Is telepsychiatry care a realistic option for community mental health services during the COVID-19 pandemic?

Zulfic, Zlatan; Liu, Dennis; Lloyd, Cynthia B.; Rowan, Jacqueline; Schubert, Klaus Oliver

doi:10.1177/0004867420937788

Cited by 22 publications

(25 citation statements)

References 3 publications

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“…Best practices are already in place [ 3 ], and there is a supportive evidence base for telepsychiatry [ 4 - 6 ], particularly for web-based therapy for depression [ 7 ] and posttraumatic stress disorder [ 8 ]. However, the forced adoption of and mass transition to telehealth during the COVID-19 pandemic has resulted in significant challenges for the implementation of telehealth for psychiatric services [ 9 , 10 ]. While guidelines exist for postpandemic telepsychiatry [ 11 , 12 ], given the unique characteristics of this COVID-19 pandemic, lessons learned from these transitions as well as implementation-specific guidelines would be highly applicable to other practices.…”

Section: Introductionmentioning

confidence: 99%

“…While guidelines exist for postpandemic telepsychiatry [ 11 , 12 ], given the unique characteristics of this COVID-19 pandemic, lessons learned from these transitions as well as implementation-specific guidelines would be highly applicable to other practices. To date, clinical implementations and lessons learned (and with largely positive results) have been reported largely from settings outside the United States, such as China [ 13 , 14 ], Europe [ 15 - 23 ], Turkey [ 24 ], and Australia [ 10 , 25 - 28 ], with only some US coverage (notably [ 9 ], [ 29 ], and [ 30 ]). In this paper, we document our experience with telehealth adoption at a psychiatry practice embedded in a large health system in the United States and summarize several important successful improvisations and challenges to support broader and more diverse adoption efforts.…”

Section: Introductionmentioning

confidence: 99%

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Adapting an Outpatient Psychiatric Clinic to Telehealth During the COVID-19 Pandemic: A Practice Perspective

Sasangohar¹,

Bradshaw²,

Carlson³

et al. 2020

J Med Internet Res

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As the demand for telepsychiatry increases during the COVID-19 pandemic, the strengths and challenges of telepsychiatry implementation must be articulated to improve clinical practices in the long term. Currently, observations within US contexts are lacking; therefore, we report on the rapid implementation of telepsychiatry and workflow experiences in a psychiatric practice based within a large health care system in southeast Texas with a national catchment area. We discuss the logistics of the implementation, including modes of communication, scheduling, coordination, and capacity; the psychological effects of web-based services, including both the loss of the physical therapeutic environment and the unique interpersonal dynamics experienced in the virtual environment; and postadoption patterns of engagement with our services and with other clinical functions affected by the rapid adaptation to telemedicine. Our art therapy group programming serves as an applied case study, demonstrating the value of a well-managed web-based program (eg, patients were receptive and well-engaged, and they appreciated the continuity of accessible service) as well as the challenges (eg, the need for backup plans and technological fallbacks, managing interruptions and telecommunication learning curves, and working around the difference in resources for art and music therapy between a well-stocked clinical setting versus clients’ home spaces). We conclude from our experience that the overall strengths of telepsychiatry include receptive and well-engaged responses from patients as well as the expansion of boundaries, which provides a directly contextualized view into patients’ home lives. Challenges and corresponding recommendations include the need for more careful safety planning for high-risk patients; maintaining professional boundaries in the newly informal virtual setting; designing the physical space to both frame the patient encounter and maintain work-life balance for the therapist; allowing for delays and interruptions (including an initial acclimation session); and preserving interprofessional care team collaboration when the physical locations that normally facilitate such encounters are not accessible. We believe that careful observations of the strengths and challenges of telepsychiatry during this pandemic will better inform practices that are considering telepsychiatry adoption both within pandemic contexts and more broadly thereafter.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Adapting an Outpatient Psychiatric Clinic to Telehealth During the COVID-19 Pandemic: A Practice Perspective

Sasangohar¹,

Bradshaw²,

Carlson³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Although the use of phone-based methods in psychological counseling and crisis intervention has a long history, especially for some targets as suicidal crisis ( Lester, 1977 ), and its specificity has been widely examined ( Lester and Rogers(eds), 2012 ), its potential in managing psychosocial stress following community trauma exposure has not been consistently reported or investigated ( Watson and Hamblen, 2017 ), especially for global-scale phenomena such as the COVID-19 pandemic. Indeed, the current pandemic scenario invigorated the interest ( Zulfic et al, 2020 ) for the more general issue of telepsychology ( American Psychological Association, 2013 ), in which it is possible to include phone-based psychological support.…”

