The Impact of COVID-19 on Provider Perceptions of Telemental Health

Abstract

The present study was designed to assess mental health provider attitudes and perceptions of telemental health (TMH) prior to and during the COVID-19 Pandemic, as well as the nature of their TMH utilization. The study aimed to gather information about positive and negative attitudes towards TMH, perceptions and correlates based on the modality of care, and beliefs about the overall effectiveness of TMH as compared to face-to-face care. The current study is part of a larger mixed methods project utilizing a repeated cross-sectional design. An online survey was administered to a sample of 1448 mental health providers and included demographic and professional information, experiences with and perceptions of TMH prior to and during the COVID-19 Pandemic, as well as a brief measure of pandemic-related stress. The COVID-19 Pandemic resulted in an increased use of TMH in the study sample. During COVID-19, providers reported increased agreement with TMH being necessary, important, and effective for care delivery. Providers who primarily used video, compared with telephone, reported that TMH was more useful, satisfying, and effective. While negative attitude towards TMH was predicted only by prior attitudes and belief in TMH effectiveness, positive attitude towards TMH was also predicted by female sex and current level of pandemic related stress. TMH use during the pandemic was predicted by primary use of video platform and previous TMH use. The 2020 COVID-19 Pandemic resulted in increased use of TMH and significantly increased positive perceptions about TMH among mental health providers.

Overcoming Clinician Technophobia: What We Learned from Our Mass Exposure to Telehealth During the COVID-19 Pandemic

“…One study found that only 29% of clinical psychologists used telehealth for a portion of their caseload prior to the pandemic and, within weeks of the pandemic, over 80% of the sample reported using telehealth for nearly their entire caseload (Sammons et al, 2020 ). When faced with the necessity to use telehealth, some evidence suggests clinicians experienced negative feelings including anxiety (Doorn et al, 2021 ; Doran & Lawson, 2021 ). A qualitative study found about a quarter of the sample’s clinicians described an initial negative and pessimistic reaction to their transition to telehealth, citing concerns about the quality of care and the ability to manage complex cases and crisis situations (Hersch et al, 2022 ).…”

“…These conditions provided the opportunity for informal exposure exercises that resulted in adaptive changes in behavior and perspectives. Direct experience with telehealth resulted in reduced negative reactions to telehealth (Doorn et al, 2021 ; Doran & Lawson, 2021 ). Qualitative studies illustrated how clinicians faced their telehealth concerns during the pandemic and committed to behavior change that ultimately enriched the experience of their patients and themselves (Hersch et al, 2022 ; Uscher-Pines et al, 2020 ).…”

“…A large international survey found the majority of mental health clinicians during the pandemic were concerned with technical issues, quality of care, and responding to crises (Montoya et al, 2022 ). Another large survey found about 28% of mental health clinicians had negative feelings about telehealth prior to the pandemic and that these feelings decreased significantly after migrating to telehealth (Doran & Lawson, 2021 ).…”

The Good, The Bad, The Uncertain: Diverse Provider Experiences with Telemental Health During COVID-19

“…As a result of the pandemic, the urgent and rapid adoption of TMH created wide variability across TMH utilization and protocols [1]. Research evaluating the clinical efficacy and feasibility of specific TMH modalities used in clinical care suggests that synchronous video conferencing is preferable to telephone [8][9][10] and is comparable to face-to-face treatment delivery across a wide range of populations, settings, and diagnoses [11][12][13]. However, a recent review of evaluation approaches for TMH programs found that there is inconsistency in assessment methods and no clear gold standard for TMH program measurement [14].…”

Perceptions of Telemental Health Care Delivery During COVID-19: A Cross-Sectional Study With Providers, February-March 2021

“…Some mental health providers’ caseloads increased by 25–50% during the pandemic with patient surges as high as 6,558% ( 1 , 3 ). Telemedicine revolutionized the delivery of evidence-based mental health care ( 4 ), and proved to be a dependable solution that 90% of providers surveyed intend to use beyond the resolution of COVID-19 ( 5 ). It is imperative to understand how mental health providers deliver remote services to inform and sustain post-pandemic TMH care models.…”