Telemental Health in the Context of a Pandemic: the COVID-19 Experience

Whaibeh, Emile; Mahmoud, Hossam; Naal, Hady

doi:10.1007/s40501-020-00210-2

Cited by 170 publications

(177 citation statements)

References 9 publications

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“…Redeployment protocols were established for staff not normally working in inpatient or residential settings. Videoconference and telemedicine facilities within the service were developed, in line with international commentary and recommendations (Whaibeh et al, 2020; Royal College of Psychiatrists). There were some understandable delays in moving towards a telemedicine service, and working from home, as the necessary equipment was not available to all clinicians at the outbreak of the pandemic.…”

Section: Perspective Piecementioning

confidence: 99%

“…On a more optimistic note, there may be some unexpected benefits from COVID-19 in the long term such as an increase in access to telemedicine which could have many potential uses in CMHTs (Whaibeh et al, 2020). Increased governance planning may strengthen team spirit, and if we can harness this in a positive manner, we may be better equipped to deal with any subsequent increase in population mental illness (Xiang et al, 2020).…”

Section: Ongoing Challenges For Cmhtsmentioning

confidence: 99%

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COVID-19 from the perspective of urban and rural general adult mental health services

Lyne

Roche

Kamali

et al. 2020

Ir. j. psychol. Med.

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COVID-19 has presented society with one of the greatest challenges in living memory. Community Mental Health Teams (CMHTs)have needed to adapt quickly to a rapidly developing situation which has had a dramatic impact on society. In this piece, we describe some of the early challenges for CMHTs within two mental health services based in Dublin and Wicklow. We also discuss ongoing developments and anticipate the need for further vigilance as the COVID-19 pandemic continues to evolve.

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Section: Perspective Piecementioning

confidence: 99%

Section: Ongoing Challenges For Cmhtsmentioning

confidence: 99%

COVID-19 from the perspective of urban and rural general adult mental health services

Lyne

Roche

Kamali

et al. 2020

Ir. j. psychol. Med.

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“…Telemental health services have strong potential in overcoming traditional barriers to mental health service use such as transportation challenges, unequal distribution of specialists among others, and may enhance access to services (Naal et al, 2020). Importantly, considering the mobility restrictions brought forth by the COVID-19, telemental health adheres to the social distancing requirements, and enables access to mental health services for remote and underserved populations (Whaibeh et al, 2020). PHCs in Lebanon are usually equipped with the minimally required technological hardware and software needed for that, they tend to have minimally available specialized mental health care services, and their catchment areas tend to reach rural and underserved populations (Hemadeh et al, 2020).…”

Section: Recommendations and Implicationsmentioning

confidence: 99%

Prevalence of Depression Symptoms and Associated Sociodemographic and Clinical Correlates Among Syrian Refugees in Lebanon

Naal

Nabulsi

Arnaout

et al. 2020

Preprint

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Background: Since the outbreak of the Syrian war in 2011, close to 6 million Syrian refugees have escaped to Syria’s neighbouring countries, including Lebanon. Evidence suggests rising levels of mental health disorders among Syrian refugee populations. Yet, to the best of our knowledge, large-scale studies addressing the mental health of adult Syrian refugees in Lebanon are lacking. Aims: We examined the prevalence of depression symptoms, which represent a common and debilitating mental health disorder among Syrian refugee populations in Lebanon, along with their sociodemographic and clinical correlates.Methods: A cross-sectional survey design was conducted as part of a collaborative project-“Sijilli”- led by the Global Health Institute at the American University of Beirut (Beirut, Lebanon) across 4 informal tented settlements for refugees (Beirut, Bekaa, North, South) in Lebanon among adult Syrian refugees (≥18), over a period extending from 2018 to 2020. The survey inquired about participants’ sociodemographic and clinical characteristics, and screened participants for symptoms of depression through sequential methodology using the Patient Health Questionnaire (PHQ-2 and PHQ-9). Results: A total of 3255 adult Syrian refugees were enrolled in the study. Of those refugees, only 51.6% (n=1678) screened positive on the PHQ-2 and were therefore eligible to complete the PHQ-9. The PHQ-9 analysis revealed high prevalence (25%) of moderate to severe depression in the total sample, suggestive of high probability for major depression disorder (MDD). Further analyses indicate that being ≥45 years of age (OR 1.70, 95% CI 1.22-2.36), a woman (OR 1.35, 95% CI 1.07-1.69), divorced/separated (OR 3.32, 95% CI 1.57-7.01), reporting a neurological (OR 1.77, 95% CI 1.20-2.61) or a mental health condition (OR 5.30, 95% CI 2.40-11.66) are major risk factors for MDD.Conclusion: Our study suggests that one in four Syrian refugees in Lebanon have probable MDD, and our findings have important public health and clinical implications on refugee health. There is a need to enhance screening efforts, to improve access and referral to mental health services, and to improve post-migration factors among Syrian refugees in Lebanon.

