Does the telemental health approach work for everyone?

Does the telemental health approach work for everyone?
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Researchers from Kings College London and University College London (UCL) investigate telemental health approaches and their effectiveness.

Telemental health is a combination of mental health care, patient care, administrative activities, and health education delivered using telecommunications technologies such as video or phone calls. Following the COVID-19 pandemic, this practice has become commonly used in GP practices and other healthcare facilities.

New research from the National Institute for Health & Care Research (NIHR) Mental Health Policy Research Unit (MHPRU) has shown that certain groups of people benefit from telemental health, but this is not true for all members of the public. The findings were published in the Interactive Journal of Medical Research.

Digital healthcare is growing in popularity

The researchers found telemental health was beneficial for patients and healthcare professionals. This approach effectively reduces treatment gaps and barriers by enhancing mental health care access across various user groups and personal contexts. The researchers note that it is vital that healthcare practices consider key factors that determine how people respond to this method; for example, variations in access to a private and confidential space, ability to develop therapeutic relationships, individual preferences and circumstances.

King’s researcher Dr Katherine Saunders, from NIHR MHPRU and joint lead author, said: “We live in an increasingly digital world, and the COVID-19 pandemic accelerated the role of technology in mental health care. Our study found that, while certain groups do benefit from the opportunities telemental health can provide, it is not a one size fits all solution. Receiving telemental health requires access to a device, an internet connection and an understanding of technology. If real-world barriers to telemental health are ignored in favour of wider implementation, we risk further embedding inequalities into our healthcare system.”

 Telemental health has limitations for certain people

During the study, the researchers uncovered the downfalls of telemental health experienced by user groups. One of the most concerning negatives about this approach is that it could fuel pre-existing inequalities in healthcare. Moreover, people without internet or phone access, experiencing social and economic disadvantages, cognitive difficulties, auditory or visual impairments, or severe mental health problems benefit less from telemental health.

Professor Sonia Johnson from UCL and Director, NIHR MHPRU and the senior author added: “Our research findings emphasise the importance of personal choice, privacy and safety, and therapeutic relationships in telemental health care. The review also identified particular service users likely to be disadvantaged by telemental health implementation. For those people, we recommend a need to ensure that face-to-face care of equivalent timeliness remains available.”

The authors suggested the findings have implications across the board of clinical practice, service planning, policy and research. They outlined that if telemental healthcare will be widely integrated into routine care, there must be a clear understanding of where this method is acceptable and who may need in-person support. 

Professor Alan Simpson, from King’s and Co-Director, NIHR MHPRU, concluded: “As well as reviewing a huge amount of research literature, in this study, we also involved and consulted with many clinicians and users of mental health services. This included young people, those that worked in or used inpatient and crisis services, and those who had personal lived experience of telemental throughout the pandemic. This gives this research a relevance that will be of interest to policymakers, service providers and those working in and using our services.”

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