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Guinart D, Marcy P, Hauser M, Dwyer M, Kane JM. Mental Health Care Providers' Attitudes Toward Telepsychiatry: A Systemwide, Multisite Survey During the COVID-19 Pandemic. Psychiatr Serv 2021; 72:704-707. [PMID: 33593104 DOI: 10.1176/appi.ps.202000441] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has forced a rapid transition to telepsychiatry. This study examined the experience and attitudes of mental health care providers toward telehealth. METHODS At 18 centers across the United States, 819 mental health care providers completed an electronic survey about telepsychiatry use and satisfaction. RESULTS Overall, 73% of providers using videoconferencing and 66% using the telephone rated their experience as excellent or good. Flexible scheduling or rescheduling (77%) and timely start (69%) were frequently reported advantages for both modalities. Challenges were related to patients' inability to use conferencing devices (52%), lack of sense of closeness or connection (46%), and technical problems (39%). After the pandemic resolves, 64% of respondents would want to continue using telepsychiatry in at least 25% of their caseload. CONCLUSIONS Telepsychiatry was very well perceived among mental health care providers, and many would like to continue using it. Access to technology and training raises concerns.
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Affiliation(s)
- Daniel Guinart
- Department of Psychiatry Research (Guinart, Kane) and Ambulatory Care Division (Dwyer), Zucker Hillside Hospital, Queens, New York City; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York (Guinart, Kane); Vanguard Research Group, Glen Oaks, New York (Marcy, Hauser)
| | - Patricia Marcy
- Department of Psychiatry Research (Guinart, Kane) and Ambulatory Care Division (Dwyer), Zucker Hillside Hospital, Queens, New York City; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York (Guinart, Kane); Vanguard Research Group, Glen Oaks, New York (Marcy, Hauser)
| | - Marta Hauser
- Department of Psychiatry Research (Guinart, Kane) and Ambulatory Care Division (Dwyer), Zucker Hillside Hospital, Queens, New York City; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York (Guinart, Kane); Vanguard Research Group, Glen Oaks, New York (Marcy, Hauser)
| | - Michael Dwyer
- Department of Psychiatry Research (Guinart, Kane) and Ambulatory Care Division (Dwyer), Zucker Hillside Hospital, Queens, New York City; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York (Guinart, Kane); Vanguard Research Group, Glen Oaks, New York (Marcy, Hauser)
| | - John M Kane
- Department of Psychiatry Research (Guinart, Kane) and Ambulatory Care Division (Dwyer), Zucker Hillside Hospital, Queens, New York City; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York (Guinart, Kane); Vanguard Research Group, Glen Oaks, New York (Marcy, Hauser)
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Connolly SL, Miller CJ, Lindsay JA, Bauer MS. A systematic review of providers’ attitudes toward telemental health via videoconferencing. ACTA ACUST UNITED AC 2020; 27. [PMID: 35966216 PMCID: PMC9367168 DOI: 10.1111/cpsp.12311] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Telemental health conducted via videoconferencing (TMH-V) has the potential to improve access to care, and providers’ attitudes toward this innovation play a crucial role in its uptake. This systematic review examined providers’ attitudes toward TMH-V through the lens of the unified theory of acceptance and use of technology (UTAUT). Findings suggest that providers have positive overall attitudes toward TMH-V despite describing multiple drawbacks. Therefore, the relative advantages of TMH-V, such as its ability to increase access to care, may outweigh its disadvantages, including technological problems, increased hassle, and perceptions of impersonality. Providers’ attitudes may also be related to their degree of prior TMH-V experience, and acceptance may increase with use. Limitations and implications of findings for implementation efforts are discussed.
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Affiliation(s)
- Samantha L. Connolly
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Christopher J. Miller
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jan A. Lindsay
- HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
- Baylor College of Medicine, Houston, Texas
- South Central Mental Illness Research, Education and Clinical Center, Houston, Texas
| | - Mark S. Bauer
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Naskar S, Victor R, Das H, Nath K. Telepsychiatry in India - Where Do We Stand? A Comparative Review between Global and Indian Telepsychiatry Programs. Indian J Psychol Med 2017; 39:223-242. [PMID: 28615754 PMCID: PMC5461830 DOI: 10.4103/0253-7176.207329] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
A wide discrepancy exists in India between the existing mental healthcare repertoire and the alarmingly high burden of individuals requiring immediate attention from requisite mental healthcare services. Providing equitable mental healthcare across a vast country characterized by profound cultural variations and territorial caveats has remained a major public health concern. Against this gloomy backdrop, the emergence of distant communications technology offers solace and optimism as an ingenious approach to bridge the existing gap between clients and mental health professionals. Using inexpensive equipment and basic technical knowhow, telepsychiatry expands the scope of the discipline to distant and hazy suburbs and villages from its urban centers of excellence. The current academic endeavor intends to perform a systematic review of relevant literature from India as well as from other countries. The various models of telepsychiatry-both asynchronous and synchronous models-in practice have been elaborated on with a focus on effectiveness, feasibility and acceptability of this latest modality. A sincere attempt to chronicle the remarkable journey of telepsychiatry in India, beginning in the dawn of the 21st century to the current Indian scenario, has been made. The legal and ethical issues, along with a few words of caution and contemplation, have been briefly touched on. A set of recommendations has been provided with the hope that policy makers and administrators in the domain of mental health may benefit from them. It is anticipated that telepsychiatry will be adequately utilized in India to tackle the raging menace of inadequate mental healthcare services.
