Implementation, Adoption, and Perceptions of Telemental Health during the COVID-19 Pandemic: Systematic Review

Rebecca Appleton; Julie Williams; Norha Vera San Juan; Justin J. Needle; Merle Schlief; Harriet Jordan; Luke Sheridan Rains; Lucy Goulding; Monika Badhan; Emily Roxburgh; Phoebe Barnett; Spyros Spyridonidis; Magdalena Tomaskova; Jiping Mo; Jasmine Harju-Seppänen; Zoë Haime; Cecilia Casetta; Alexandra Papamichail; Brynmor Lloyd-Evans; Alan Simpson; Nick Sevdalis; Fiona Gaughran; Sonia Johnson

doi:10.2196/31746

Implementation, Adoption, and Perceptions of Telemental Health during the COVID-19 Pandemic: Systematic Review

Rebecca Appleton^*, Julie Williams, Norha Vera San Juan, Justin J. Needle, Merle Schlief, Harriet Jordan, Luke Sheridan Rains, Lucy Goulding, Monika Badhan, Emily Roxburgh, Phoebe Barnett, Spyros Spyridonidis, Magdalena Tomaskova, Jiping Mo, Jasmine Harju-Seppänen, Zoë Haime, Cecilia Casetta, Alexandra Papamichail, Brynmor Lloyd-Evans, Alan SimpsonNick Sevdalis, Fiona Gaughran, Sonia Johnson

^*Corresponding author for this work

Research output: Contribution to journal › Literature review › peer-review

102 Citations (Scopus)

54 Downloads (Pure)

Abstract

Background: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health and to debates on its future use in routine mental health care. Objective: To investigate the adoption and impacts of telemental health approaches during the COVID-19 pandemic, and facilitators and barriers to optimal implementation. Methods: Four databases (PubMed, PsycINFO, CINAHL, and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesized using framework synthesis. Results: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. Conclusions: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these.

Original language	English
Article number	e31746
Journal	Journal of Medical Internet Research
Volume	23
Issue number	12
DOIs	https://doi.org/10.2196/31746
Publication status	Published - Dec 2021

Keywords

COVID-19
Mental health
Remote care
Systematic review, implementation science
Telemedicine
Telemental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Appleton, R., Williams, J., Juan, N. V. S., Needle, J. J., Schlief, M., Jordan, H., Rains, L. S., Goulding, L., Badhan, M., Roxburgh, E., Barnett, P., Spyridonidis, S., Tomaskova, M., Mo, J., Harju-Seppänen, J., Haime, Z., Casetta, C., Papamichail, A., Lloyd-Evans, B., ... Johnson, S. (2021). Implementation, Adoption, and Perceptions of Telemental Health during the COVID-19 Pandemic: Systematic Review. Journal of Medical Internet Research, 23(12), Article e31746. https://doi.org/10.2196/31746

@article{abb788ad16ba4347957bc61ab3da8381,

title = "Implementation, Adoption, and Perceptions of Telemental Health during the COVID-19 Pandemic: Systematic Review",

abstract = "Background: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health and to debates on its future use in routine mental health care. Objective: To investigate the adoption and impacts of telemental health approaches during the COVID-19 pandemic, and facilitators and barriers to optimal implementation. Methods: Four databases (PubMed, PsycINFO, CINAHL, and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesized using framework synthesis. Results: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. Conclusions: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these.",

keywords = "COVID-19, Mental health, Remote care, Systematic review, implementation science, Telemedicine, Telemental health",

author = "Rebecca Appleton and Julie Williams and Juan, {Norha Vera San} and Needle, {Justin J.} and Merle Schlief and Harriet Jordan and Rains, {Luke Sheridan} and Lucy Goulding and Monika Badhan and Emily Roxburgh and Phoebe Barnett and Spyros Spyridonidis and Magdalena Tomaskova and Jiping Mo and Jasmine Harju-Sepp{\"a}nen and Zo{\"e} Haime and Cecilia Casetta and Alexandra Papamichail and Brynmor Lloyd-Evans and Alan Simpson and Nick Sevdalis and Fiona Gaughran and Sonia Johnson",

