Telemedicine and mental health care of young adults during COVID-19: A qualitative study.

Abstract

To examine barriers and facilitators to mental health care and use of telemedicine for university students during the COVID-19 pandemic. Key informant interviews of mental health clinicians in 1 university addressed the impact of COVID-19 on students' mental health, adoption of telemedicine, and general mental health care. Theoretical thematic analysis identified positive and negative effects on care. Interviews with 6 psychologists and 4 psychiatrists (50% of invitees; 3 men and 7 women) highlighted social isolation and lifestyle restrictions as primary contributors to prevalent mood disorders. Telemedicine offered accessibility, safety, and efficiency but limitations included: technical problems; patient distraction; lack of confidentiality; compromised therapeutic alliance; and management of unstable patients. Lower-income students were described as commonly lacking peer support and an appropriate setting for telemedicine visits. Mental health clinicians described university students as commonly affected by mental health disorders. Telemedicine offered safer, accessible care but, for mental health care, was limited by lack of confidentiality, patient distraction, and care for unstable patients. Lower income patients were especially challenged by less peer support and privacy for telemedicine. Clinical Impact StatementStudy clinicians highlighted negative effects of the COVID-19 pandemic on mental health that required rapid adoption of safe, accessible remote care via telemedicine. Yet for mental health, challenges with telemedicine require innovative strategies to promote patient engagement, foster a therapeutic alliance, and manage unstable patients remotely.

COVID-19 Changes the Nature of Tele-Mental Health: A Scope Review

“…Many participants commented on how tiring intensive concentration during teletherapy can be (McBeath et al, 2020); provider interviews with those who treat college students identified the same issues. Online therapy brings the opportunity to treat such young adults remotely, but technical problems and skills, patient distractions, and a lack of confidentiality challenge both patients and therapists (Turner and Siegel, 2022). Another online qualitative survey with 51 mental health care professionals identified three themes of practitioners' experience with online treatment during Covid 19.…”

Leveraging Mobile Health to Manage Mental Health/Behavioral Health Disorders: Systematic Literature Review

“…Social influence and the stigma associated with mental health care greatly influence this age bracket (18-24 years) and their willingness to answer questions over their mobile devices. Telemedicine offers safety and efficiency, but several limitations prevent wide adoption such as technical problems, patient distraction, lack of confidentiality, compromised therapeutic alliance, and the management of unstable patients through a distance modality [6]. mHealth for an older population has not been entirely successful as well mostly due to the digital divide inherent to older populations and overall digital literacy [14].…”

“…Depression can be described as a mood (sadness or lack of enjoyment), a symptom, a syndrome, or a disorder [ 5 ]. During the COVID-19 pandemic, college students were particularly affected by depression due to the isolation created by the pandemic thrust upon them during a time in their lives when they expected to be highly socially active [ 6 ]. Anxiety often refers to multiple mental and physiological phenomena, including fear, distress, and a constant state of worry over events or actual situations [ 7 ].…”