Research Paper Title

Use of Tele-Mental Health in Conjunction With In-Person Care: A Qualitative Exploration of Implementation Models.

Background

Although use of tele-mental health services is growing, there is limited research on how tele-mental health is deployed.

This project aimed to describe how health centres use tele-mental health in conjunction with in-person care.

Methods

The 2018 Substance Abuse and Mental Health Services Administration Behavioural Health Treatment Services Locator database was used to identify community mental health centres and federally qualified health centres with telehealth capabilities.

Maximum diversity sampling was applied to recruit health centre leaders to participate in semi-structured interviews.

Inductive and deductive approaches were used to develop site summaries, and a matrix analysis was conducted to identify and refine themes.

Results

Twenty health centres in 14 states participated. All health centres used telepsychiatry for diagnostic assessment and medication prescribing, and 10 also offered therapy via telehealth.

Some health centres used their own staff to provide tele-mental health services, whereas others contracted with external providers. In most health centres, tele-mental health was used as an adjunct to in-person care.

In choosing between tele-mental health and in-person care, health centres often considered patient preference, patient acuity, and insurance status or payer.

Although most health centres planned to continue offering tele-mental health, participants noted drawbacks, including less patient engagement, challenges sharing information within the care team, and greater inefficiency.

Conclusions

Tele-mental health is generally used as an adjunct to in-person care.

The results of this study can inform policy makers and clinicians regarding the various delivery models that incorporate tele-mental health.

Reference

Uscher-Pines, L., Raja, P., Qureshi, N., Huskamp, H.A., Busch, A.B. & Mehrotra, A. (2020) Use of Tele-Mental Health in Conjunction With In-Person Care: A Qualitative Exploration of Implementation Models. Psychiatric Services (Washington, D.C.). 71(5), pp.419-426. doi: 10.1176/appi.ps.201900386. Epub 2020 Jan 30.