP (VC-ERP) treatment for OCD during the coronavirus disease 2019 pandemic.
METHODS This prospective, observational study was conducted in the psychiatric unit of a multi-specialty hospital in north India over 12 mo (July 2020-June 2021). All patients with OCD were assessed using the home-based TMH services of the department. The VC-ERP protocol for OCD was the outcome of weekly Zoom meetings with a group of clinicians involved in administering the treatment. After a systematic evaluation of the available treatment options, an initial protocol for delivering VC-ERP was developed. Guidelines for clinicians and educational materials for patients and their families were prepared. The protocol was implemented among patients with OCD attending the TMH services, and their progress was monitored. The weekly meetings were used to upgrade the protocol to meet the needs of all stakeholders. Feasibility and efficacy outcomes were examined.
RESULTS All patients were diagnosed with OCD as a primary or a comorbid condition according to the International Classification of Diseases, 10th version criteria. Out of 115 patients who attended the services during the study period, 37 were excluded from the final analysis. Of the remaining 78 patients, VC-ERP was initiated in 43 patients. Six patients dropped out, and three were hospitalized for inpatient ERP. Eleven patients have completed the full VC-ERP treatment. One patient completed the psychoeducation part of the protocol. VC-ERP is ongoing in 22 patients. The protocol for VC-ERP treatment was developed and upgraded online. A large proportion of the eligible patients (n = 34/43; 79%) actively engaged in the VC-ERP treatment. Drop-out rates were low (n = 6/43; 14%). Satisfaction with the treatment was adequate among patients, caregivers, and clinicians. Apart from hospitalization in 3 patients, there were no other adverse events. Hybrid care and stepped care approaches could be incorporated into the VC-ERP protocol. Therefore, the feasibility of VC-ERP treatment in terms of operational viability, service utilization, service engagement, need for additional in-person services, frequency of adverse events, and user satisfaction was adequate. The VC-ERP treatment was found to be efficacious in the 11 patients who had completed the full treatment. Significant reductions in symptoms and maintenance of treatment gains on follow-up were observed.
CONCLUSION This study provided preliminary evidence for the feasibility and usefulness of VC-ERP in the treatment of OCD. The results suggest that VC-ERP can be a useful option in resource-constrained settings.
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Affiliation(s)
- Sanjana Kathiravan
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
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Web-Based Psychosocial Interventions for Disaster-Related Distress: What Has Been Trialed in the Past, and What Can We Learn From This? Disaster Med Public Health Prep 2023; 17:e299. [PMID: 36785535 DOI: 10.1017/dmp.2022.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To summarize reports describing implementation and evaluation of Web-based psychosocial interventions for disaster-related distress with suggestions for future intervention and research, and to determine whether a systematic literature review on the topic is warranted. METHODS Systematic searches of Embase, PsycINFO, and MEDLINE were conducted. Duplicate entries were removed. Two rounds of inclusion/exclusion were conducted (abstract and full-text review). Relevant data were systematically charted by 2 reviewers. RESULTS The initial search identified 112 reports. Six reports, describing and evaluating 5 interventions, were included in a data analysis. Four of the 5 interventions were asynchronous and self-guided modular programs, with interactive components. The fifth was a short-term, online supportive group intervention. Studies utilized a variety of evaluation methods, and only 1 of 14 outcome measures used across the studies was utilized in more than 1 project. CONCLUSIONS Several Web-based psychosocial interventions have been developed to target disaster-related distress, but few programs have been formally evaluated. A systematic review of the topic would not be recommended at this time due to heterogeneity in reported studies. Further research on factors impacting participation, generalizability, and methods of program delivery with consistent outcome measures is needed.
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Miola A, Caiolo S, Pontoni G, Pozzan E, Moriglia C, Simionato F, Garofalo S, Perini G, Sambataro F. Anxiety and Depression during the Second Wave of the COVID-19 Pandemic: The Role of Coping Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2974. [PMID: 36833670 PMCID: PMC9957361 DOI: 10.3390/ijerph20042974] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Evidence suggests increased anxious-depressive symptoms in the general population during the COVID-19 pandemic, also in its second wave. High symptom variability across individuals suggests that risk and protective factors, including coping strategies, can play a mediating role. METHODS General Anxiety Disorder-7, Patient Health Questionnaire-9, and Brief-COPE questionnaires were administered to people attending a COVID-19 point-of-care. Univariate and multivariate methods were used to test the association of symptoms with risk and protective factors. RESULTS A total of 3509 participants (27.5% with moderate-severe anxiety; 12% with depressive symptoms) were recruited. Sociodemographic and lifestyle factors, including age, sex, sleep, physical activity, psychiatric treatments, parenthood, employment, and religiosity were associated with affective symptoms. Avoidant (self-distraction, venting, behavioral disengagement) and approach (emotional support, self-blame but not positive reframing and acceptance) coping strategies predicted greater anxiety. Avoidant strategies, including venting, denial, behavioral disengagement, substance use, and self-blame, and the humor strategy were associated with more severe depressive symptoms, while the planning predicted the opposite. CONCLUSIONS Coping strategies, in addition to socio-demographic and life-habit factors, could have contributed to modulating anxious and depressive symptoms during the second-wave of the COVID-19 pandemic, thus advocating for interventions aimed at promoting positive coping strategies to reduce the psychosocial toll of the pandemic.