Section: Contextmentioning

confidence: 99%

Psychological Support to the Community During the COVID-19 Pandemic: Field Experience in Reggio Emilia, Northern Italy

et al. 2020

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We report the field experience of the psychological staff of Azienda USL-IRCCS di Reggio Emilia, a local health system conglomerate serving half a million inhabitants within a catchment area of the Emilia Romagna Region of Italy, during the coronavirus (COVID-19) pandemic. We provided free telephone-based psychological support for the community, with the specific aim of reducing stress caused by the COVID-19 pandemic and its consequences, such as quarantine and lock-down. We describe how the community used this opportunity of psychological support in terms of problems reported and interventions provided. Our field experience suggests that a service of phone psychological support is feasible and quickly implementable in the case of sudden emergencies that affect, to different extents, the whole community.

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“…Best practices are already in place [3], and there is a supportive evidence base for telepsychiatry [4][5][6], particularly for web-based therapy for depression [7] and posttraumatic stress disorder [8]. However, the forced adoption of and mass transition to telehealth during the COVID-19 pandemic has resulted in significant challenges for the implementation of telehealth for psychiatric services [9,10]. While guidelines exist for postpandemic telepsychiatry [11,12], given the unique characteristics of this COVID-19 pandemic, lessons learned from these transitions as well as implementation-specific guidelines would be highly applicable to other practices.…”

Section: Introductionmentioning

confidence: 99%

Adapting an Outpatient Psychiatric Clinic to Telehealth During the COVID-19 Pandemic: A Practice Perspective (Preprint)

Sasangohar¹,

Bradshaw²,

Carlson³

et al. 2020

Preprint

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UNSTRUCTURED As the demand for telepsychiatry increases during COVID-19, articulating strengths and challenges of telepsychiatry implementation are needed to improve clinical practices long-term. Currently, observations within United States contexts are lacking; therefore, we report on the rapid implementation and workflow experiences as a psychiatric practice based within a large healthcare system in Southeast Texas with a national catchment area. We discuss implementation logistics including modes of communication, scheduling, coordination, and capacity; psychological effects of online services, including both the loss of the physical therapeutic environment as well as unique interpersonal dynamics experienced in the virtual environment; and post-adoption patterns of engagement in our services and other clinical functions affected by the rapid adaptation to telemedicine. Our art therapy group programming serves as an applied case study, demonstrating the value of a well-managed online program (e.g., patients were receptive, well-engaged, and appreciated the continuity of accessible service) as well as the challenges (e.g., the need for backup plans and technological fallbacks, managing interruptions and telecommunications learning curves, and working around the difference in resources for art and music therapy between a well-stocked clinical setting versus clients’ home spaces). Overall, we conclude from our experience that overall strengths of telepsychiatry include surprisingly receptive and well-engaged response from patients, and the expansion of boundaries allowing for a directly contextualized view into patients’ home lives. Challenges and corresponding recommendations include the need for more careful safety planning for high risk patients, maintaining professional boundaries in the newly informal virtual setting, designing the physical space both to frame the patient encounter and to maintain work-life balance for the therapist, allowing for delays and interruptions (including an initial acclimation session), and preserving interprofessional care team collaboration when the physical hallways normally facilitating such encounters are absent. We believe careful observations on strengths and challenges of telepsychiatry during this pandemic will better inform practices considering telepsychiatry adoption both within pandemic contexts and more broadly thereafter.

show abstract

Is telepsychiatry care a realistic option for community mental health services during the COVID-19 pandemic?

Cited by 22 publications

References 3 publications

Adapting an Outpatient Psychiatric Clinic to Telehealth During the COVID-19 Pandemic: A Practice Perspective

Adapting an Outpatient Psychiatric Clinic to Telehealth During the COVID-19 Pandemic: A Practice Perspective

Psychological Support to the Community During the COVID-19 Pandemic: Field Experience in Reggio Emilia, Northern Italy

Adapting an Outpatient Psychiatric Clinic to Telehealth During the COVID-19 Pandemic: A Practice Perspective (Preprint)

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