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Journal ArticleDOI: 10.1016/J.PSYCHRES.2021.113848

Implementation lessons from the transition to telehealth during COVID-19: a survey of clinicians and young people from youth mental health services.

02 Mar 2021-Psychiatry Research-neuroimaging (Elsevier)-Vol. 299, pp 113848-113848
Abstract: Whilst telehealth may overcome some traditional barriers to care, successful implementation into service settings is scarce, particularly within youth mental health care. This study aimed to leverage the rapid implementation of telehealth due to COVID-19 to understand the perspectives of young people and clinicians on how telehealth impacts service delivery, service quality, and to develop pathways for future uses. Youth mental health service users (aged 12-25) and clinicians took part in an online survey exploring service provision, use, and quality following the adoption of telehealth. Service use data from the period were also examined. Ninety-two clinicians and 308 young people responded to the survey. Service use was reduced compared to the same period in 2019, however, attendance rates were higher. Across eight domains of service quality, the majority of young people reported that telehealth positively impacted service quality, and were significantly more likely to rate telehealth as having a positive impact on service quality than clinicians. There was high interest in continuing to use telehealth as part of care beyond the pandemic, supporting its permanent role in youth mental health care for a segment of service users. Future work should explore how best to support its long-term implementation.

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Topics: Telehealth (65%), Service delivery framework (61%), Telemedicine (57%) ... show more
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11 results found


Open accessJournal ArticleDOI: 10.1186/S12913-021-06321-7
Lisa D. Hawke1, Lisa D. Hawke2, Natasha Y Sheikhan1, Karen MacCon1  +2 moreInstitutions (2)
Abstract: During the COVID-19 pandemic, youth mental health and substance use services rapidly moved to virtual modalities to meet social distancing requirements It is important to understand youth attitudes toward and experience of virtual services This study examined the attitudes toward and experiences of virtual mental health and substance use services among youth drawn from clinical and non-clinical samples Four hundred nine youth completed a survey including questions about their attitudes toward and experience of virtual services The survey included quantitative and open-ended questions on virtual care, as well as a mental health and substance use screener The majority of youth with mental health or substance use challenges would be willing to consider individual virtual services, but fewer would consider group virtual services However, many have not received virtual services Youth are interested in accessing a wide variety of virtual services and other supportive wellness services Advantages and disadvantages of virtual services are discussed, including accessibility benefits and technological barriers As youth mental health and substance use services have rapidly gone virtual during the COVID-19 pandemic, it is essential that we hear the perspectives of youth to promote service utilization among those in need Diverse, accessible, technologically stable virtual services are required to meet the needs of different youth, possibly with in-person options for some youth Future research, engaging youth in the research process, is needed to evaluate the efficacy of virtual services to plan for the sustainability of some virtual service gains beyond the pandemic period

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Topics: Mental health (53%), Service (business) (51%)

3 Citations


Open accessJournal ArticleDOI: 10.3389/FBUIL.2021.740903
Abstract: Background: Based on recent experiences with the COVID-19 pandemic, designers and design researchers are crafting guidelines for the development of future environments. In this context, this paper focuses on future best practices regarding environments for health, hospitality and senior care. Methods: An extensive literature review was conducted, the results of which were distributed to a group of experts (N=12) specializing in health, hospitality and design. After receiving their input, expert focus groups were conducted to further explore the proposed concepts. The document was revised based on the contributions of these field experts, resubmitted for additional input, and ultimately summarized in this paper. Results: Based on the literature review and expert input, dozens of recommendations were made regarding post-COVID health, hospitality and seniors environments. Healthcare facilities will require additional space, access to the outdoors, service hubs, and additional infrastructure to all conversion of garages for emergency use. Hospitality settings will employ new cleaning methods, use of robotics, improved HVAC, Wellness programming, workspace options, and flexible food service operations. Senior facilities will engage more technology, socially distance visiting facilities, increase access to nature, and smaller scale residential clusters. Discussion: By considering health and hospitality simultaneously, we come to understand the symbiotic benefits of applying goals from one sector to the other. Senior living environments are an excellent example of this approach in action. By implementing some of the proposed design recommendations generated by this research, we will be better prepared to face future challenges.