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“…[8] To further promote telehealth in the COVID-19 era, throughout March and April of 2020 federal and state policies have been altered to remove or ease geographic restrictions and other regulatory barriers to telehealth visits. [10] Telehealth is well-suited for use during pandemics as clinicians can provide care and consultation to isolated populations and counter the surge in demand for medical care while using telehealth as a form of electronic personal protective equipment. [9,11,12,13] Telehealth in the COVID-19 era is, thus, theorized as a useful strategy in "forward triage," the sorting of patients prior to their arrival in the emergency department [13,14] and as a means to provide patient guidance and reassurance [11].…”

Section: Introductionmentioning

confidence: 99%

On the Front (Phone) Lines: Results of a COVID-19 Hotline in Northeast Ohio

Margolius

Hennekes

Yao

et al. 2020

Preprint

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medRxiv preprint Key PointsQuestion: What is the feasibility and effectiveness of physician telehealth services during a pandemic?Findings: In this cohort study of a COVID-19 telehealth hotline that included 10,112 callers and 4,213 physician telehealth visits, most patients (79%) were advised to self-isolate at home, 14% were found unlikely to have COVID-19, 4% dispositions (e.g. testing or office visit) and 3% were advised to immediately seek care emergency department. 83% of patients who were advised to stay home did not require in-person visits.Meaning: Physician-directed telehealth services conserve scarce resources and provide effective, equitable care during a pandemic without compromising patient safety.ABSTRACT Importance: Severe acute respiratory syndrome coronavirus (SARS-CoV-2) and the associated coronavirus disease of 2019 (COVID-19) have presented immense challenges for health care systems. Many regions have struggled to adapt to disruptions to health care practice and employ systems that effectively manage the demand for services.Objective: To examine the effectiveness of the first five weeks' of a 24/7 physician-staffed COVID-19 hotline.Design: Cohort study using electronic health records.Setting: A single large health care system in Northeast Ohio.Participants: During 5 weeks of operation, 10,112 patients called the hotline (callers) and were evaluated by a registered nurse (RN) using standardized protocols. Of these, 4,213 (42%) were referred for a physician telehealth visit (telehealth patients). The mean age of callers was 42 years. 67% were female, 51% white, and 46% were on Medicaid or uninsured.Intervention: Physician telehealth visits for COVID-19. Main Outcomes and Measures:We describe clinical diagnosis, patient characteristics (age, sex race/ethnicity, smoking status, insurance status), and visit disposition. We use logistic regression to evaluate associations between patient characteristics, visit disposition and subsequent emergency department use, hospitalization, and SARS-Cov-2 PCR testing. Results:Common caller concerns included cough, fever, and shortness of breath. Most telehealth patients (79%) were advised to self-isolate at home, 14% were determined to be unlikely to have COVID-19, 3% were advised to seek emergency care, and 4% had miscellaneous other dispositions. A total of 287 (7%) patients had a subsequent ED visit, and 44 (1%) were hospitalized with a COVID-19 diagnosis. Of the callers, 482 (5%) had a COVID-19 test reported with 69 (14%) testing positive. Among patients advised to stay at home, 83% had no further face-to-face visits. In multivariable results, only a physician recommendation to seek emergency care was associated with emergency room use (OR=4.73, 95%CI 1.37-16.39, p=.014). Only older age was associated with having a positive test result. Conclusions and Relevance:Robust, physician-directed telehealth services can meet a wide range of needs during the acute phase of a pandemic, conserving scarce resources such as personal protective equipment and testing sup...

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Telemental Health in the Context of a Pandemic: the COVID-19 Experience

Cited by 170 publications

References 9 publications

COVID-19 from the perspective of urban and rural general adult mental health services

COVID-19 from the perspective of urban and rural general adult mental health services

Prevalence of Depression Symptoms and Associated Sociodemographic and Clinical Correlates Among Syrian Refugees in Lebanon

On the Front (Phone) Lines: Results of a COVID-19 Hotline in Northeast Ohio

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