Integrating technology in mental healthcare practice: A repeated cross-sectional survey study on professionals’ adoption of Digital Mental Health before and during COVID-19

Abstract

As a consequence of the outbreak of the COVID-19 global pandemic in the spring of 2020, large-scale social distancing measures were implemented, resulting in the forced adoption of online or digital forms of psychological treatment. This sudden transition to digital care offered a unique opportunity to investigate if and how this experience impacted mental healthcare professionals’ perceptions and use of Digital Mental Health tools. The current paper presents findings of a repeated cross-sectional study consisting of three iterations of a national online survey in the Netherlands. This survey contained open and closed questions on professionals’ adoption readiness, frequency of use, perceived competency, and perceived value of Digital Mental Health collected in 2019 (before the pandemic), in 2020 (after the first wave), and in 2021 (after the second wave). The inclusion of data gathered prior to the COVID-19 pandemic offers a unique window to assess how professionals’ adoption has developed through this transition from voluntary to mandatory use of Digital Mental Health tools. Our study also re-assesses the drivers, barriers, and needs of mental healthcare professionals after having gained experience with Digital Mental Health. In total, 1,039 practitioners completed the surveys (Survey 1: n = 432, Survey 2: n = 363, and Survey 3: n = 244). Results indicate that compared to the period before the pandemic, there was a particularly large increase in use, competency, and perceived value regarding videoconferencing. Small differences were also found for some other basic tools that were crucial to ensure the continuation of care, such as e-mail, text messaging, and online screening, but not for more innovative technologies, such as virtual reality and biofeedback. Many practitioners reported to have gained skills regarding Digital Mental Health and experienced several benefits of it. They expressed the intention to continue with a blended approach, using Digital Mental Health tools in combination with face-to-face care, focused on situations in which they found it to have specific added value, such as when clients are unable to travel. Others were less satisfied with the technology-mediated interactions and remained more reluctant to future use of DMH. Implications for broader implementation of Digital Mental Health and future research are discussed.

Clinicians’ and Users’ Views and Experiences of a Tele-Mental Health Service Implemented Alongside the Public Mental Health System during the COVID-19 Pandemic

“…The clinicians in this study indicated that TMH was most useful when used in combination with face-to-face interactions and for the continuity of care and maintenance of recovery. The role and usefulness of TMH as an adjunct to face-to-face care have also been reported by other authors [45][46][47].…”

Interpersonal Neural Synchrony and Mental Disorders: Unlocking Potential Pathways for Clinical Interventions

“…For example, it may help to increase interpersonal synchrony in a therapeutic setting (Fiskum, 2019) or promote empathy and social entrainment between two people (Tennant et al, 2019). Besides heart rate variability, skin conductance has been used to provide (simulated) dyadic feedback (Feijt et al, 2020) and other studies have provided ANS-based biofeedback based on breathing rhythm (Järvelä et al, 2019;Stepanova et al, 2020;Salminen et al, 2022). Popular feedback modalities in this context are pure visual (Feijt et al, 2020), or auditory feedback (Tennant et al, 2019) as well as a multisensorial approach via virtual realities (Järvelä et al, 2019;Stepanova et al, 2020;Salminen et al, 2022).…”

Guidelines for the Provision of Remote Psychological Services

“…A recent study (Feijt et al, 2023) added that the forced use of digital technologies to deliver fully remote psychological services during the COVID-19 pandemic positively changed the perception of psychologists about digital mental health but did not change their perception of proficiency and/or readiness to use it. Despite the increase in the use and perceived value of digital technologies for the provision of psychological services, most psychologists reported the intention to use it in a blended approach (Feijt et al, 2023). Another study (Mendes-Santos et al, 2022) points in the same direction, with mental healthcare professionals increasing the use of digital technologies to provide remote services, although considering that the absence of validated interventions and structured training programs, among others, limits their adoption of this modality in their daily practice.…”

“…This aspect might have contributed to the disruption most countries reported in mental health services (World Health Organization, 2020; 2021). Furthermore, although most psychologists resorted to digital technologies to provide fully remote mental health services during COVID-19 lockdowns, the lack of knowledge and training on using digital technologies for clinical purposes inhibited their sustained adoption post-confinement (Dores et al, 2020; Feijt et al, 2023). Psychologists reported technological (i.e., more related to the interaction between the professional and the technical devices), clinical (i.e., limitations in approaching some topics therapeutically), safety, and privacy-related concerns, and underlined the importance of accessing clear guidelines on the provision of remote psychology services to pursue such a practice (Dores et al, 2020; Mendes-Santos et al, 2022).…”

“…Psychologists reported technological (i.e., more related to the interaction between the professional and the technical devices), clinical (i.e., limitations in approaching some topics therapeutically), safety, and privacy-related concerns, and underlined the importance of accessing clear guidelines on the provision of remote psychology services to pursue such a practice (Dores et al, 2020; Mendes-Santos et al, 2022). A recent study (Feijt et al, 2023) added that the forced use of digital technologies to deliver fully remote psychological services during the COVID-19 pandemic positively changed the perception of psychologists about digital mental health but did not change their perception of proficiency and/or readiness to use it. Despite the increase in the use and perceived value of digital technologies for the provision of psychological services, most psychologists reported the intention to use it in a blended approach (Feijt et al, 2023).…”