Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts

Hong, James S W; Sheriff, Rebecca Syed; Smith, Katharine; Tomlinson, Anneka; Saad, Fathi; Smith, Tanya; Engelthaler, Tomas; Phiri, Peter; Henshall, Catherine; Ede, Roger; Denis, Mike; Mitter, Pamina; D’Agostino, Armando; Cerveri, Giancarlo; Tomassi, Simona; Rathod, Shanaya; Broughton, Nick; Marlowe, Karl; Geddes, John; Cipriani, Andrea

doi:10.1136/ebmental-2021-300287

Cited by 27 publications

(28 citation statements)

References 30 publications

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“…Finally, the study took place just before the outbreak of the COVID-19 pandemic in Israel and the questionnaires were completed before or at the very beginning of the COVID-19 era. The pandemic resulted in rapid assimilation of telemedicine and telepsychiatry in the world including in Israel ( 39 – 41 ), with higher odds of attending and completing treatment than FTF during this period ( 42 , 43 ). Mental health providers reported satisfaction with electronic health services ( 44 ), patients received telepsychiatry well as a solution for emergency situations when FTF meetings were not possible ( 45 ), and in a US study most patients said they would consider it in the future ( 46 ).…”

Section: Discussionmentioning

confidence: 99%

The Attitudes and Perceptions of Israeli Psychiatrists Toward Telepsychiatry and Their Behavioral Intention to Use Telepsychiatry

2022

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BackgroundAlthough telemedicine care has grown in recent years, telepsychiatry is growing at a slower pace than expected, because service providers often hamper the assimilation and expansion of telepsychiatry due their attitudes and perceptions. The unified theory of acceptance and use of technology (UTAUT) is a model that was developed to assess the factors influencing the assimilation of a new technology. We used the UTAUT model to examine the associations between the attitudes and perceptions of psychiatrists in Israel toward telepsychiatry and their intention to use it.MethodsAn online, close-ended questionnaire based on a modified UTAUT model was distributed among psychiatrists in Israel. Seventy-six questionnaires were completed and statistically analyzed.ResultsThe behavioral intention of Israeli psychiatrists to use telepsychiatry was relatively low, despite their perceptions of themselves as capable of high performance with low effort. Nonetheless, they were interested in using telepsychiatry voluntarily. Experience in telepsychiatry, and to a lesser extent, facilitating conditions, were found to be positively correlated with the intention to use telepsychiatry. Psychiatrists have a positive attitude toward treating patients by telepsychiatry and perceive its risk as moderate.DiscussionDespite high performance expectancy, low effort expectancy, low perceived risk, largely positive attitudes, high voluntariness, and the expectancy for facilitating conditions, the intention to use telepsychiatry was rather low. This result is explained by the low level of experience, which plays a pivotal role. We recommend promoting the facilitating conditions that affect the continued use of telepsychiatry when initiating its implementation, and conclude that it is critical to create a sense of success during the initial stages of experience.

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Section: Discussionmentioning

confidence: 99%

The Attitudes and Perceptions of Israeli Psychiatrists Toward Telepsychiatry and Their Behavioral Intention to Use Telepsychiatry

2022

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“…The latter are unlikely to explain all the reduction. For example, a recent study on mental health and telepsychiatry showed that the rapid shift to remote service delivery has not reached some groups of patients (in particular patients with dementia and mild cognitive impairment) who may require more tailored management 24 . Dementia was not widely represented in our results, perhaps being covered by a range of CTv3 codes; we will conduct further research on the impacts of COVID on dementia in primary care to capture this fully.…”

Section: Mental Healthmentioning

confidence: 99%

OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care activity across six clinical areas during the COVID-19 pandemic