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Affiliation(s)
- Subrata Naskar
- Department of Neuropsychiatry, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Robin Victor
- Department of Psychiatry, Silchar Medical College and Hospital, Silchar, Assam, India
| | - Himabrata Das
- Department of Psychiatry, Silchar Medical College and Hospital, Silchar, Assam, India
| | - Kamal Nath
- Department of Psychiatry, Silchar Medical College and Hospital, Silchar, Assam, India
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Hubley S, Lynch SB, Schneck C, Thomas M, Shore J. Review of key telepsychiatry outcomes. World J Psychiatry 2016; 6:269-82. [PMID: 27354970 PMCID: PMC4919267 DOI: 10.5498/wjp.v6.i2.269] [Citation(s) in RCA: 287] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/27/2016] [Accepted: 03/14/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To conduct a review of the telepsychiatry literature. METHODS We conducted a systematic search of the literature on telepsychiatry using the search terms, "telepsychiatry", "telemental health", "telecare", "telemedicine", "e-health", and "videoconferencing". To meet criteria for inclusion, studies had to: (1) be published in a peer-reviewed journal after the year 2000; (2) be written in English; (3) use videoconferencing technology for the provision of mental health assessment or treatment services; and (4) use an adequately-powered randomized controlled trial design in the case of treatment outcome studies. Out of 1976 studies identified by searches in PubMed (Medline database), Ovid medline, PsychInfo, Embase, and EBSCO PSYCH, 452 met inclusion criteria. Studies that met all inclusion criteria were organized into one of six categories: (1) satisfaction; (2) reliability; (3) treatment outcomes; (4) implementation outcomes; (5) cost effectiveness; and (6) and legal issues. All disagreements were resolved by reassessing study characteristics and discussion. RESULTS Overall, patients and providers are generally satisfied with telepsychiatry services. Providers, however, tend to express more concerns about the potentially adverse of effects of telepsychiatry on therapeutic rapport. Patients are less likely to endorse such concerns about impaired rapport with their provider. Although few studies appropriately employ non-inferiority designs, the evidence taken together suggests that telepsychiatry is comparable to face-to-face services in terms of reliability of clinical assessments and treatment outcomes. When non-inferiority designs were appropriately used, telepsychiatry performed as well as, if not better than face-to-face delivery of mental health services. Studies using both rudimentary and more sophisticated methods for evaluating cost-effectiveness indicate that telepsychiatry is not more expensive than face-to-face delivery of mental health services and that telepsychiatry is actually more cost-effective in the majority of studies reviewed. Notwithstanding legal concerns about loss of confidentiality and limited capacity to respond to psychiatric emergencies, we uncovered no published reports of these adverse events in the use of telepsychiatry. CONCLUSION A large evidence base supports telepsychiatry as a delivery method for mental health services. Future studies will inform optimal approaches to implementing and sustaining telepsychiatry services.
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Ohinmaa A, Roine R, Hailey D, Kuusimäki ML, Winblad I. The use of videoconferencing for mental health services in Finland. J Telemed Telecare 2008; 14:266-70. [DOI: 10.1258/jtt.2008.071212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts. The overall rate of TMH consultations was 4 per 100,000 population. The highest TMH consultation per population ratio, 22 per 100,000, was in northern Finland. Most of the sites used telepsychiatry services for less than 10% of clinical outpatient services. The sites with over 20% utilization of clinical TMH services from all psychiatric consultations were all rural health centres. Compared with Finland, the utilization rates of TMH were higher in Canada; that might be due to differences between the countries in the organization of mental health services in primary and specialized care. In Finland TMH consultations made up only a very small proportion of all mental health services. The use of TMH was particularly common in remote areas; however, there were many rural centres that did not utilize clinical TMH. TMH was widely utilized for continuing and medical education.
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Affiliation(s)
- Arto Ohinmaa
- Institute of Health Economics, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Risto Roine
- Helsinki and Uusimaa Hospital District, Helsinki, Finland
| | - David Hailey
- Institute of Health Economics, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Ilkka Winblad
- University of Oulu, FinnTelemedicum and Department of Public Health Sciences and General Practice, Oulu, Finland
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