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Topics: Hospitality (57%), Health care (52%)

1 Citations


Open accessJournal ArticleDOI: 10.1111/EIP.13250
Abstract: AIM: The COVID-19 pandemic has presented significant challenges for young people and youth mental health services. To address a gap in knowledge about the impact of the pandemic and associated restrictions on youth mental health services, this paper examined the nature of young people's engagement with Jigsaw's brief intervention service during the pandemic. METHOD: Data gathered from young people engaging with Jigsaw's brief intervention service in the 12 months after the official declaration of the COVID-19 pandemic (n = 6161), and 12 months prior (n = 8665) were examined. RESULTS: There were less referrals to Jigsaw during the pandemic, especially during lockdown periods, but this rebounded when public health restrictions were eased. A higher proportion of females (p < .001) and 12-17 year olds (p < .001) were referred during the pandemic period. There was an increase in the proportion of young people who presented with anxiety (p < .001) and sleep changes (p < .001). Although 12-16 year olds reported significantly higher levels of distress during the pandemic (p < .05), the effect size was small. Young people reported high levels of satisfaction with the new phone/video modes of support offered by Jigsaw, and the overall attendance rate improved during the pandemic period. CONCLUSIONS: The impact of COVID-19 on young people's mental health needs to be considered as a priority. This paper is helpful for services considering the long-term mental health needs of young people, and the best way of meeting those needs.

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Topics: Mental health (53%), Public health (53%)

Open accessJournal ArticleDOI: 10.3390/IJERPH18189622
Abstract: Background: The impact of the 2019 coronavirus pandemic on the mental health of millions worldwide has been well documented, but its impact on prevention and treatment of mental and behavioral health conditions is less clear. The COVID-19 pandemic also created numerous challenges and opportunities to implement health care policies and programs under conditions that are fundamentally different from what has been considered to be usual care. Methods: We conducted a qualitative study to determine the impact of the COVID-19 pandemic on implementation of evidence-based policy and practice by State Mental Health Authorities (SMHA) for prevention and treatment of mental health problems in children and adolescents. Semi-structured interviews were conducted with 29 SMHA representatives of 21 randomly selected states stratified by coronavirus positivity rate and rate of unmet services need. Data analysis with SMHA stakeholders used procedures embedded in the Rapid Assessment Procedure—Informed Community Ethnography methodology. Results: The need for services increased during the pandemic due primarily to family stress and separation from peers. States reporting an increase in demand had high coronavirus positivity and high unmet services need. The greatest impacts were reduced out-of-home services and increased use of telehealth. Barriers to telehealth services included limited access to internet and technology, family preference for face-to-face services, lack of privacy, difficulty using with young children and youth in need of substance use treatment, finding a Health Insurance Portability and Accountability Act (HIPAA)-compliant platform, training providers and clients, and reimbursement challenges. Policy changes to enable reimbursement, internet access, training, and provider licensing resulted in substantially fewer appointment cancellations or no-shows, greater family engagement, reduction in travel time, increased access for people living in remote locations, and increased provider communication and collaboration. States with high rates of coronavirus positivity and high rates of unmet need were most likely to continue use of telehealth post-pandemic. Despite these challenges, states reported successful implementation of policies designed to facilitate virtual services delivery with likely long-term changes in practice. Conclusions: Policy implementation during the pandemic provided important lessons for planning and preparedness for future public health emergencies. Successful policy implementation requires ongoing collaboration among policy makers and with providers.

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Topics: Health policy (59%), Telehealth (58%), Health care (57%) ... show more

Open accessJournal ArticleDOI: 10.1007/S10488-021-01175-X
Abstract: Covid-19 has led to an unprecedented shift to telemental health (TMH) in mental healthcare. This study examines the impact of this transition on visit adherence for mental health services in an integrated behavioral health department. Monthly visit data for 12,245 patients from January, 2019 to January, 2021 was extracted from the electronic medical record. Interrupted time series (ITS) analysis examined the impact of the Covid-19 transition to TMH on immediate level and trend changes in the percentage of cancelled visits and no shows in the 10 months following the transition. ITS also compared changes across the three largest services types: adult, pediatric, and substance use. Following the TMH-transition, completed visits increased by 10% amounting to an additional 3644 visits. In April, 2020, immediately following the TMH-transition, no shows increased by 1.4%, (95% CI 0.1, 2.7, p < 0.05) and cancellations fell by 13.5% (95% CI − 17.9, − 9.0, p < 0.001). Across the 10-month post-TMH period, 18.2% of visits were cancelled, compared to 28.3% across the 14-month pre-TMH period. The proportion of no-shows remained the same. The pattern was similar for pediatric and adult sub-clinics, but no significant changes in cancellations or no shows were observed in the substance use sub-clinic. TMH during the Covid-19 pandemic is associated with improved visit adherence over time and may be a promising model for improving the efficiency of mental health care delivery once it is safe to resume in person care.

