Home direct-to-consumer telehealth solutions for children with mental health disorders and the impact of Covid-19

2021 ◽  
pp. 135910452110641
Author(s):  
Sierra Norman ◽  
Shireen Atabaki ◽  
Kathleen Atmore ◽  
Cara Biddle ◽  
Marc DiFazio ◽  
...  

Delivery of mental health treatment in the home can close gaps in care. Telehealth also provides access to healthcare that has been disrupted due to the COVID-19 pandemic. In 2016, a home direct-to-consumer telehealth program was initiated. Mental health encounters made up a significant portion of all telehealth encounters and COVID-19 had a significant impact on accelerating the utilization of telehealth. Telemental health has been more successful at meeting targeted volumes than the overall health system. Of all the mental health diagnoses before and during COVID-19, attention deficit hyperactivity disorder, Autism Spectrum Disorder, and Anxiety Disorder were most common. The direct-to-consumer telehealth program saved patients a significant amount of travel miles and associated time, based on data from the period before COVID-19. Payment reimbursement for direct-to-consumer telehealth professional services was similar to reimbursement for in-person visits. This program demonstrates direct-to-consumer telehealth is a feasible and acceptable care modality for a variety of youth mental health disorders.

Spine ◽  
2018 ◽  
Vol 43 (21) ◽  
pp. 1455-1462 ◽  
Author(s):  
Bassel G. Diebo ◽  
Joshua D. Lavian ◽  
Shian Liu ◽  
Neil V. Shah ◽  
Daniel P. Murray ◽  
...  

2021 ◽  
Author(s):  
Victoria Welch ◽  
Tom Joshua Wy ◽  
Anna Ligezka ◽  
Leslie C. Hassett ◽  
Paul E. Croarkin ◽  
...  

BACKGROUND Mental health disorders across the life span are a leading cause of medical disabilities. This burden is particularly significant in children and adolescents due to challenges in diagnoses and lack of precision medicine approaches. The advent and widespread adoption of wearable devices (e.g., smartwatches) that generate large volumes of passively collected data that are conducive for artificial intelligence applications to remotely diagnose and manage child and adolescent mental health disorders is promising. OBJECTIVE This study conducted a scoping review to study, characterize and identify areas of innovations with wearable devices that can augment current in-person physician assessments to individualize diagnosis and management of mental health disorders in child and adolescent psychiatry. METHODS This scoping review used PRISMA’s information as a guide. A comprehensive search of several databases from 2011 to June 25, 2021, limited to English language and excluding animal studies, was conducted. The databases included Ovid MEDLINE (R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Web of Science, and Scopus. RESULTS The initial search yielded 344 articles. 19 articles were left on the final source list for this scoping review. Articles were divided into three main groups: Studies with the main focus on Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorders (ADHD) and Internalizing disorders such as anxiety disorders. Majority of the studies used either ECG strap or wrist worn biosensor. CONCLUSIONS Our scoping review found large heterogeneity of methods and findings in artificial intelligence studies in child psychiatry. Overall, the largest gaps identified in this scoping review are the lack of randomized control trials, most available studies are pilot feasibility trials.


2012 ◽  
Vol 25 (2) ◽  
pp. 310-319 ◽  
Author(s):  
Simone Freitag ◽  
Elmar Braehler ◽  
Silke Schmidt ◽  
Heide Glaesmer

