Remote Mental Health Services Research Articles

Remote mental health services during the COVID-19 pandemic in Finland and the Netherlands: a qualitative study

BackgroundThe COVID-19 pandemic has increased worldwide mental health conditions, substantially affecting the demand and provision of mental health services. To continue services and safeguard the health and well-being of mental health service users, service providers have responded to the pandemic with the adoption of remote services. The objective of our study was to identify and compare the promoters and challenges of the adoption of remote mental health services experienced by service users in Finland and the Netherlands during the COVID-19 pandemic with help of the FITTE framework.MethodsThe study adopted a qualitative descriptive approach, consisting of in-depth semi-structured interviews with mental health service users in Finland (n = 12) and the Netherlands (n = 13) during the COVID-19 pandemic. Qualitative content analysis with both inductive and deductive approach was utilized, and the extended FITTE framework was applied to identify the factors related to the fit between individual, task, technology, and environment that influenced the adoption of remote services.ResultsOverall, the adoption of remote mental health services during the COVID-19 pandemic involved several promoters related to easy access to mental health services, support for mental health and well-being, and benefits of the home environment such as not having to leave outside for services and having less risk of getting the corona virus. Most of the challenges were related to lack of non-verbal communication, difficulties with expressing oneself and interpreting others, technological issues, the organization of remote services, usability and suitability of services, affinity of the health professional with the provision of remote services, and the safety and security of remote services.ConclusionsWhile remote services are accessible, support our well-being and mental health and protect us against the coronavirus, our findings also show that face-to-face contact was often indispensable when adopting mental health services. Therefore, the design of future mental health services should include both remote and face-to-face delivery. Further research should be done on blended approaches and on ways in which the challenges and development needs which emerged from this study can be tackled to improve remote mental health services.

Comparing University Students’ Satisfaction with In-Person and Remote Mental Health Services During the COVID-19 Pandemic

Comparing University Students’ Satisfaction with In-Person and Remote Mental Health Services During the COVID-19 Pandemic

Successes, challenges, and opportunities in providing evidence-based teletherapy to children who have experienced trauma as a response to Covid-19: A national survey of clinicians

While teletherapy is not a new phenomenon, most clinicians have not been trained and do not routinely practice it. The current study was designed to ascertain challenges and opportunities presented by the widescale usage of teletherapy especially for traumatized children, which was necessitated by the COVID-19 pandemic. Two hundred and fifty clinicians across the United States providing teletherapy to traumatized children completed an online survey. Results revealed that many logistical aspects of treatment were perceived to be easier when implemented remotely. Some clinical aspects of care were also perceived to be easier, notably engagement with caregivers. Developing rapport, assessing emotions, and keeping children’s attention, however, were perceived as more challenging. Child characteristics such as age, attention span, and screen fatigue were viewed as creating challenges. Most clinicians had not received training in relevant topics for teletherapy and were eager to receive such training. These results suggest many avenues for refining and fine-tuning remote mental health services especially for children.

Feasibility and Acceptability of a Remote Stepped Care Mental Health Programme for Adolescents during the COVID-19 Pandemic in India.

Remote mental health services were rapidly deployed during the COVID-19 pandemic, yet there is relatively little contemporaneous evidence on their feasibility and acceptability. This study assessed the feasibility and acceptability of a stepped care mental health programme delivered remotely by lay counsellors to adolescents in New Delhi, India, during a period of 'lockdown'. The programme consisted of a brief problem-solving intervention ("Step 1") followed by a tailored behavioural module ("Step 2") for non-responders. We enrolled 34 participants (M age = 16.4 years) with a self-identified need for psychological support. Feasibility and acceptability were assessed through quantitative process indicators and qualitative interviews (n = 17 adolescents; n = 5 counsellors). Thirty-one (91%) adolescents started Step 1 and 16 (52%) completed the planned Step 1 protocol. Twelve (75%) of the Step 1 completers were non-responsive. Eight (67%) non-responsive cases started Step 2, all of whom met response criteria when reassessed at 12 weeks post-enrolment. Adolescents favoured voice-only sessions over video-calls due to privacy concerns and difficulties accessing suitable devices. Counsellors noted challenges of completing remote sessions within the allotted time while recognising the importance of supervision for developing competence in new ways of working. Both adolescents and counsellors discussed the importance of working collaboratively and flexibly to fit around individual preferences and circumstances. Disentangling pandemic-specific barriers from more routine challenges to remote delivery should be a focus of future research.