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Affiliation(s)
- Alessandro Miola
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, 35127 Padua, Italy
- Medicine Faculty, University of Padova, 35127 Padua, Italy
- Casa di Cura Parco dei Tigli, 35037 Teolo, Italy
| | - Stefano Caiolo
- Medicine Faculty, University of Padova, 35127 Padua, Italy
- Psychiatry Section, Military Department of Forensic Medicine, 35137 Padua, Italy
| | - Giancarlo Pontoni
- Psychiatry Section, Psychophysiological Selection Office, Italian Army National Recruitment and Selection Center, 06034 Foligno, Italy
| | - Erica Pozzan
- Medicine Faculty, University of Padova, 35127 Padua, Italy
| | - Chiara Moriglia
- Psyops Development Center, 28th (APICE) Regiment “Pavia”, 61121 Pesaro, Italy
| | | | - Sergio Garofalo
- Psychiatry Section, Military Department of Forensic Medicine, 35137 Padua, Italy
| | - Giulia Perini
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, 35127 Padua, Italy
- Medicine Faculty, University of Padova, 35127 Padua, Italy
- Casa di Cura Parco dei Tigli, 35037 Teolo, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, 35127 Padua, Italy
- Medicine Faculty, University of Padova, 35127 Padua, Italy
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Kumar SP, Anandan K, Balathay D, Vishnu Kumar S, Bhattacharjee B, Ravichandran S. A survey on connected healthcare beyond COVID in India: clinical perspectives. J Med Eng Technol 2023; 47:85-93. [PMID: 35856890 DOI: 10.1080/03091902.2022.2098397] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The COVID-19 pandemic has seen the advent of novel medical devices and practices. Demand for quality healthcare services rose exponentially which eventually led to accessibility becoming a major issue of concern. In addition to this, in-person consultations and various other conventional treatment methods were proven to be problematic. Limitations of traditional health care systems such as in-person consultations were highlighted, and conventional treatment methods have proven to be problematic. As an alternative approach, telehealth services are now gaining recognition due to their high efficiency, ease of use, and state-of-the-art technology. In this article, trends of telemedicine and its evolving popularity across the medical community due to the pandemic and beyond are studied and highlighted. An online survey form was circulated to 42 medical practitioners and interns to analyse the growing interest in telemedicine. The questionnaire covered the physicians' perspectives, preferences, experiences, and other important aspects of home-based teleconsultation. Based on the responses collected from doctors and medical interns, 14.2% disapproved, whereas 38.1% favoured and 47.6% showed a neutral response to the teleconsultation. More than 50% of the respondents claim the process to be time-consuming and 42% of them perceived it to be the other way round. 4.8% of the doctors preferred it to be only through computers whereas 45.2% per cent preferred consultation through smartphones and 50% of them preferred it be both ways. More than half (59.5%) of the doctors preferred the pandemic scenario and the remaining for its continued usage post-pandemic. Although India has the world's second-largest online market, a major population in India is digitally illiterate according to the Digital Foundation of India. Thus, it is important to devise telehealth technology that is simplest to use to reach also the economically backward patient communities.
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Affiliation(s)
- S Pravin Kumar
- Department of Biomedical Engineering, Center for Healthcare Technologies, Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, India
| | - Kavitha Anandan
- Department of Biomedical Engineering, Center for Healthcare Technologies, Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, India
| | - Divya Balathay
- Department of Biomedical Engineering, Center for Healthcare Technologies, Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, India
| | - Sivagami Vishnu Kumar
- Department of Biomedical Engineering, Center for Healthcare Technologies, Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, India
| | - Basundhara Bhattacharjee
- Department of Biomedical Engineering, Center for Healthcare Technologies, Sri Sivasubramaniya Nadar College of Engineering, Kalavakkam, India
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Hamlett GE, Tyler J, Bredemeier K, Ballentine E, Brown LA. The impact of COVID-19 on treatment seeking and interest in internet-based therapy for anxiety-related disorders: An interrupted time-series analysis. Psychiatry Res 2023; 320:115044. [PMID: 36638695 PMCID: PMC9798668 DOI: 10.1016/j.psychres.2022.115044] [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: 11/08/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022]
Abstract
AIMS To examine whether the onset of the COVID-19 pandemic led to a change in demand for psychiatric treatment, interest in internet-based therapy, and differences in treatment requests by self-reported diagnoses (e.g., Posttraumatic Stress Disorder, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, and Social Anxiety Disorder). METHODS Using an interrupted time series design, we analyzed intake questionnaires of treatment-seeking patients (N = 1,954) at an anxiety treatment center between June 6, 2019 through September 13, 2021. RESULTS The change in general treatment-seeking from before to immediately after the global pandemic declaration was not statistically significant. However, there was a steady increase in treatment seeking, with a more pronounced increase from 2020 into 2021. Interest in internet-based therapy increased significantly after the onset of COVID-19. The number of treatment-seeking individuals who self-reported "concerns or diagnoses" of PTSD increased significantly. CONCLUSION The study supports anecdotal reports from clinics across the country about unprecedented demand for services. It highlights that many patients experienced an immediate impact of the pandemic on their self-reported concerns about trauma and PTSD symptoms, which has important clinical implications. It also highlights a shifting openness to internet-based services during the pandemic.
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Affiliation(s)
- Gabriella E. Hamlett
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA,Harvard University, Department of Psychology, Cambridge, MA, USA
| | - Jeremy Tyler
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Keith Bredemeier
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Emily Ballentine
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Lily A. Brown
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA,Corresponding author
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Looi JC, Maguire PA, Bastiampillai T, Allison S. Penumbra of the pandemic workplace for psychiatrists and trainees in Australia. Australas Psychiatry 2022; 30:736-738. [PMID: 35748803 PMCID: PMC9234374 DOI: 10.1177/10398562221109742] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A commentary on the workforce, infrastructure and health of psychiatrists and trainees providing psychiatric care during the COVID-19 pandemic in Australia. CONCLUSIONS The wide-ranging workplace, health system and societal changes necessitated by the SARS-CoV-2 virus have altered the practice and working lives of psychiatrists, trainees and other healthcare workers, as well as the general population. There have been workplace innovations, recalibrations and losses. There is a new baseline upon which to build better psychiatric services, as the pandemic's penumbra recedes.
