The pros and cons of telemental health services

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Technology has made mental health services more readily available to some people. Getty Images
  • A new report says telehealth is making mental health services more accessible to people in remote communities as well as those who can’t attend in-person sessions.
  • The researchers note, however, that lack of internet access and knowledge of technology can make telehealth services more difficult for some people.
  • They also note that some people who use telemental health services are less engaged and more easily distracted than people who use in-person services.

Virtual counseling sessions for mental health disorders may be effective for some people, but the limitations of technology and other barriers to care must be overcome for “telemental” care to be more universally applicable, a new study concludes.

The COVID-19 pandemic has accelerated the use of telehealth services, including for mental health, say researchers from the Mental Health Policy Research Unit of the UK’s National Institute for Health & Care Research at King’s College London and University College London.

However, the researchers say that experience and research show that the effectiveness of telehealth can be greatly influenced, for good or ill, by factors such as access to private and confidential spaces, the ability to develop therapeutic relationships between physician and patient, individual preferences and circumstances, and technological issues such as internet connection quality.

“We live in an increasingly digital world, and the COVID-19 pandemic has accelerated the role of technology in mental health care,” Catherine Saunders, PhD, MSc, the study’s co-lead author and mental health policy research associate at King’s College, said in a news release. “Our study found that while some groups benefit from the opportunities that telemental health can provide, it is not a one-size-fits-all solution. Telemental health requires access to a device, an internet connection, and an understanding of technology. If the real barriers to telemental health are ignored in favor of broader implementation, we risk further entrenching inequities in our healthcare system.

The study, published in the Interactive Journal of Medical Research, found that thethe use of telemental health has become increasingly widespread and is particularly useful for serving people in remote communities and in situations where face-to-face counseling is not possible.

“I believe telemental health care is effective with appropriate risk management strategies in place,” said Jodi Tinglingfounder of the Canadian mental health counseling program Creating New Steps.

“In my experience providing internet-based cognitive behavioral therapy during the height of the pandemic, it was a great alternative to traditional face-to-face therapy when there are effective pain management strategies. risks in place,” she told Healthline.

Ideally, the researchers said, telemental health interventions delivered through video calls, telephones or text messages can increase access to care.

However, the study found that providing mental health care remotely was less beneficial for people without internet or phone access, those experiencing social and economic disadvantages, people with cognitive difficulties, hearing impairments or vision and those with serious mental health problems.

“Clients with paranoia or severe anxiety whose symptoms may worsen due to a lack of confidence in the platform or technology should work with someone in person,” Sabrina EadsLPC, a therapist at Enteave Counseling in Austin, Texas, told Healthline.

“For these people, we recommend the need to ensure that face-to-face care of equivalent speed remains available,” said Sonia JohnsonMSc, Director of the Center for Mental Health Policy Research at King’s College London and lead author of the study.

A recent study published in the journal JMIR Formative Research found that telehealth can be used successfully for people with suicidal thoughts.

The study reported that patients who received both medication and counseling via text and video calls were 4 times more likely to have remission of suicidal ideation than those in a control group.

Andrea Rowella social worker practicing telehealth in Toronto in a family health team and private practice, told Healthline that virtual counseling has become more accepted and even preferred over traditional in-person therapy.

“Even though we now offer the choice of in-person, phone, and video calls to have our sessions, the majority of people happily choose to do sessions over the phone,” she said. “People now seem to agree with providers that a phone or video session is much more convenient.”

However, Rowell said experience has shown that people can sometimes be less committed to advice delivered via telehealth, particularly if it’s offered for free.

“Therapy is all about communication,” she said. “On the phone, part of a therapist’s role is taken away when therapists can no longer comment on their client’s body language. I recommend videotherapy because of the ability to create a face-to-face connection while enjoying the benefits of being in the comfort of your own home… Some barriers of telehealth for mental health can be lowered by the therapist setting the Expectations from the start that the space should be confidential, and that there would be a recommendation to drop by in person if the client felt more engaged that way.

Distraction may be another downside to telemental health, said Myisha Jacksonmental health counselor and owner of the Healing Journey Counseling Center in Monroe, Louisiana.

“Some patients try to get therapy at work, in the car, or while their young children are at home,” she told Healthline. “Therapists need to set boundaries and let the client know that they need to conduct the session in an environment like home or work. [where there are] no distractions.

michelle wagnerthe chief executive of virtual mental health platform Mindstrong, told Healthline that telemental health is crucial to overcoming the nationwide shortage of mental health counselors, which often leads to long and potentially dangerous delays in accessing care.

“Virtual platforms often improve outcomes because access to care is more immediate and engaging,” Wagner said.

“Patients are often more open and comfortable at home. Additionally, telehealth services do not maintain the traditional office hours of 9 a.m. to 5 p.m., Monday through Friday, and most offer patients the ability to communicate with their therapists between appointments. This helps providers manage medications in real time, measure progress and intervene before a patient is in crisis,” she added.

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