note = "Funding Information: This study is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King{\textquoteright}s College Hospital NHS Foundation Trust. NS and LG are members of King{\textquoteright}s Improvement Science, which offers co-funding to the NIHR ARC South London and is funded by King{\textquoteright}s Health Partners (Guy{\textquoteright}s and St Thomas{\textquoteright} NHS Foundation Trust, King{\textquoteright}s College Hospital NHS Foundation Trust, King{\textquoteright}s College London and South London and Maudsley NHS Foundation Trust), and Guy{\textquoteright}s and St Thomas{\textquoteright} Foundation. The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS, the charities, or the Department of Health and Social Care. Funding Information: LG is funded by King{\textquoteright}s Improvement Science, which is part of the NIHR ARC South London and comprises a specialist team of improvement scientists and senior researchers based at King{\textquoteright}s College London. King{\textquoteright}s Improvement Science is funded by King{\textquoteright}s Health Partners (Guy{\textquoteright}s and St Thomas{\textquoteright} NHS Foundation Trust, King{\textquoteright}s College Hospital NHS Foundation Trust, King{\textquoteright}s College London and South London and Maudsley NHS Foundation Trust), and the Guy{\textquoteright}s and St Thomas{\textquoteright} Foundation. Publisher Copyright: {\textcopyright} 2021 Journal of Medical Internet Research. All rights reserved.",

year = "2021",

month = dec,

doi = "10.2196/31746",

language = "English",

volume = "23",

journal = "Journal of Medical Internet Research",

issn = "1438-8871",

publisher = "Journal of medical Internet Research",

number = "12",

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Appleton, R, Williams, J , Juan, NVS, Needle, JJ, Schlief, M, Jordan, H, Rains, LS, Goulding, L, Badhan, M, Roxburgh, E, Barnett, P, Spyridonidis, S, Tomaskova, M, Mo, J, Harju-Seppänen, J, Haime, Z, Casetta, C, Papamichail, A, Lloyd-Evans, B, Simpson, A , Sevdalis, N , Gaughran, F & Johnson, S 2021, 'Implementation, Adoption, and Perceptions of Telemental Health during the COVID-19 Pandemic: Systematic Review', Journal of Medical Internet Research, vol. 23, no. 12, e31746. https://doi.org/10.2196/31746

TY - JOUR

T1 - Implementation, Adoption, and Perceptions of Telemental Health during the COVID-19 Pandemic

T2 - Systematic Review

AU - Appleton, Rebecca

AU - Williams, Julie

AU - Juan, Norha Vera San

AU - Needle, Justin J.

AU - Schlief, Merle

AU - Jordan, Harriet

AU - Rains, Luke Sheridan

AU - Goulding, Lucy

AU - Badhan, Monika

AU - Roxburgh, Emily

AU - Barnett, Phoebe

AU - Spyridonidis, Spyros

AU - Tomaskova, Magdalena

AU - Mo, Jiping

AU - Harju-Seppänen, Jasmine

AU - Haime, Zoë

AU - Casetta, Cecilia

AU - Papamichail, Alexandra

AU - Lloyd-Evans, Brynmor

AU - Simpson, Alan

AU - Sevdalis, Nick

AU - Gaughran, Fiona

AU - Johnson, Sonia

N1 - Funding Information: This study is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. NS and LG are members of King’s Improvement Science, which offers co-funding to the NIHR ARC South London and is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), and Guy’s and St Thomas’ Foundation. The views expressed are those of the author(s) and not necessarily those of the NIHR, the NHS, the charities, or the Department of Health and Social Care. Funding Information: LG is funded by King’s Improvement Science, which is part of the NIHR ARC South London and comprises a specialist team of improvement scientists and senior researchers based at King’s College London. King’s Improvement Science is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), and the Guy’s and St Thomas’ Foundation. Publisher Copyright: © 2021 Journal of Medical Internet Research. All rights reserved.

PY - 2021/12

Y1 - 2021/12

N2 - Background: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health and to debates on its future use in routine mental health care. Objective: To investigate the adoption and impacts of telemental health approaches during the COVID-19 pandemic, and facilitators and barriers to optimal implementation. Methods: Four databases (PubMed, PsycINFO, CINAHL, and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesized using framework synthesis. Results: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. Conclusions: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these.

AB - Background: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health and to debates on its future use in routine mental health care. Objective: To investigate the adoption and impacts of telemental health approaches during the COVID-19 pandemic, and facilitators and barriers to optimal implementation. Methods: Four databases (PubMed, PsycINFO, CINAHL, and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesized using framework synthesis. Results: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. Conclusions: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these.

KW - COVID-19

KW - Mental health

KW - Remote care

KW - Systematic review, implementation science

KW - Telemedicine

KW - Telemental health

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U2 - 10.2196/31746

DO - 10.2196/31746

M3 - Literature review

C2 - 34709179

AN - SCOPUS:85121990390

SN - 1438-8871

VL - 23

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

IS - 12

M1 - e31746

ER -

Implementation, Adoption, and Perceptions of Telemental Health during the COVID-19 Pandemic: Systematic Review

Abstract

Keywords

UN SDGs

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