Process model of emotion regulation-based digital intervention for emotional problems.

To address the lack of mental health practitioners in developing countries, the current study explored the feasibility of a newly developed self-guided digital intervention program TEA (training for emotional adaptation) in alleviating depressive and anxiety symptoms, as one of a few studies which adapted from theoretical models with effective intervention techniques. The first part of this study involved 11 professional mental health practitioners giving feedback on the feasibility of the TEA; while the second part involved a mixed-method single-arm study with 32 participants recruited online, who went through the seven intervention sessions within 14 days. The questionnaires were collected before, after, 14 days after, and 30 days after intervention. Additionally, 10 participants were invited to semi-structured interviews regarding their suggestions. Practitioners thought that the TEA showed high professionalism (8.91/10) and is suitable for treating emotional symptoms (8.09/10). The generalized estimating equation model showed that the TEA significantly reduced participants' depressive and anxiety symptoms, while the effects of the intervention remained 30 days post intervention (Cohen's d > 1). Thematic analysis revealed three main themes about future improvement, including content improvement, interaction improvement, and bug-fixing. To address the current needs for digital mental health intervention programs to account for the insufficient availability of mental health services in China, the current study provides preliminary evidence of the effectiveness of TEA, with the potential to address the urgent need for remote mental health services. The study was registered at the Chinese Clinical Trial Register (ChiCTR), with number [ChiCTR2200065944].

Atypical jobs in psychology: Interview of Dr. Donna Rasin-Waters.

This article provides an overview of Dr. Donna Rasin-Waters' career path and experiences providing telehealth at the Brooklyn Campus of the Veterans Affairs New York Harbor Healthcare Systems. Dr. Rasin-Waters, a psychologist and neuropsychologist with a specialty in geropsychology, began working toward the provision of evidence-based therapy via telehealth for Veterans in 2010. She believed that, in addition to rural communities, telehealth held utility for Veterans in densely populated areas, particularly for elderly adults with limited means for transportation. Since the COVID-19 pandemic, Dr. Rasin-Waters has seen a rapid boom in the use of telehealth for a variety of clinical activities with Veterans. This has further brought to light promising implications for the provision of remote mental health services, as well as important telehealth training and cultural considerations for clinicians. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Lockdown stringency and paediatric self-harm presentations during COVID-19 pandemic: retrospective cohort study.

Lockdown during the pandemic has had significant impacts on public mental health. Previous studies suggest an increase in self-harm and suicide in children and adolescents. There has been little research on the roles of stringent lockdown. To investigate the mediating and predictive roles of lockdown policy stringency measures in self-harm and emergency psychiatric presentations. This was a retrospective cohort study. We analysed data of 2073 psychiatric emergency presentations of children and adolescents from 23 hospital catchment areas in ten countries, in March to April 2019 and 2020. Lockdown measure stringency mediated the reduction in psychiatric emergency presentations (incidence rate ratio of the natural indirect effect [IRRNIE] = 0.41, 95% CI [0.35, 0.48]) and self-harm presentations (IRRNIE = 0.49, 95% CI [0.39, 0.60]) in 2020 compared with 2019. Self-harm presentations among male and looked after children were likely to increase in parallel with lockdown stringency. Self-harm presentations precipitated by social isolation increased with stringency, whereas school pressure and rows with a friend became less likely precipitants. Children from more deprived neighbourhoods were less likely to present to emergency departments when lockdown became more stringent. Lockdown may produce differential effects among children and adolescents who self-harm. Development in community or remote mental health services is crucial to offset potential barriers to access to emergency psychiatric care, especially for the most deprived youths. Governments should aim to reduce unnecessary fear of help-seeking and keep lockdown as short as possible. Underlying mediation mechanisms of stringent measures and potential psychosocial inequalities warrant further research.