Curtis

MacKenna

Wiedemann

et al. 2022

Preprint

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Background The COVID-19 pandemic has disrupted healthcare activity across a broad range of clinical services. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible. Aims Using routinely collected data, our aim was to describe changes in the volume and variation of coded clinical activity in general practice in: (i) cardiovascular disease, (ii) diabetes, (iii) mental health, (iv) female and reproductive health, (v) screening, and (vi) processes related to medication. Design and setting With the approval of NHS England, we conducted a cohort study of 23.8 million patient records in general practice, in-situ using OpenSAFELY. Methods We selected common primary care activity using CTV3 codes and keyword searches from January 2019 - December 2020, presenting median and deciles of code usage across practices per month. Results We identified substantial and widespread changes in clinical activity in primary care since the onset of the COVID-19 pandemic, with generally good recovery by December 2020. A few exceptions showed poor recovery and warrant further investigation, such as mental health, e.g. "Depression interim review" (median across practices in December 2020 -41.6% compared to December 2019). Conclusions Granular NHS GP data at population-scale can be used to monitor disruptions to healthcare services and guide the development of mitigation strategies. The authors are now developing real-time monitoring dashboards for key measures identified here as well as further studies, using primary care data to monitor and mitigate the indirect health impacts of Covid-19 on the NHS.

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“…At the start of the COVID-19 pandemic, mental health services around the world, along with health services in general, needed to adapt quickly to reduce the risk of infection and transmission while continuing to support those with mental health problems [ 1 ]. However, as identified early in the COVID-19 pandemic by the World Health Organization (WHO), the pandemic went beyond the physical threat to also affect mental health [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Prompted by this, several countries modified national telemedicine regulations to promote its spread [ 16 ]. However, it is unclear whether the apparently rapid transition to TMH observed in many high-income countries [ 1 ] has occurred globally, which services have been affected, and whether this change has been sustained through the different phases of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review

Zangani¹,

Ostinelli²,

Smith³

et al. 2022

JMIR Ment Health

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Background The COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were implemented to continue to safely provide mental health care. However, it is unclear to what extent service provision transitioned to telemental health worldwide. Objective We aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic. Methods We searched systematically for quantitative papers focusing on the impact of the COVID-19 pandemic on mental health services published until April 13, 2021, in the PubMed, Embase, medRxiv, and bioXriv electronic bibliographic databases, using the COVID-19 Open Access Project online platform. The screening process and data extraction were independently completed by at least two authors, and any disagreement was resolved by discussion with a senior member of the team. The findings were summarized narratively in the context of each country’s COVID-19 Stringency Index, which reflects the stringency of a government’s response to COVID-19 restrictions at a specific time. Results Of the identified 24,339 records, 101 papers were included after the screening process. Reports on general services (n=72) showed that several countries’ face-to-face services reduced their activities at the start of the pandemic, with reductions in the total number of delivered visits and with some services forced to close. In contrast, telemental health use rapidly increased in many countries across the world at the beginning of the pandemic (n=55), with almost complete virtualization of general and specialistic care services by the end of the first year. Considering the reported COVID-19 Stringency Index values, the increased use of virtual means seems to correspond to periods when the Stringency Index values were at their highest in several countries. However, due to specific care requirements, telemental health could not be used in certain subgroups of patients, such as those on clozapine or depot treatments and those who continued to need face-to-face visits. Conclusions During the pandemic, mental health services had to adapt quickly in the short term, implementing or increasing the use of telemental health services across the globe. Limited access to digital means, poor digital skills, and patients’ preferences and individual needs may have contributed to differences in implementing and accessing telemental health services during the pandemic. In the long term, a blended approach, combining in-person and virtual modalities, that takes into consideration the needs, preferences, and digital skills of patients may better support the future development of mental health services. It will be required to improve confidence with digital device use, training, and experience in all modalities for both clinicians and service users.

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Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts

Cited by 27 publications

References 30 publications

The Attitudes and Perceptions of Israeli Psychiatrists Toward Telepsychiatry and Their Behavioral Intention to Use Telepsychiatry

The Attitudes and Perceptions of Israeli Psychiatrists Toward Telepsychiatry and Their Behavioral Intention to Use Telepsychiatry

OpenSAFELY NHS Service Restoration Observatory 2: changes in primary care activity across six clinical areas during the COVID-19 pandemic

Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review

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