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Affiliation(s)
- Jeffrey Cl Looi
- Academic Unit of Psychiatry and Addiction Medicine, 104822The Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia; Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Paul A Maguire
- Academic Unit of Psychiatry and Addiction Medicine, 104822The Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia; Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Tarun Bastiampillai
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Department of Psychiatry, 2541Monash University, Clayton, VIC, Australia
| | - Stephen Allison
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia; College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Lakeman R, Hurley J, Campbell K, Hererra C, Leggett A, Tranter R, King P. High fidelity dialectical behaviour therapy online: Learning from experienced practitioners. Int J Ment Health Nurs 2022; 31:1405-1416. [PMID: 35789190 PMCID: PMC9795868 DOI: 10.1111/inm.13039] [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: 06/18/2022] [Indexed: 12/30/2022]
Abstract
Dialectical behaviour therapy (DBT) is an effective treatment for borderline personality disorder and other problems underpinned by difficulties with emotional regulation. The main components of DBT are skills training groups and individual therapy. The COVID-19 outbreak forced a rapid adaptation to online delivery, which largely mirrored face-to-face programmes using videoconferencing technology. This study aimed to elicit and describe the experiences and learning of therapists involved in providing high-fidelity DBT programmes via the Australian DBT Institute, which established an online delivery platform called DBT Assist™ prior to the COVID-19 pandemic. The report conforms with the consolidated criteria for reporting qualitative research (COREQ). Seven therapists were interviewed. Data were transcribed and analysed thematically. Delivering skills training online, either exclusively or in hybrid form (with face-to-face individual therapy), was acceptable and even preferable to therapists and clients. It was considered safe, the programme was associated with few non-completers, and it improved the accessibility of DBT to those who might otherwise not be able to engage in a face-to-face programme. Skills training utilized a 'flipped-learning' approach which improved the efficiency of online delivery. Other unique and helpful features of the online programme were described. The best outcomes associated with online DBT are likely to be achieved through careful adaptation to the online environment in accord with the principles of DBT rather than mirroring face-to-face processes. Further research is required to determine the efficacy of online therapy relative to face-to-face, and who might be best suited to different modes of delivery.
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Affiliation(s)
- Richard Lakeman
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - John Hurley
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | - Katrina Campbell
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
| | | | - Andrew Leggett
- Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia
| | - Richard Tranter
- Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia
| | - Peter King
- Faculty of Health, Southern Cross University, Bilinga, Queensland, Australia
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Bean CAL, Aurora P, Maddox CJ, Mekota R, Updegraff A. A comparison of telehealth versus in-person group therapy: Results from a DBT-based dual diagnosis IOP. J Clin Psychol 2022; 78:2073-2086. [PMID: 35531794 PMCID: PMC9790325 DOI: 10.1002/jclp.23374] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/20/2022] [Accepted: 04/27/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The effectiveness of remotely delivered group interventions and treatments for individuals with more complex psychiatric presentations is understudied. Nevertheless, the emergence of the COVID-19 pandemic shifted such treatments from in-person to remote service delivery without the establishment of comparable effectiveness between in-person and remote delivery. The current study presents the results of a private practice's transition from in-person treatment delivery to a videoconference-delivered Dialectical Behavior Therapy (DBT)-based intensive outpatient program (IOP) for individuals with comorbid mental health and substance use disorder diagnoses in response to the pandemic. METHODS Change in symptoms of depression, anxiety, and stress following completion of the IOP was compared between the in-person and videoconference groups. RESULTS Large reductions in symptoms were found following completion of the IOP for both the in-person and videoconference groups. Furthermore, no significant differences in symptom reduction were found between the groups. CONCLUSION Although large-scale replication is needed, these results suggest that IOPs and other intensive group therapies delivered via videoconference may be as effective as in-person therapies, even among individuals with more complex psychiatric presentations. Providers who have transitioned group therapies to videoconference formats or are considering creating remote groups can be more confident that they are not sacrificing treatment efficacy.
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Affiliation(s)
| | - Pallavi Aurora
- Department of Psychological SciencesKent State UniversityKentOhioUSA
| | | | | | - Alanna Updegraff
- Department of Psychological SciencesKent State UniversityKentOhioUSA
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Duden GS, Gersdorf S, Stengler K. Global impact of the COVID-19 pandemic on mental health services: A systematic review. J Psychiatr Res 2022; 154:354-377. [PMID: 36055116 PMCID: PMC9392550 DOI: 10.1016/j.jpsychires.2022.08.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/19/2022]
Abstract
The purpose of the review was to investigate the changes in mental health services during the COVID-19 pandemic. A systematic review of qualitative, quantitative and mixed-methods studies was conducted from February 2021 to March 2022 using four databases and five languages. 29 studies reporting on mental health services in 63 countries were included. Findings were organised according to nine major topics: (1) lack of preparedness vs. timely response and flexible solutions, (2) changes in access, referrals, and admission, (3) impacts on outpatient, community and psychosocial services, (4) inpatient: reorganisation of hospital psychiatric units/acute wards, (5) diagnostic and therapeutic adaptations, (6) effects on medication, (7) infection control measures, (8), changes in patients' demands, engagement, and mental health, and (9) impacts on staff and team. Many services were closed intermittently or considerably reduced while telepsychiatric services were extensively expanded. Face-to-face services decreased, as did the work with therapeutic groups. Many inpatient units restructured their services to accommodate COVID-19 patients. While the digitalisation of services allowed for better access to services for some, restrictive measures hindered access for most. Staff experienced changes such as heightened impacts on their own mental health, burdens on patients and the pausing of professional training. Clearly, diverse findings of studies relate to different (national) contexts, type of service offered, but also to the time of the investigation, as studies noted several distinct phases of change during the pandemic. This review suggests directions for policy and service development, such as fostering community services and providing support services for particularly vulnerable populations.
