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Telemental health for clinical assessment and treatment or ZOOM!

Telemental health for clinical assessment and treatment or ZOOM!

Ken Pope shared this article from The British Medical Journal :

Before the covid-19 pandemic, the use of telemedicine (i.e., care delivered via videoconferencing or phone/audio only) had been increasing in mental healthcare but was not prevalent.

The pandemic, with its pressure to enact social distancing when possible and a concomitant relaxation of healthcare payment and regulatory policies to facilitate rapid adoption of telemedicine, vastly accelerated its use, particularly for the care of mental health conditions.

Several terms have been used to describe the delivery of mental healthcare via telemedicine, including telemental health, telepsychology, telepsychiatry, and teletherapy. These terms can encompass a variety of different technology based modalities such as videoconferencing, telephone, mobile applications (apps), websites, and text messaging. In this review, we focus on synchronous interactions (i.e., videoconferencing and telephone). We use the term “telemental health” as defined by the United States’ National Institute on Mental Health as the “use of telecommunications or videoconferencing technology to provide mental health services.”

It is perhaps not surprising that the adoption of telemental health has been particularly robust. Mental healthcare, which commonly does not rely on physical examination of patients, may be uniquely suited to telemedicine. Prior to the pandemic, there had been considerable study of its efficacy and effectiveness, particularly for depression and anxiety disorders. Further, ample literature describes the benefits of telemedicine for improving access to care for patients who would need to travel long geographical distances to access care, who are caregivers and find it difficult to leave home for appointments, or who have jobs that make it difficult to access care if they had to leave work to do so.

Given the potential for the newly prominent ongoing role for telemental health, it is important to understand the scope of the evidence base for telemental health thus far. This narrative review fills a gap in the literature by summarizing meta-analyses on telemental health. 

Given the volume and complexity of the telemental health literature (spanning several decades and including a variety of study methodologies, patient populations, and settings), a narrative review provides clarity to the scope and strength of the telemental health literature. We are unaware of any prior narrative reviews that summarize meta-analyses for telemental health. This review also further assists clinicians in their ongoing or continued use of telemental health by providing a summary of telemental health guidelines. Thus, the combination of these two literature types that summarize the evidence base and the guideline contents provides clinicians with an implementation framework for considerations of best practice in their use of telemental health.

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