Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping

Abstract

Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health).Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges.Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health.Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework.Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations.Systematic Review Registration:https://osf.io/4dxms/.

Telehealth-Supported Decision-making Psychiatric Care for Suicidal Ideation: Longitudinal Observational Study

“…Finally, these results align with a growing body of literature demonstrating the effectiveness of using a telehealth platform for providing mental health services [ 79 - 82 ]. Clinical decision support tools have demonstrated efficacy in depression outcomes in primary care and general practices [ 83 - 85 ].…”

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

“…Because access to in-person treatment and primary care was limited, alternatives for in-person treatment were quickly introduced at the start of the pandemic in order to maintain continuity and accessibility of care [ 64 ]. We refer to ‘online treatment’ as real-time, remote clinical services between healthcare providers and patients, including video-telephony.…”

“…Body image concerns, technological difficulties, and lack of privacy reduced satisfaction with online treatment [ 30 , 32 ]. Those with limited access to online services (e.g., because of unfamiliarity or unavailability) and those living in middle- and low-income countries are currently being overlooked – both in studies and in online treatment options [ 64 , 78 ▪ , 79 ]. None of the studies reported on experiences with online therapy prior to the pandemic.…”

Patient and provider experiences of telemental health during the COVID-19 pandemic in a New York City academic medical center

“…Explorations in factors affecting quality, satisfaction, accessibility, and outcomes have proliferated since the beginning of the pandemic. A recent review on TMH during the COVID-19 pandemic highlighted the challenge of regulations and standard of care, effectiveness, privacy and confidentiality ( Abraham et al, 2021 ). However, the growing consensus is that TMH is a reasonable modality of health care delivery, and that patients and providers are more accepting of TMH since the pandemic.…”