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Service user experiences and views regarding telemental health during the COVID-19 pandemic: A co-produced framework analysis.
Vera San Juan, Norha; Shah, Prisha; Schlief, Merle; Appleton, Rebecca; Nyikavaranda, Patrick; Birken, Mary; Foye, Una; Lloyd-Evans, Brynmor; Morant, Nicola; Needle, Justin J; Simpson, Alan; Lyons, Natasha; Rains, Luke Sheridan; Dedat, Zainab; Johnson, Sonia.
  • Vera San Juan N; Department of Health Service and Population Research, NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom.
  • Shah P; NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, London, United Kingdom.
  • Schlief M; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Appleton R; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Nyikavaranda P; NIHR Mental Health Policy Research Unit COVID-19 Co-Production Group, London, United Kingdom.
  • Birken M; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Foye U; Department of Health Service and Population Research, NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom.
  • Lloyd-Evans B; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Morant N; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Needle JJ; Division of Health Services Research and Management, City University of London, London, United Kingdom.
  • Simpson A; Department of Health Service and Population Research, NIHR Mental Health Policy Research Unit, King's College London, London, United Kingdom.
  • Lyons N; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Rains LS; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Dedat Z; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
  • Johnson S; Division of Psychiatry, NIHR Mental Health Policy Research Unit, University College London, London, United Kingdom.
PLoS One ; 16(9): e0257270, 2021.
Article in English | MEDLINE | ID: covidwho-1416892
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ABSTRACT

BACKGROUND:

The prominence of telemental health, including providing care by video call and telephone, has greatly increased during the COVID-19 pandemic. However, there are clear variations in uptake and acceptability, and concerns that digital exclusion may exacerbate previous inequalities in access to good quality care. Greater understanding is needed of how service users experience telemental health, and what determines whether they engage and find it acceptable.

METHODS:

We conducted a collaborative framework analysis of data from semi-structured interviews with a sample of people already experiencing mental health problems prior to the pandemic. Data relevant to participants' experiences and views regarding telemental health during the pandemic were identified and extracted. Data collection and analysis used a participatory, coproduction approach where researchers with relevant lived experience, contributed to all stages of data collection, analysis and interpretation of findings alongside clinical and academic researchers.

FINDINGS:

The experiences and preferences regarding telemental health care of the forty-four participants were dynamic and varied across time and settings, as well as between individuals. Participants' preferences were shaped by reasons for contacting services, their relationship with care providers, and both parties' access to technology and their individual preferences. While face-to-face care tended to be the preferred option, participants identified benefits of remote care including making care more accessible for some populations and improved efficiency for functional appointments such as prescription reviews. Participants highlighted important challenges related to safety and privacy in online settings, and gave examples of good remote care strategies they had experienced, including services scheduling regular phone calls and developing guidelines about how to access remote care tools.

DISCUSSION:

Participants in our study have highlighted advantages of telemental health care, as well as significant limitations that risk hindering mental health support and exacerbate inequalities in access to services. Some of these limitations are seen as potentially removable, for example through staff training or better digital access for staff or service users. Others indicate a need to maintain traditional face-to-face contact at least for some appointments. There is a clear need for care to be flexible and individualised to service user circumstances and preferences. Further research is needed on ways of minimising digital exclusion and of supporting staff in making effective and collaborative use of relevant technologies.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Mental Health / Telemedicine / Delivery of Health Care / COVID-19 / Mental Health Services Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0257270

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Mental Health / Telemedicine / Delivery of Health Care / COVID-19 / Mental Health Services Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0257270