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Affiliation(s)
| | - Stefanie Gersdorf
- Kunstakademie Düsseldorf, Eiskellerstraße 1, 40213, Düsseldorf, Germany.
| | - Katarina Stengler
- Zentrum für Seelische Gesundheit, Helios Park-Klinikum Leipzig Psychiatrische Kliniken, Morawitzstraße 2, 04289, Leipzig, Germany
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White-Williams C, Liu X, Shang D, Santiago J. Use of Telehealth Among Racial and Ethnic Minority Groups in the United States Before and During the COVID-19 Pandemic. Public Health Rep 2022; 138:149-156. [PMID: 36113138 PMCID: PMC9482875 DOI: 10.1177/00333549221123575] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has propelled the use of technology for health care services delivery. Because of inequities in health care and technology access, we investigated the use of telehealth services among racial and ethnic minority groups before and during the COVID-19 pandemic. METHODS For this retrospective study, we examined the electronic health records of privately insured patients in the Healthjump database, provided by the COVID-19 Research Database Consortium. We examined 17.98 million unique visit records of 2.93 million patients from March through December 2019 and 22.17 million records of 3.55 million patients from March through December 2020. We conducted a descriptive analysis and used multiple logistic regression to examine differences in the use of telehealth services among 3 racial and ethnic groups: non-Hispanic White, non-Hispanic Black, and Hispanic people. RESULTS Telehealth visits before and during COVID-19 accounted for 8.3% and 10.9% of total visits, respectively, with a peak of 15.5% in April 2020. Pre-COVID-19, Hispanic patients had a significantly lower monthly utilization rate (5.3%) than non-Hispanic White patients (8.4%, P < .001) and non-Hispanic Black patients (10.4%, P = .001). During the pandemic study period, Hispanic patients were 41% less likely than non-Hispanic White patients to have a telehealth visit, controlling for age and sex. CONCLUSIONS The likelihood of using telehealth was lower among Hispanic patients than among non-Hispanic White and non-Hispanic Black patients during the pandemic. Culturally sensitive measures are needed to support telehealth use among the Hispanic population.
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Affiliation(s)
- Cynthia White-Williams
- Center for Aging Research, Brooks College of Health, University of North Florida, Jacksonville, FL, USA,School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA,Cynthia White-Williams, PhD, MHA, PT, University of Central Florida, School of Global Health Management and Informatics, 12494 University Blvd, Orlando, FL 32816, USA.
| | - Xinliang Liu
- Department of Community and Population Health, Lehigh University, Bethlehem, PA, USA
| | - Di Shang
- Coggin College of Business, University of North Florida, Jacksonville, FL, USA
| | - Jared Santiago
- Center for Aging Research, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
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Palitsky R, Kaplan DM, Brodt MA, Anderson MR, Athey A, Coffino JA, Egbert A, Hallowell ES, Han GT, Hartmann MA, Herbitter C, Herrera Legon M, Hughes CD, Jao NC, Kassel MT, Le TAP, Levin-Aspenson HF, López G, Maroney MR, Medrano M, Reznik SJ, Rogers ML, Stevenson BL. Systemic Challenges in Internship Training for Health-Service Psychology: A Call to Action From Trainee Stakeholders. Clin Psychol Sci 2022; 10:819-845. [PMID: 36465892 PMCID: PMC9718483 DOI: 10.1177/21677026211072232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
The challenges observed in health service psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic, but became more visible during the global health crisis. In a position paper written by 23 trainees across different sites and training specializations, the authors use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe longstanding dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. The authors make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.
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Affiliation(s)
- R Palitsky
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
| | - D M Kaplan
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
- 12. Brown University, Center for Alcohol and Addiction Studies
| | - M A Brodt
- 2. Oklahoma State University, Counseling and Counseling Psychology Department, College of Education and Human Sciences
| | - M R Anderson
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
| | - A Athey
- 3. Johns Hopkins University School of Public Health
| | - J A Coffino
- 4. Department of Population Health, New York University School of Medicine
| | - A Egbert
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
- 5. The Miriam Hospital, Providence, RI
| | - E S Hallowell
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
| | - G T Han
- 6. Yale Child Study Center, Yale School of Medicine
| | | | - C Herbitter
- 8. VA Boston Healthcare System
- 18. Boston University Medical School
| | | | - C D Hughes
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
| | - N C Jao
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
- 5. The Miriam Hospital, Providence, RI
| | | | - T-A P Le
- 11. Capital OCD and Anxiety Practice
| | - H F Levin-Aspenson
- 1. Warren Alpert Medical School at Brown University, Department of Psychiatry and Human Behavior
| | - G López
- 12. Brown University, Center for Alcohol and Addiction Studies
| | - M R Maroney
- 13. Werklund School of Education, University of Calgary
| | | | - S J Reznik
- 15. Texas Institute for Excellence in Mental Health, University of Texas at Austin
| | - M L Rogers
- 16. Icahn School of Medicine, Mount Sinai Beth Israel
| | - B L Stevenson
- 17. University of Minnesota Department of Psychiatry
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Chatterton ML, Marangu E, Clancy EM, Mackay M, Gu E, Moylan S, Langbein A, O’Shea M. Telehealth service delivery in an Australian regional mental health service during COVID-19: a mixed methods analysis. Int J Ment Health Syst 2022; 16:43. [PMID: 35986332 PMCID: PMC9388972 DOI: 10.1186/s13033-022-00553-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
COVID-19 required mental health services to quickly switch from face-to-face service delivery to telehealth (telephone and videoconferencing). This evaluation explored implementation of a telehealth mental health response in a regional public mental health provider.
Methods
A mixed methods approach, combining service use data, brief satisfaction surveys, and qualitative interviews/focus groups was undertaken. Number and types of contacts from de-identified mental health service data were compared between April–May 2020 and April–May 2019. Mental health consumers and providers completed brief online satisfaction surveys after videoconferencing sessions. Attitudes and perspectives on the implementation of telehealth were further explored by applying a descriptive qualitative framework to the analysis of interview and focus group data supplied by consumers and providers. Template thematic analysis was used to elucidate key themes relating to the barriers and enablers of telehealth uptake and future implementation recommendations.