Cohort study comparison of Mental Health and Wellbeing Services delivered by The Royal Flying Doctor Service, across Far North and Central West Queensland

SummaryBackgroundUnderstanding cultural differences between geographical regions is essential in delivering culturally appropriate healthcare. We aimed to describe the characteristics and outcomes of diverse clients using the Far North Mental Health and Wellbeing Service (FNS) and the Central West Health and Wellbeing Service (CWS).MethodsWe conducted a cohort study within Queensland, Australia, on all clients who received a mental health therapy session at either the FNS or the CWS. Patient data was prospective data collected form July 2019 to December 2020.FindingsThere were1202 clients, with a median number of individual contacts per-client of 3.0 (IQR 2.0-6.0). There was 428 (35.6% 95% CI 32.90-38.39) males and 772 (64.2% 95% CI 61.44-66.94) females with a median age across the genders of 38.0 (IQR 28.0-51.0). There was 505 (42.0% 95% CI 39.20-44.86) identifying as Indigenous and 697 (58.0% 95% CI 55.14-60.80) as non-Indigenous Australians. The FNS had a significantly higher proportion of Indigenous clients (n=484; 54.8% 95% CI 51.46-58.13) as compared to the CWS (n=21; 6.6% 95% CI 4.12-9.89). Of the 1202 clients, 946 (78.7% 95% CI 76.28-80.99) had a socio-economic classification of ‘most disadvantaged’, consisting of 740 (83.8%) clients from the FNS and 206 (64.6%) clients from the CWS. The majority of presentations were for neurotic, stress-related and somatoform disorders (n=568; 47.3%), followed by mood affective disorders (n=310; 25.8%). The overall number of treatments strategies employed was 10798, equalling a median of 6.0 (IQR 4.0-9.0) strategies per-client, with the leading strategies being counselling/psychosocial (n=1394; 12.9%), reflective listening (n=1191; 11.0%), and strengths based reasoning (n=1116; 10.3%). There were 511 (42.5%) clients who completed the Kessler Psychological Distress Scale (K10/K5), with 493 (41.0%) clients not offered as deemed not culturally appropriate by the treating team. The mean initial K10/K5 score was 23.7 (SD 9.4) which significantly decreased (p<0.001) to 18.0 (SD 10.0) at final consultation.InterpretationThis study highlighted client socioeconomic differences between two geographically remote mental health services. It is essential that services are regionally co-designed to ensure cultural appropriateness.FundingNo funding to declare.

Mental health policy response to COVID-19: lessons learned

BackgroundGood mental health is critical to the functioning of society and recovery from COVID-19 pandemics. Corona pandemics is considered as crisis, causing uncertainty and unpredictability resulting in fear and high levels of psychological distress in populations. Mental health impacts occur as an impact of the virus or as the consequences of physical isolation. Mental health of other specific (vulnerable) populations affected by the COVID-19. Mitigating the hazardous effects of COVID-19 on mental health is an international public health priority. The aim of the study is to review mental health policy responses to COVID-19 crisis internationally and present successful examples as well as learned lessons.MethodsA rapid clustered review of evidences reflecting mental health policy responses in the face of COVID-19 pandemics has been conducted.ResultsCOVID-19 pandemics is an indisputable emergency for health systems and challenge for mental health care. Major mental health policy response measures should be based on whole of society approach and include access to remote mental health service provision as well as emergency mental health and psychosocial services especially to vulnerable populations in order to strengthen social cohesion and social support. COVID-19 crisis, on the other hand, might also be considered as an opportunity to improve the scale and effectiveness of mental health services and increase funding to mental health care and psychosocial services. It raised concerns and stimulated discussion about the re-shifting institutional long term care more into community based service approach.ConclusionsEnsuring preparedness and planning of mental health service is an important for staying ahead of mental health impacts that will be long term, complex, and may take time to fully emerge. Further transdisciplinary research on mental health system, policy and COVID-19 epidemics prevention, preparedness, responses and impacts is needed.

