Mental Health Practitioners’ Immediate Practical Response During the COVID-19 Pandemic: Observational Questionnaire Study

Abstract

Background The COVID-19 pandemic has been associated with increased psychological distress, signaling the need for increased mental health services in the context of stay-at-home policies. Objective This study aims to characterize how mental health practitioners have changed their practices during the pandemic. The authors hypothesize that mental health practitioners would increase tele–mental health services and that certain provider types would be better able to adapt to tele–mental health than others. Methods The study surveyed 903 practitioners, primarily psychologists/doctoral-level (Psych/DL) providers, social workers/master’s-level (SW/ML) providers, and neuropsychologists employed in academic medical centers or private practices. Differences among providers were examined using Bonferroni-adjusted chi-square tests and one-way Bonferroni-adjusted analyses of covariance. Results The majority of the 903 mental health practitioners surveyed rapidly adjusted their practices, predominantly by shifting to tele–mental health appointments (n=729, 80.82%). Whereas 80.44% (n=625) were not using tele–mental health in December 2019, only 22.07% (n=188) were not by late March or early April 2020. Only 2.11% (n=19) reported no COVID-19–related practice adjustments. Two-thirds (596/888, 67.10%) reported providing additional therapeutic services specifically to treat COVID-19–related concerns. Neuropsychologists were less likely and Psych/DL providers and SW/ML providers were more likely than expected to transition to tele–mental health (P<.001). Trainees saw fewer patients (P=.01) and worked remotely more than licensed practitioners (P=.03). Despite lower rates of information technology service access (P<.001), private practice providers reported less difficulty implementing tele–mental health than providers in other settings (P<.001). Overall, the majority (530/889, 59.62%) were interested in continuing to provide tele–mental health services in the future. Conclusions The vast majority of mental health providers in this study made practice adjustments in response to COVID-19, predominantly by rapidly transitioning to tele–mental health services. Although the majority reported providing additional therapeutic services specifically to treat COVID-19–related concerns, only a small subset endorsed offering such services to medical providers. This has implications for future practical directions, as frontline workers may begin to seek mental health treatment related to the pandemic. Despite differences in tele–mental health uptake based on provider characteristics, the majority were interested in continuing to provide such services in the future. This may help to expand clinical services to those in need via tele–mental health beyond the COVID-19 pandemic.

Exploring telemental health practice before, during, and after the COVID-19 pandemic

“…Consistent with recent studies, 18,19 the daily use of mental health providers and the proportion of their caseload treated remotely increased during the pandemic. The proportion of providers who used telemedicine on a daily basis nearly doubled from 17% to 41%.…”

“…Consistent with previous research conducted during the initial phases of the COVID-19 pandemic, 19 telemental health providers in this study expected to use telemedicine services about the same amount once the pandemic ends regardless of their practice type (i.e. small clinic and large healthcare organization).…”

“…18 Moreover, ∼78% of psychologists, social workers, and neuropsychologists have integrated telemental health services into their practices since early April 2020. 19 While the number of telemental health providers has increased since the onset of the COVID-19 pandemic, less is known about the degree to which these providers expect to continue using telemedicine in the future. A study conducted in March and May 2020 during the COVID-19 pandemic found that 75% of US telemental health providers treated only 25% or less of their caseload remotely.…”

“Psychological Antibodies” to Safeguard Frontline Healthcare Warriors Mental Health Against COVID-19 Pandemic-Related Psychopathology

“…Though HCWs would have their Behavioral Immune System continuously active during this pandemic situation (2), excessive workload, the risk of nosocomial transmission, lack of essential resources and specific medical treatment, and frequent encounters with trauma and death have heightened their risk of psychological distress (3) and trauma (4); psychopathology, such as substance use (2); mood disorders, such as insomnia, anxiety, and depression (3); delusional episodes; suicidality (4); and even suicide (5,6). An eventual rise in the need of mental health services by HCWs is probable as these mental health consequences may remain even after the pandemic remits (7,8). As the medical professionals are the most significant assets in countering the pandemic, safeguarding the physically and emotionally exhausted (9) HCWs' mental health becomes significant.…”

Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint

“…By June 2020, in-person health care visits were down by 30% while telehealth visits increased by up to 2013% [ 47 ]. This shift was even more pronounced for mental health services, which saw 70% fewer patients in person while telehealth sessions increased by up to 6558% [ 48 , 49 ].…”