Results
Total contacts decreased by 13% from 2019 to 2020. Face-to-face contacts decreased from 55% of total in 2019 to 24% in 2020. In 2019, 45% of contacts were by telephone, increasing to 70% in 2020. Only four videoconferencing contacts were made in 2019; increasing to 886 in 2020. Consumer surveys (n = 26) rated videoconferencing as good or excellent for technical quality (92%), overall experience (86%), and satisfaction with personal comfort (82%). Provider surveys (n = 88) rated technical quality as good or excellent (68%) and 86% could achieve assessment/treatment goals with videoconferencing. Provider focus groups/interviews (n = 32) identified that videoconferencing was well-suited to some clinical tasks. Consumers interviewed (n = 6) endorsed the ongoing availability of telehealth within a blended approach to service delivery. Both groups reflected on videoconferencing limitations due to infrastructure (laptops, phones, internet access), cumbersome platform and privacy concerns, with many reverting to telephone use.
Conclusions
While videoconferencing increased, technical and other issues led to telephone being the preferred contact method. Satisfaction surveys indicated improvement opportunities in videoconferencing. Investment in user-friendly platforms, telehealth infrastructure and organisational guidelines are needed for successful integration of videoconferencing in public mental health systems.
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Dunn N, Walton CJ, Matsunaga E, Williams C, Dimeff LA. Acceptability of Telehealth for Multidiagnostic Suicidal Patients in a Real-World Dialectical Behavior Therapy Clinic During the COVID-19 Pandemic. Telemed J E Health 2022; 29:593-601. [PMID: 35984847 DOI: 10.1089/tmj.2022.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: This study aimed to evaluate the acceptability of Dialectical Behavior Therapy (DBT) delivered through telehealth to complex, suicidal patients during the COVID-19 pandemic. Methods: We surveyed 163 adult participants enrolled in outpatient services at a private, free-standing DBT clinic certified by the DBT-Linehan Board of Certification for its fidelity to the treatment. Treatment satisfaction was assessed, as well as ease of telehealth over time, differences in satisfaction between patients who had previously experienced face-to-face treatment and those who had only experienced telehealth, patients' beliefs regarding the impact of telehealth on their progress, and preference for face-to-face versus telehealth services. Additionally, participants' reasons for liking and disliking telehealth were reported. Results: The average overall satisfaction rating was 82.26 (±18.71) on a 100-point scale. Factors identified as being relevant to satisfaction included increased access to care, saving time and money, and increased comfort participating in therapy from home. Factors identified as relevant to dissatisfaction included feeling less connected to therapists and other patients. The majority of participants reported that telehealth positively impacted or did not impact treatment progress. Satisfaction was significantly related to participants' perception of telehealth's impact on progress in treatment. Demographic variables were also included in the analyses, but were unrelated to satisfaction. Conclusions: Findings indicate that, from the point of view of consumer satisfaction, telehealth appears satisfactory for delivery of DBT and may play an increased role in behavioral health care postpandemic.
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Affiliation(s)
| | - Carla J Walton
- Hunter New England Mental Health Service, Newcastle, New South Wales, Australia
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Gliske K, Berry KA, Ballard J, Evans-Chase M, Solomon PL, Fenkel C. Does Insurance Type Matter on the Computer Too? Comparing Outcomes for Youth with Public v Private Health Insurance Attending a Telehealth Intensive Outpatient Program: A Quality Improvement Analysis (Preprint). JMIR Form Res 2022; 6:e41721. [DOI: 10.2196/41721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/21/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
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Tekkas Kerman K, Albayrak S, Arkan G, Ozabrahamyan S, Beser A. The effect of the COVID-19 social distancing measures on Turkish women's mental well-being and burnout levels: A cross-sectional study. Int J Ment Health Nurs 2022; 31:985-1001. [PMID: 35466490 PMCID: PMC9111787 DOI: 10.1111/inm.13009] [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: 04/03/2022] [Indexed: 11/30/2022]
Abstract
Lockdown and social distancing measures during the COVID-19 pandemic increase women's responsibilities and influence their mental health. This study aimed to assess the effect of COVID-19 social distancing measures on mental well-being and burnout levels of women using an online cross-sectional survey in Turkey. The Warwick-Edinburgh Mental Well-being Scale, The Burnout Measure, and Sociodemographic form were used in this study. All analyses were performed on a sample of 438 women aged between 18 and 65. The mean score of mental well-being was 47.86 (SD = 10.04) and the mean score of burnout was 3.86 (SD = 1.16). Being younger than 30 years old (t = 2.14, P = 0.033), having undergraduate education or above (F = 5.09, P = 0.007), part-time working (F = 5.39, P = 0.005), attending to school (t = 2.68, P = 0.008), having COVID-19 symptoms (t = 6.01, P < 0.001), and perceiving spousal emotional support (F = 3.47, P = 0.016) were the factors associated with high burnout. Being older than 30 years old (z = -3.11, P = 0.002), full time working (H = 11.96, P = 0.003), not attending to school (z = -2.09, P = 0.036), perceiving spousal emotional (H = 13.22, P = 0.004), or social (H = 13.11, P = 0.004) support were the factors associated with higher mental well-being. Age (β = -0.03, P = 0.001), having two or more children (β = 0.42, P = 0.015), and perceiving COVID-19 symptoms (β = -0.73, P < 0.001) were the predictors of women's burnout. This study shows that mental well-being and burnout levels of women in Turkey have been considerably affected as a result of social distancing measures taken with the first wave of the pandemic. Findings signal the immediate need for targeted mental health nursing interventions. Therefore, technology-based mental health support programmes are recommended to be designed and utilized by mental health nurses.