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Topics: Telemental health (51%)

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28 results found


Open accessJournal ArticleDOI: 10.1001/ARCHPSYC.62.6.593
Ronald C. Kessler1, Patricia A. Berglund1, Olga Demler1, Robert Jin1  +2 moreInstitutions (1)
Abstract: Context Little is known about lifetime prevalence or age of onset of DSM-IV disorders. Objective To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older. Main Outcome Measures Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders. Results Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups. Conclusions About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.

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Topics: National Comorbidity Survey (65%), Mood disorders (57%), Comorbidity (56%) ... show more

15,369 Citations


Journal ArticleDOI: 10.1111/J.1365-2648.2007.04569.X
Satu Elo1, Helvi Kyngäs1Institutions (1)
Abstract: Aim This paper is a description of inductive and deductive content analysis. Background Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. Discussion When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Conclusion Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.

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Topics: Palliative care (51%)

11,985 Citations


Journal ArticleDOI: 10.1177/1077800410383121
Abstract: This article presents a model for quality in qualitative research that is uniquely expansive, yet flexible, in that it makes distinc- tions among qualitative research's means (methods and practices) and its ends. The article first provides a contextualization and rationale for the conceptualization. Then the author presents and explores eight key markers of quality in qualitative research including (a) worthy topic, (b) rich rigor, (c) sincerity, (d) credibility, (e) resonance, (f) significant contribution, (g) ethics, and (h) meaningful coherence. This eight-point conceptualization offers a useful pedagogical model and provides a common language of qualitative best practices that can be recognized as integral by a variety of audiences. While making a case for these markers of quality, the article leaves space for dialogue, imagination, growth, and improvisation.

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3,770 Citations


Journal ArticleDOI: 10.1080/00048670902970882
Abstract: Objective: To provide a description of the methods and key findings of the 2007 Australian National Survey of Mental Health and Wellbeing. Method: A national face-to-face household survey of 8841 (60% response rate) community residents aged between 16 and 85 years was carried out using the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Diagnoses were made according to ICD-10. Key findings include the prevalence of mental disorder, sex and age distributions of mental disorders, severity of mental disorders, comorbidity among mental disorders, and the extent of disability and health service use associated with mental disorders. Results: The prevalence of any lifetime mental disorder was 45.5%. The prevalence of any 12 month mental disorder was 20.0%, with anxiety disorders (14.4%) the most common class of mental disorder followed by affective disorders (6.2%) and substance use disorders (5.1%). Mental disorders, particularly affective disorders, were disabling. One in four people (25.4%) with 12 month mental disorders had more than one class of mental disorder. One-third (34.9%) of people with a mental disorder used health services for mental health problems in the 12 months prior to the interview. Conclusions: Mental disorders are common in Australia. Many people have more than one class of mental disorder. Mental disorders are associated with substantial disability, yet many people with mental disorders do not seek help for their mental health problems.

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712 Citations


Open accessJournal ArticleDOI: 10.1089/TMJ.2013.0075
Abstract: Introduction: The effectiveness of any new technology is typically measured in order to determine whether it successfully achieves equal or superior objectives over what is currently offered. Research in telemental health—in this article mainly referring to telepsychiatry and psychological services—has advanced rapidly since 2003, and a new effectiveness review is needed. Materials and Methods: The authors reviewed the published literature to synthesize information on what is and what is not effective related to telemental health. Terms for the search included, but were not limited to, telepsychiatry, effectiveness, mental health, e-health, videoconferencing, telemedicine, cost, access, and international. Results: Telemental health is effective for diagnosis and assessment across many populations (adult, child, geriatric, and ethnic) and for disorders in many settings (emergency, home health) and appears to be comparable to in-person care. In addition, this review has identified new models of car...

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Topics: Telemental health (78%), Telepsychiatry (65%), Telemedicine (52%)

604 Citations