ABSTRACTBackground: Long-term effects of World War II experiences affect psychological and physical health in aged adults. Forced displacement as a traumatic event is associated with increased psychological burden even after several decades. This study investigates the contribution of forced displacement as a predictor for mental health disorders and adds the aspect of health-related quality of life (QoL).Method: A sample of 1,659 German older adults aged 60–85 years was drawn from a representative survey. Post-traumatic stress disorder (PTSD), somatoform symptoms, depressive syndromes, and health-related QoL were assessed as outcome variables. Chi-square and t-test statistics examined differences between displaced and non-displaced people. Logistic regression analyses were performed to examine the impact of forced displacement on mental health disorders and QoL.Results: Displaced people reported higher levels of PTSD, depressive and somatoform symptoms, and lower levels of health-related QoL. Displacement significantly predicted PTSD and somatoform symptoms in late life, but not depressive disorders. Health-related QoL was predicted by forced displacement and socio-demographic variables.Conclusion: Forced displacement is associated with an elevated risk for PTSD and somatoform symptoms and lowered health-related QoL in aged adults. Its unique impact declines after including socio-demographic variables. Long-term consequences of forced displacement need further investigations and should include positive aspects in terms of resilience and protective coping strategies.


2014 ◽  
Vol 15 (3) ◽  
pp. 81-96 ◽  
Author(s):  
R Nassen ◽  
K Donald ◽  
K Walker ◽  
S Paruk ◽  
M Vujovic ◽  
...  

HIV-positive children and adolescents are at increased risk of both central nervous system (CNS) sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood) and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1) and HIV-associated neurocognitive disorders (section 2) among children and adolescents.  


2019 ◽  
Vol 24 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Joanna L. Hudson ◽  
Rona Moss-Morris

Abstract. Cognitive-behavioral therapy (CBT) is an evidence-based treatment for depression and anxiety recommended for those with and without physical long-term conditions (LTCs). However, the cognitive-behavioral mechanisms targeted in CBT protocols are based on empirical cognitive-behavioral models of depression and anxiety. In these models, emotions are conceptualized as primary mental health disorders rather than a reaction to the challenges of living with a LTC commonly referred to as illness distress. This raises important clinical questions with theoretical implications. These include: Is the experience of illness distress conceptually distinct from primary mental health diagnoses of anxiety and mood disorder? Are there unique cognitive-behavioral mechanisms related to illness self-management, which should be incorporated into CBT for illness distress? How can illness self-management interventions be embedded within existing CBT protocols for depression and anxiety? To address these questions, we distinguish between primary mental health disorders and illness distress conceptually and explore the impact of this on tailored treatment planning and engagement. Second, we review how health psychology theoretical models can help to inform modifications of existing cognitive-behavioral treatments for anxiety and depression to better support the needs of individuals experiencing illness distress. Third, we provide examples of how to embed processes important for illness self-management including, illness cognitions and adherence, alongside existing CBT techniques. The mechanisms and intervention techniques discussed may help to inform the development of integrated CBT treatments for illness distress for future hypothesis testing in comparative effectiveness trials.


2020 ◽  
Vol 7 ◽  
Author(s):  
Adam D. Brown ◽  
Katharina Schultebraucks ◽  
Meng Qian ◽  
Meng Li ◽  
Danny Horesh ◽  
...  

Abstract Background United Nations (UN) personnel address a diverse range of political, social, and cultural crises throughout the world. Compared with other occupations routinely exposed to traumatic stress, there remains a paucity of research on mental health disorders and access to mental healthcare in this population. To fill this gap, personnel from UN agencies were surveyed for mental health disorders and mental healthcare utilization. Methods UN personnel (N = 17 363) from 11 UN entities completed online measures of generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), trauma exposure, mental healthcare usage, and socio-demographic information. Results Exposure to one or more traumatic events was reported by 36.2% of survey responders. Additionally, 17.9% screened positive for GAD, 22.8% for MDD, and 19.9% for PTSD. Employing multivariable logistic regressions, low job satisfaction, younger age (<35 years of age), greater length of employment, and trauma exposure on or off-duty was significantly associated with all the three disorders. Among individuals screening positive for a mental health disorder, 2.05% sought mental health treatment within and 10.01% outside the UN in the past year. Conclusions UN personnel appear to be at high risk for trauma exposure and screening positive for a mental health disorder, yet a small percentage screening positive for mental health disorders sought treatment. Despite the mental health gaps observed in this study, additional research is needed, as these data reflect a large sample of convenience and it cannot be determined if the findings are representative of the UN.


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