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Affiliation(s)
| | | | - Gulcihan Arkan
- Faculty of Health Sciences, Izmir Demokrasi University, Izmir, Turkey
| | | | - Ayse Beser
- Koç University School of Nursing, Istanbul, Turkey
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Honig TJ, Hannibal N. Client Experiences of Shifting from In-Person to Telehealth Formats of Guided Imagery and Music (GIM) Sessions. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Qvarfordt M, Nilsson E, Nilsson L. Healthcare professionals’ experiences in telehabilitation: a qualitative study (Preprint). JMIR Hum Factors 2022; 10:e40690. [PMID: 37074772 PMCID: PMC10157457 DOI: 10.2196/40690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/17/2023] [Accepted: 02/26/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The use of digital communication in Swedish health care has increased in an effort to make health care more accessible. At the organizational level, trust in digitalization has stabilized, but a certain degree of skepticism regarding technology appears to exist among health care employees. OBJECTIVE This study aimed to explore health care professionals' (HCPs) experiences of digital communication with patients and colleagues in a habilitation context. METHODS Qualitative content analysis was used to analyze data derived from individual interviews. RESULTS The results revealed that there were mixed feelings regarding the digital format used at the habilitation center. Although some skepticism remained regarding the digital format, there seemed to be a parallel understanding of the motives and benefits of digitalization. Hence, positive aspects, such as increased health care accessibility, were identified. However, emphasis was placed on the considerations required to make digital consultations appropriate for each patient. CONCLUSIONS Managing a workday influenced by the balance between digital and physical demands forces HCPs to adjust to the digital format and new ways of working. This requires HCPs to consider whether digital means are appropriate for communication in individual patient-specific cases.
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Affiliation(s)
- Maria Qvarfordt
- eHealth Institute, Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Evalill Nilsson
- eHealth Institute, Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Lina Nilsson
- eHealth Institute, Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
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Masters GA, Xu L, Cooper KM, Moore Simas TA, Brenckle L, Mackie TI, Schaefer AJ, Straus J, Byatt N. Perspectives on addressing bipolar disorder in the obstetric setting. Gen Hosp Psychiatry 2022; 77:130-140. [PMID: 35640435 PMCID: PMC10858616 DOI: 10.1016/j.genhosppsych.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Perinatal Psychiatry Access Programs have emerged to help obstetric professionals meet the needs of perinatal individuals with mental health conditions, including bipolar disorder (BD). We elucidate obstetric professionals' perspectives on barriers and facilitators to managing BD in perinatal patients, and how Access Programs may affect these processes. METHODS We conducted three focus groups with obstetric professionals, two with- and one without-exposure to an Access Program, the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms. Focus groups discussed experiences, barriers, facilitators, and solutions to caring for perinatal individuals with BD. Qualitative data were coded and analyzed by two independent coders; emergent themes were examined across exposure groups. RESULTS Thirty-one obstetric professionals (7 without-exposure, 24 with-exposure) participated. Identified themes included: (1) gaps in perinatal BD education; (2) challenges in patient assessment; (3) MCPAP for Moms as a facilitator for addressing BD; and (4) importance of continued outreach and destigmaization to increase care collaboration. CONCLUSIONS Barriers to obstetric professionals accessing adequate mental healthcare for their patients with BD abound. With psychiatric supports in place, it is possible to build obstetric professionals' capacity to address BD. Perinatal Psychiatry Access Programs can facilitate obstetric professionals bridging these gaps in mental health care.
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Affiliation(s)
- Grace A Masters
- University of Massachusetts Chan Medical School, Worcester, MA, United States of America.
| | - Lulu Xu
- University of Massachusetts Chan Medical School, Worcester, MA, United States of America
| | - Katherine M Cooper
- University of Massachusetts Chan Medical School, Worcester, MA, United States of America
| | - Tiffany A Moore Simas
- University of Massachusetts Chan Medical School, Worcester, MA, United States of America; UMass Memorial Health, Worcester, MA, United States of America
| | - Linda Brenckle
- University of Massachusetts Chan Medical School, Worcester, MA, United States of America
| | - Thomas I Mackie
- SUNY Downstate Health Sciences University, School of Public Health, Brooklyn, NY, United States of America
| | - Ana J Schaefer
- SUNY Downstate Health Sciences University, School of Public Health, Brooklyn, NY, United States of America
| | - John Straus
- Massachusetts Behavioral Health Partnership, Boston, MA, United States of America
| | - Nancy Byatt
- University of Massachusetts Chan Medical School, Worcester, MA, United States of America; UMass Memorial Health, Worcester, MA, United States of America
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Efficacy of Internet-Based Cognitive Behavioral Therapy for Depression and Anxiety among Global Population during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis of a Randomized Controlled Trial Study. Healthcare (Basel) 2022; 10:healthcare10071224. [PMID: 35885751 PMCID: PMC9315502 DOI: 10.3390/healthcare10071224] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Depression and anxiety have become the most common mental health disorders worldwide during the COVID-19 pandemic, and increasing interest in telemedicine has led to the innovation of using internet-based cognitive behavioral therapy (iCBT). Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of iCBT for depression and anxiety among the global population during the COVID-19 pandemic. Methods: A literature search was conducted on PubMed, Scopus, Cochrane, ProQuest, Wiley, and Web of Science using the PRISMA framework, and only randomized controlled trials (RCTs) were included in the study. A critical appraisal was also performed using Cochrane’s Risk of Bias (RoB) 2. The meta-analysis used random-effects models to analyze pooled mean difference (MD) and its p-value. Results: Twelve RCTs were included for qualitative analysis and nine RCTs, which yielded 6778 patients with depression and 6556 patients with anxiety during the COVID-19 pandemic, were included for quantitative analysis. Despite high heterogeneity, all studies had a low risk of bias. Pre- and post-iCBT intervention in the depression forest plot depicts a significant effect (p < 0.00001) with a pooled MD of 4.73 (95% CI: 4.55−4.90), while the pre- and post-iCBT intervention depicts a significant effect (p < 0.00001) with a pooled MD of 4.50 (95% CI: 4.34−4.67). This demonstrates that iCBT was found to significantly decrease depression and anxiety scores in patients during the COVID-19 pandemic. However, substantial heterogeneity was also found (I2 = 93%; p < 0.00001 and I2 = 90%) for the pre-/post-depression and anxiety forest plots, respectively. Conclusions: This meta-analysis comprises an evidence-based result for iCBT to treat depression and anxiety in the COVID-19 population, as indicated by the significantly lower assessment scores. Delivering iCBT in this situation needs to be considered more extensively, as it has promising results and yields the benefits of technological advancement in psychotherapy.
