Opportunities and Challenges for Professionals in Psychiatry and Mental Health Care Using Digital Technologies During the COVID-19 Pandemic: Systematic Review

Abstract

Background The COVID-19 pandemic has required psychiatric and mental health professionals to change their practices to reduce the risk of transmission of SARS-CoV-2, in particular by favoring remote monitoring and assessment via digital technologies. Objective As part of a research project that was cofunded by the French National Research Agency (ARN) and the Centre-Val de Loire Region, the aim of this systematic literature review was to investigate how such uses of digital technologies have been developing. Methods This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was carried out in the MEDLINE (ie, PubMed) and Cairn databases, as well as in a platform specializing in mental health, Ascodocpsy. The search yielded 558 results for the year 2020. After applying inclusion and exclusion criteria, first on titles and abstracts and then on full texts, 61 articles were included. Results The analysis of the literature revealed a heterogeneous integration of digital technologies, not only depending on countries, contexts, and local regulations, but also depending on the modalities of care. Notwithstanding these variations, the use of videoconferencing has developed significantly, affecting working conditions and therapeutic relationships. For many psychiatric and mental health professionals, the pandemic has been an opportunity to build up their experience of remote care and, thus, better identify the possibilities and limits of these digital technologies. Conclusions New uses of such technologies essentially consist of a transition from the classic consultation model toward teleconsultation and make less use of the specific potential of artificial intelligence. As professionals were not prepared for these uses, they were confronted with practical difficulties and ethical questions, such as the place of digital technology in care, confidentiality and protection of personal data, and equity in access to care. The COVID-19 health crisis questions how the organization of health care integrates the possibilities offered by digital technology, in particular to promote the autonomy and empowerment of mental health service users.

Mental Health Mobile Apps in the French App Store: Assessment Study of Functionality and Quality

“…The COVID-19 pandemic has changed the use of digital technology in the field of mental health and, more particularly, by mental health professionals. The pandemic has made it possible to revisit the ways in which the most fragile people are cared for with connected tools and to move toward an evolution of practices [ 64 ]. Mental health apps can improve accessibility to mental health services and be beneficial for mental health [ 32 ].…”

Remote mental health care interventions during the COVID-19 pandemic: An umbrella review

“…Practioners: beliefs, perceptions, knowledge, and self-efficacy in terms of TMH TMH/VMH: lack of technological literacy and experience in providers (Bertuzzi et al, 2021;Cabrera et al, 2020;Narvaez, 2022;Siegel et al, 2021) TMH increases access for young people with mental health problems (destigmatizing) (Keyes et al, 2022) TMH/VMH: concerns about therapeutic relationship/impersonal (Appleton et al, 2021;Kane et al, 2022;Li et al, 2021;Meloni et al, 2020;Selick et al, 2021;Siegel et al, 2021;Thenral & Annamalai, 2020;Tuczyńska et al, 2021) Limitations of TMH/VMH less important in medication consultations compared to psychotherapy (Segenreich, 2022) TMH: reluctance to use because desire for face-to-face or lack of confidence (Ardekani et al, 2021;Baumgart et al, 2021;Narvaez, 2022) TMH: more control over timeschedule (Keyes et al, 2022;Narvaez, 2022) TMH: requires more concentration; screen fatigue (Appleton et al, 2021;Keyes et al, 2022;Siegel et al, 2021) TMH: missing essential psychological cues (Drissi et al, 2021;Siegel et al, 2021) TMH: intercultural communication and language (Keyes et al, 2022) TMH: ethical concerns (Kane et al, 2022) TMH: inadequate information to support diagnosis (Li et al, 2021) TMH/VMH: increases pre-existing health inequalities (Keyes et al, 2022) TMH/VMH: perceived inefficacy (Abraham, Jithesh, et al, 2021) (Devoe et al, 2022) (continued on next page) Baumgart et al, 2021;Murphy et al, 2021;…”

Are we ready for Telepsychiatry? Benefits and challenges of digital psychotherapy

“…A factor significantly influencing the accelerated development of telemedicine services was the COVID-19 pandemic, which limited access to all medical services, not just psychiatric ones. Closure of facilities, and reduction of interpersonal contacts due to the risk of virus transmission forced people to look for new forms of service delivery to maintain the continuity of treatment [14][15][16][17].…”

“…Czynnikiem istotnie wpływającym na przyspieszony rozwój usług telemedycyny była pandemia COVID19, która ograniczyła dostęp do wszystkich usług medycznych, nie tylko psychiatrycznych. Zamknięcie placówek, ograniczenie kontaktów interpersonalnych ze względu na ryzyko transmisji wirusa zmusiło ludzi do poszukiwania nowych form świadczenia usług w celu utrzymania ciągłości terapii [14][15][16][17].…”