Remote mental health services: a mixed-methods survey and interview study on the use, value, benefits and challenges of a national video consulting service in NHS Wales, UK

Social distancing laws during the first year of the pandemic, and its unprecedented changes to the National Health Service (NHS) forced a large majority of services, especially mental health teams...

MENTAL HEALTH SERVICES DURING THE PANDEMIC: THE EXPERIENCES OF LITHUANIAN PSYCHOLOGISTS

With the COVID-19 pandemic and its restrictions, many countries face an unprecedented mental health crisis, which is being addressed in various ways, including the use of remote mental health services. Lithuania faced two quarantines: in March-June of 2020 and starting November 2020 up to Spring of 2021. The aim of this study is to explore the experiences of Lithuanian psychologists providing mental health services during the pandemic. Using the qualitative content analysis method, the following categories were made: from shock to discovery of new opportunities (differences in two lockdowns, better accessibility of services, help-seeking during the pandemic, and the importance of self-care) and contextual challenges (confidentiality, computer literacy, and blurred home/work boundaries). Implications for addressing psychological service issues are discussed, with an emphasis on self-care, setting boundaries, and finding new ways to enhance mental health via mediated communication as well as to reach out to vulnerable groups.

A Review of Tele-Therapy Possibilities in Combating Psychological Distress of COVID-19 In India

The rapid transmission characteristic of the COVID 19 virus is a huge concern for humanity. With the rising death toll and unavailability of the vaccine, it has been creating psychological distress around the globe. This paper through its doctrinal approach has tried to explore the various guidelines or enactments for psychosocial support and mental health services, adopted in various countries. It is necessary to attempt to understand the policies incorporated by various countries in combatting psychological distress during the pandemic to help people cope with the contingency and be resilient in adapting to the new normal. This paper also looks into the strategy adopted by government in dealing with mental health issues specifically in India which is still struggling to have a legal enactment on remote Mental Health Services. Tele Therapy has been a success in the state of Kerala in India. Hence the paper focuses on the different programmes undertaken by the Kerala government to combat mental health related issues to the general masses and the people in quarantine.

When COVID-19 enters in a community setting: an exploratory qualitative study of community perspectives on COVID-19 affecting mental well-being

ObjectiveThe COVID-19 pandemic has resulted in an increased level of anxiety and fear among the general population related to its management and infection spread. Considering the relevance of present circumstances,...

Leveraging parent-child interaction therapy and telehealth capacities to address the unique needs of young children during the COVID-19 public health crisis.

COVID-19 and related efforts to mitigate its spread have dramatically transformed the structure and predictability of modern childhood, resulting in growing concerns children may be particularly vulnerable to serious mental health consequences. Worldwide stay-at-home directives and emergency changes in healthcare policy and reimbursement have smoothed the trail for broad implementation of technology-based remote mental health services for children. Parent-Child Interaction Therapy (PCIT) is particularly well-positioned to address some of the most pressing child and parental needs that arise during stressful times, and telehealth formats of PCIT, such as Internet-delivered PCIT (iPCIT), have already been supported in controlled trials. This commentary explores PCIT implementation during the COVID-19 public health crisis and the challenges encountered in the move toward Internet-delivered services. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Enhancing Team-Work and Supportive Working Environment of the Admission and Transfer Processes in Rural Mental Healthcare Services Using Lean Philosophy

