Understanding Mental Health Professionals’ Perspectives and Practices Regarding the Implementation of Digital Mental Health: Qualitative Study

Abstract

Background Despite the potential of digital mental health to provide cost-effective mental health care, its adoption in clinical settings is limited, and little is known about the perspectives and practices of mental health professionals regarding its implementation or the factors influencing these perspectives and practices. Objective This study aims to characterize in depth the perspectives and practices of mental health professionals regarding the implementation of digital mental health and explore the factors affecting such perspectives and practices. Methods A qualitative study using in-depth semistructured interviews with Portuguese mental health professionals (N=13)—psychologists and psychiatrists—was conducted. The transcribed interviews were thematically analyzed. Results Mental health professionals deemed important or engaged in the following practices during the implementation of digital mental health: indication evaluation, therapeutic contract negotiation, digital psychological assessment, technology setup and management, and intervention delivery and follow-up. Low-threshold accessibility and professionals’ perceived duty to provide support to their clients facilitated the implementation of digital mental health. Conversely, the lack of structured intervention frameworks; the unavailability of usable, validated, and affordable technology; and the absence of structured training programs inhibited digital mental health implementation by mental health professionals. Conclusions The publication of practice frameworks, development of evidence-based technology, and delivery of structured training seem key to expediting implementation and encouraging the sustained adoption of digital mental health by mental health professionals.

Guidelines for the Provision of Remote Psychological Services

“…In this recent study (Mendes-Santos et al, 2022), the participants mentioned the importance of setting up the physical space of the room from where the session is occurring considering the flow and confidentiality of the session, the lighting and camera position, and the use of an ethernet cable for connection stability, which is in line with the guidelines presented in this review. Furthermore, both the difficulty and the importance of establishing clear therapeutic boundaries are also mentioned in recent studies (Dores et al, 2020;James et al, 2022;Mendes-Santos et al, 2022;Simpson et al, 2021). The online provision of psychological services demands boundaries to be flexible enough to benefit from the advantages of the remote environment but also stable and clearly stated in a therapeutic contract to avoid transgressions (Simpson et al, 2021).…”

“…Studies have been pointing to these two topics both as difficulties that are reported by psychologists (Dores et al, 2020) and as factors that shall be considered prior to and during remote psychological sessions (Mendes-Santos et al, 2022;Simpson et al, 2021). In this recent study (Mendes-Santos et al, 2022), the participants mentioned the importance of setting up the physical space of the room from where the session is occurring considering the flow and confidentiality of the session, the lighting and camera position, and the use of an ethernet cable for connection stability, which is in line with the guidelines presented in this review. Furthermore, both the difficulty and the importance of establishing clear therapeutic boundaries are also mentioned in recent studies (Dores et al, 2020;James et al, 2022;Mendes-Santos et al, 2022;Simpson et al, 2021).…”

“…Despite the increase in the use and perceived value of digital technologies for the provision of psychological services, most psychologists reported the intention to use it in a blended approach (Feijt et al, 2023). Another study (Mendes-Santos et al, 2022) points in the same direction, with mental healthcare professionals increasing the use of digital technologies to provide remote services, although considering that the absence of validated interventions and structured training programs, among others, limits their adoption of this modality in their daily practice. These reports highlight the need to provide guidelines or training programs that can support mental health professionals' practice when delivering remote psychological services.…”

“…Furthermore, although most psychologists resorted to digital technologies to provide fully remote mental health services during COVID-19 lockdowns, the lack of knowledge and training on using digital technologies for clinical purposes inhibited their sustained adoption post-confinement (Dores et al, 2020; Feijt et al, 2023). Psychologists reported technological (i.e., more related to the interaction between the professional and the technical devices), clinical (i.e., limitations in approaching some topics therapeutically), safety, and privacy-related concerns, and underlined the importance of accessing clear guidelines on the provision of remote psychology services to pursue such a practice (Dores et al, 2020; Mendes-Santos et al, 2022). A recent study (Feijt et al, 2023) added that the forced use of digital technologies to deliver fully remote psychological services during the COVID-19 pandemic positively changed the perception of psychologists about digital mental health but did not change their perception of proficiency and/or readiness to use it.…”

Effectiveness of the virtual psychosocial empowerment program on the quality of life of family caregivers of chronic mental disorders: a quasi-experimental study

“…Looking at the studies mentioned, it can be seen that Internet-based interventions can be as effective as face-to-face interventions (30). Nowadays, using smartphones, while saving time and being cost-effective, can be a great alternative to face-to-face health promotion programs (31).…”