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McQueen M, Strauss P, Lin A, Freeman J, Hill N, Finlay-Jones A, Bebbington K, Perry Y. Mind the distance: experiences of non-face-to-face child and youth mental health services during COVID-19 social distancing restrictions in Western Australia. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2078649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
| | - Penelope Strauss
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | | | - Nicole Hill
- Telethon Kids Institute, Perth, Australia
- Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | | | - Keely Bebbington
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Perth, Australia
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Reay RE, Looi JC. Recommendations for psychiatrists regarding better access during the COVID-19 pandemic. Australas Psychiatry 2022; 30:409-410. [PMID: 35152777 PMCID: PMC8847699 DOI: 10.1177/10398562211065281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Batz F, Lermer E, Hatzler L, Vilsmaier T, Schröder L, Chelariu-Raicu A, Behr J, Mahner S, Buspavanich P, Thaler CJ. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022; 19:907-922. [PMID: 35370105 PMCID: PMC8898699 DOI: 10.1016/j.jsxm.2022.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/12/2022] [Accepted: 02/26/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Preliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare. AIM The objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany. METHODS An anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms. OUTCOMES Demographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected. RESULTS A total of 1,368 cis women participants were included: heterosexual women (n = 844), lesbian women (n = 293), bisexual women (n = 231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences before and during the pandemic lesbian women showed significant changes in sexual arousal whereas heterosexual women showed significant changes in all dimensions except capability to enjoy sexual intercourse. The data of bisexual women showed significant changes in almost all dimensions except for frequency of sexual intercourse and sexual arousal. Results of the multiple regression analysis revealed that being younger than 36 years-old, and being in a relationship as well as being heterosexual (compared with being lesbian) is positively associated with general satisfaction with sexual life during the pandemic. CLINICAL IMPLICATIONS The findings suggest that during a pandemic sexual and mental health care for (cis) women should be provided and address the specific needs of sexual minority groups. STRENGTHS & LIMITATIONS This is the first study to describe sexual behavior in heterosexual, lesbian and bisexual women during the COVID-19 pandemic in Germany. Limitations, however, include the fact that the data described were obtained at only one time point so there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46. CONCLUSION This study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises. Batz F, Lermer E, Hatzler L, et al. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19:907-922.
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Affiliation(s)
- Falk Batz
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Eva Lermer
- Center for Leadership and People Management, LMU Munich, Germany; Applied Business and Media Psychology - Ansbach University of Applied Sciences, Ansbach, Germany
| | - Laura Hatzler
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Gynecology and Breast Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Lennard Schröder
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Anca Chelariu-Raicu
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Joachim Behr
- Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany; Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Pichit Buspavanich
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany; Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany; Institute Gender in Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Christian J Thaler
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
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Zapata-Ospina JP, Gil-Luján K, López-Puerta A, Ospina LC, Gutiérrez-Londoño PA, Aristizábal A, Gómez M, García J. [Description of a telehealth mental health programme in the framework of the COVID-19 pandemic in Colombia]. REVISTA COLOMBIANA DE PSIQUIATRIA 2022:S0034-7450(22)00051-8. [PMID: 35663408 PMCID: PMC9135670 DOI: 10.1016/j.rcp.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/26/2022] [Indexed: 12/03/2022]
Abstract
Background: A telehealth mental health programme was designed at the LivingLab of the Faculty of Medicine of the Universidad de Antioquia [University of Antioquia].Objectives: To describe the development and operation of the programme and evaluate the satisfaction of the patients treated during the COVID-19 pandemic in 2020 and 2021.Methods: Descriptive study that details the development of the programme. Data were extracted from medical records to describe the patients who were treated. A satisfaction scale was applied to a random sample and the data were summarised with descriptive statistics.Results: In March 2020 and August 2021, 10,229 patients were treated, with 20,276 treated by telepsychology and 4,164 by psychiatry, 1,808 by telepsychiatry and 2,356 by tele-expertise, with a total of 6,312 visits. The most frequent diagnoses were depressive (36.8%), anxiety (12.0%), and psychotic (10.7%) disorders. Respondents were satisfied to the point that more than 93% would recommend it to another person.Conclusions: The LivingLab telehealth mental health programme allowed for the care of patients with mental health problems and disorders in Antioquia during the first two years of the COVID-19 pandemic, and there was a high degree of satisfaction among the beneficiaries. Therefore it could be adopted in mental health care.