Aim: To improve team work through joint development of clinical processes between regional, rural community mental health teams and rural hospitals using Lean philosophy. Background: There was lack of clarity of the roles and responsibilities of staff in the admission of mental health consumers in rural hospitals and in their transfer to regional acute mental health inpatient unit. This resulted in cross departmental animosity in Central Queensland health services which further led to compromised provision of consumer care. The impetus of this paper; therefore, is to present the application of Lean to the admission process in rural mental healthcare services as well as transfer to the regional acute inpatient unit in order to enhance teamwork and supportive working environment to improve consumer outcomes. Methods: The study utilized a qualitative approach where an online survey monkey was used to capture an in-depth understanding of the perceptions and experiences of the hospital and mental health staff pre- and post-implementation of the new processes. Key results: The participants reported improved collaborative working among the staff which resulted in more effective care provision for mental health consumers. Conclusion: Lean philosophy was successfully applied in creating effective administrative and clinical processes in rural and remote mental health services. Joint development of procedures and processes enhanced adherence to standards, improved teamwork and, consequently, ameliorated consumer outcomes.

Improving specialist accessibility and involvement in treatment management planning for rural and remote mental health services using Lean practices

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

Psychiatric Consultant Helps Shape Care of Wide Range of Patients

Psychiatric Consultant Helps Shape Care of Wide Range of Patients

Is a national framework for implementing early psychosis services necessary? Results of a survey of Australian mental health service directors

Expert opinion holds that the rate of implementation of specialist services for first presentation psychosis in Australia is much too slow. We aimed to collect evidence regarding this view from the first national survey of adult public mental health services about their self-reported efforts to implement specialist early psychosis intervention (EPI). Using a purpose-designed Census form for assessing EPI implementation, adult public mental health service directors throughout Australia were asked about EPI-relevant local service activities. Sixty Census forms were returned (response rate = 61%), representing a total catchment population of 12.5 million people. A minority of services reported high levels of EPI implementation, which varied widely between area services and across state and territory jurisdictions. Rural and remote services were overrepresented in the lowest levels of reported EPI implementation. Only one service characteristic, the value of identifiable funding committed specifically to EPI, was predictive of level of reported EPI implementation. The disturbingly high levels of variability in EPI implementation across jurisdictions suggest a pressing need for a set of nationally agreed uniform EPI implementation standards. Additional specific strategies for rural and remote mental health services may be needed for these services to implement EPI.

Faecal immunological test blues: is there a psychiatric morbidity associated with the National Bowel Cancer Screening Program?

Internal Medicine JournalVolume 39, Issue 10 p. 709-709 Faecal immunological test blues: is there a psychiatric morbidity associated with the National Bowel Cancer Screening Program? L. Wigg, L. Wigg Rural and Remote Mental Health Service, Glenside Hospital andSearch for more papers by this authorJ. Chaudary, J. Chaudary Rural and Remote Mental Health Service, Glenside Hospital andSearch for more papers by this authorA. J. Wigg, A. J. Wigg Department of Gastroenterology and Hepatology, Flinders Medical Centre, Adelaide, South Australia, AustraliaSearch for more papers by this author L. Wigg, L. Wigg Rural and Remote Mental Health Service, Glenside Hospital andSearch for more papers by this authorJ. Chaudary, J. Chaudary Rural and Remote Mental Health Service, Glenside Hospital andSearch for more papers by this authorA. J. Wigg, A. J. Wigg Department of Gastroenterology and Hepatology, Flinders Medical Centre, Adelaide, South Australia, AustraliaSearch for more papers by this author First published: 14 October 2009 https://doi.org/10.1111/j.1445-5994.2009.02026.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume39, Issue10October 2009Pages 709-709 RelatedInformation

The Development of an ‘Indigenous Team’ in a Mainstream Mental Health Service in South Australia

The Social Justice Report 2005 recommended that the governments of Australia commit to achieving equal health status for all Australians "within a generation". Improving the accessibility of mainstream health services for Aboriginal people is highlighted as a central requirement. This paper describes the establishment, roles and functions of the 'Indigenous team' embedded within the South Australian Rural and Remote Mental Health Service (RRMHS) as one strategy to improve access and responsiveness of mental health services to Aboriginal patients in South Australia. We report on our progress to date and possible future directions for the team.