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Affiliation(s)
- Juan Pablo Zapata-Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
- Grupo Académico de Epidemiología Clínica (GRAEPIC), Colombia
| | - Karla Gil-Luján
- Livinglab Telesalud, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Laura Carolina Ospina
- Livinglab Telesalud, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Alexandra Aristizábal
- Livinglab Telesalud, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mauricio Gómez
- Livinglab Telesalud, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jenny García
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
- Grupo Académico de Epidemiología Clínica (GRAEPIC), Colombia
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A qualitative exploration of mental health services provided in community pharmacies. PLoS One 2022; 17:e0268259. [PMID: 35551556 PMCID: PMC9098086 DOI: 10.1371/journal.pone.0268259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/26/2022] [Indexed: 11/19/2022] Open
Abstract
The burden of mental health problems continues to grow worldwide. Community pharmacists’, as part of the primary care team, optimise care for people living with mental illness. This study aims to examine the factors that support or hinder the delivery of mental health services delivered in Australian community pharmacies and proposes ideas for improvement. A qualitative study was conducted comprising focus groups with community pharmacists and pharmacy staff across metropolitan, regional, and rural areas of New South Wales, Australia. Data were collected in eight focus groups between December 2020 and June 2021. Qualitative data were analysed using thematic analysis. Thirty-three community pharmacists and pharmacy staff participated in an initial round of focus groups. Eleven community pharmacists and pharmacy staff participated in a second round of focus groups. Twenty-four factors that enable or hinder the delivery of mental health services in community pharmacy were identified. Participant’s perception of a lack of recognition and integration of community pharmacy within primary care were identified as major barriers, in addition to consumers’ stigma and lack of awareness regarding service offering. Suggestions for improvement to mental health care delivery in community pharmacy included standardised practice through the use of protocols, remuneration and public awareness. A framework detailing the factors moderating pharmacists, pharmacy staff and consumers’ empowerment in mental health care delivery in community pharmacy is proposed. This study has highlighted that policy and funding support for mental health services is needed that complement and expand integrated models, promote access to services led by or are conducted in collaboration with pharmacists and recognise the professional contribution and competencies of community pharmacists in mental health care. The framework proposed may be a step to strengthening mental health support delivered in community pharmacies.
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Bell IH, Thompson A, Valentine L, Adams S, Alvarez-Jimenez M, Nicholas J. Ownership, Use of, and Interest in Digital Mental Health Technologies Among Clinicians and Young People Across a Spectrum of Clinical Care Needs: Cross-sectional Survey. JMIR Ment Health 2022; 9:e30716. [PMID: 35544295 PMCID: PMC9133993 DOI: 10.2196/30716] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/14/2021] [Accepted: 12/22/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There is currently an increased interest in and acceptance of technology-enabled mental health care. To adequately harness this opportunity, it is critical that the design and development of digital mental health technologies be informed by the needs and preferences of end users. Despite young people and clinicians being the predominant users of such technologies, few studies have examined their perspectives on different digital mental health technologies. OBJECTIVE This study aims to understand the technologies that young people have access to and use in their everyday lives and what applications of these technologies they are interested in to support their mental health. The study also explores the technologies that youth mental health clinicians currently use within their practice and what applications of these technologies they are interested in to support their clients' mental health. METHODS Youth mental health service users (aged 12-25 years) from both primary and specialist services, young people from the general population (aged 16-25 years), and youth mental health clinicians completed a web-based survey exploring technology ownership, use of, and interest levels in using different digital interventions to support their mental health or that of their clients. RESULTS A total of 588 young people and 73 youth mental health clinicians completed the survey. Smartphone ownership or private access among young people within mental health services and the general population was universal (611/617, 99%), with high levels of access to computers and social media. Youth technology use was frequent, with 63.3% (387/611) using smartphones several times an hour. Clinicians reported using smartphones (61/76, 80%) and video chat (69/76, 91%) commonly in clinical practice and found them to be helpful. Approximately 50% (296/609) of the young people used mental health apps, which was significantly less than the clinicians (χ23=28.8, n=670; P<.001). Similarly, clinicians were significantly more interested in using technology for mental health support than young people (H3=55.90; P<.001), with 100% (73/73) of clinicians being at least slightly interested in technology to support mental health compared with 88% (520/591) of young people. Follow-up tests revealed no difference in interest between young people from the general population, primary mental health services, and specialist mental health services (all P>.23). Young people were most interested in web-based self-help, mobile self-help, and blended therapy. CONCLUSIONS Technology access is pervasive among young people within and outside of youth mental health services; clinicians are already using technology to support clinical care, and there is widespread interest in digital mental health technologies among these groups of end users. These findings provide important insights into the perspectives of young people and clinicians regarding the value of digital mental health interventions in supporting youth mental health.
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Affiliation(s)
- Imogen H Bell
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Andrew Thompson
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Lee Valentine
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | | | - Mario Alvarez-Jimenez
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Jennifer Nicholas
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
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Ross JA, Malone PK, Levy S. The Impact of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Substance Use in the United States. Clin Infect Dis 2022; 75:S81-S85. [PMID: 35476024 PMCID: PMC9129126 DOI: 10.1093/cid/ciac311] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The SARS-CoV-2 pandemic has been associated with dramatic increases in substance use, as marked by increased alcohol, nicotine, and cannabis sales. Lethal opioid overdoses also increased dramatically, especially during the initial phases of the epidemic when lockdowns and social isolation combined with increasing fentanyl contamination of the illicit drug supply resulted in more overdoses and fewer opportunities for rescue. Substance use, and especially inhalational drug use, increases the likelihood of both transmission and severe infection. Youth are especially vulnerable to substance use and have increased risk of long-term problems. These outcomes highlight the need for greater access to substance use treatment. Virtual treatment, which emerged as a promising format during the pandemic, may reduce access barriers. This article reviews trends in substance use during the pandemic, explores root causes of increased use and overdose, and examines the potential to increase treatment through virtual care, especially during future periods of disruption.
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Affiliation(s)
- Jennifer A. Ross
- Adolescent Substance Use and Addiction Program, Boston Children’s Hospital, Boston, MA 02115,Corresponding author: Jennifer A. Ross, 300 Longwood Avenue, Mailstop 3393, Boston, MA 02115
| | - Patrice K. Malone
- Department of Psychiatry, Columbia University Irving Medical Center, New York City, New York, 10032
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children’s Hospital, Boston, MA 02115; Harvard Medical School, Boston, MA, 02115
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