Barriers and facilitators of videoconferencing psychotherapy implementation in veteran mental health care environments: a systematic review

Abstract Background Whilst treatment for mental health issues has traditionally been conducted in-person, advances in technology has seen a recent growth in the use of online video therapy services to help overcome access-to-care barriers faced by those living in rural locations and those unable to travel. These barriers are particularly apparent in the case of veteran populations, which is the focus of this review. Whilst the research investigating the efficacy of online video therapy to treat mental health issues among veterans is promising, widespread adoption and utilisation of this modality remains low with efforts often failing to progress past the pilot phase to implementation. This review focuses on the implementation of online video therapy in veteran mental health care settings and aims to identify the potential barriers and facilitators relevant to implementing the modality in military organisations. Methods A systematic search of three databases (PsycInfo, PubMed, and Web of Science) was conducted. To be eligible for inclusion, studies had to investigate the challenges, lessons learnt, or factors operating as barriers and/or facilitators to the implementation of online video therapy in veteran health care systems. Results The initial search revealed a total of 202 articles. This was reduced to 133 when duplicates were removed. After screening the titles and abstracts a further 70 articles were excluded leaving 63 to be retrieved for full review. A total of 10 studies were included in this review. The most commonly reported barriers were related to clinician concerns, logistical problems, and technology. Other barriers included access to resources as well as challenges posed by collaborations, policy and recruitment. Facilitators included experience using the modality and having dedicated staff responsible for promoting and managing the new service (e.g., on-site champions and telehealth technicians). Conclusions This review suggests that numerous barriers must be identified and addressed before attempting to implement an online video therapy service in veteran organisations. Further research is needed to establish best practice for implementation, particularly across geographically dispersed sites. It is hoped that the findings of this review will be used to help inform future implementation efforts and research initiatives in this space.

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Unintentional participant observation: a research method to inform peer support in mental health?

Mental Health and Social Inclusion ◽

10.1108/mhsi-01-2019-0001 ◽

2019 ◽

Vol 23 (2) ◽

pp. 81-85 ◽

Cited By ~ 1

Author(s):

Andrew Voyce

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Peer Support ◽

Role Models ◽

Participant Observation ◽

Meta Analysis ◽

Health Issues ◽

Content Type ◽

Mental Health Issues

Purpose The purpose of this paper is to validate peer support in mental health care. Design/methodology/approach Literature review and meta-analysis methodology are used. Findings The unintentional nature of peer support is a valid methodology for the understanding of mental health issues and mental health care. Research limitations/implications The limitation is that peer experience should be accepted as a valued method for research. Practical implications Professional domains may not keep a monopoly of research approaches in mental health. Social implications Peer support may mean more avenues for empowerment of mental health service users from peer role models who have unintentional acquaintance with mental health issues and care. Originality/value This research refers to ethnographic precedents to describe methodology relevant to twenty-first century peer support in mental health. It is original in valuing the unintentional participant observation acquired from experience of the mental health system.

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Mental health implications of COVID-19 pandemic and its response in India

International Journal of Social Psychiatry ◽

10.1177/0020764020950769 ◽

2020 ◽

pp. 002076402095076 ◽

Cited By ~ 2

Author(s):

Adrija Roy ◽

Arvind Kumar Singh ◽

Shree Mishra ◽

Aravinda Chinnadurai ◽

Arun Mitra ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Social Media ◽

Mental Health Care ◽

Intervention Strategies ◽

Health Issues ◽

Mental Health Issues ◽

The Government ◽

Novel Coronavirus ◽

Anxiety Depression

Introduction: Mental health concerns and treatment usually take a backseat when the limited resources are geared for pandemic containment. In this global humanitarian crisis of the COVID-19 pandemic, mental health issues have been reported from all over the world. Objectives: In this study, we attempt to review the prevailing mental health issues during the COVID-19 pandemic through global experiences, and reactive strategies established in mental health care with special reference to the Indian context. By performing a rapid synthesis of available evidence, we aim to propose a conceptual and recommendation framework for mental health issues during the COVID-19 pandemic. Methods: A search of the PubMed electronic database and google scholar were undertaken using the search terms ‘novel coronavirus’, ‘COVID-19’, ‘nCoV’, SARS-CoV-2, ‘mental health’, ‘psychiatry’, ‘psychology’, ‘anxiety’, ‘depression’ and ‘stress’ in various permutations and combinations. Published journals, magazines and newspaper articles, official webpages and independent websites of various institutions and non-government organizations, verified social media portals were compiled. Results: The major mental health issues reported were stress, anxiety, depression, insomnia, denial, anger and fear. Children and older people, frontline workers, people with existing mental health illnesses were among the vulnerable in this context. COVID-19 related suicides have also been increasingly common. Globally, measures have been taken to address mental health issues through the use of guidelines and intervention strategies. The role of social media has also been immense in this context. State-specific intervention strategies, telepsychiatry consultations, toll free number specific for psychological and behavioral issues have been issued by the Government of India. Conclusion: Keeping a positive approach, developing vulnerable-group-specific need-based interventions with proper risk communication strategies and keeping at par with the evolving epidemiology of COVID-19 would be instrumental in guiding the planning and prioritization of mental health care resources to serve the most vulnerable.

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Telepsychiatry -another window to escape from poverty (Preprint)

10.2196/preprints.24626 ◽

2020 ◽

Author(s):

Tanjir Rashid Soron ◽

Lamia Shams

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Mental Health Professionals ◽

Social Stigma ◽

Mental Healthcare ◽

Health Issues ◽

Socioeconomic Condition ◽

Mental Health Issues ◽

Resource Limited

UNSTRUCTURED People living in poverty are in greater risk of developing mental health issues due to its association with various stressors such as decreased productivity, loss of employment, reduced social support, stigma etc. Low socioeconomic status can hinder one’s access to mental health care and can lead him to devastating consequences. Even though Bangladesh has made a significant progress in eradicating poverty, the recent pandemic of COVID-19 has overburdened its resource limited healthcare settings. However, during lockdown a large number of people are experiencing a deterioration in their socioeconomic condition and this can negatively impact their mental health. Like many other developing countries, Bangladesh do not have equitable distribution of mental healthcare facilities in urban and rural areas. Distance to mental health care canter along with social stigma discourage people to get professional help. The psychological sufferings of the people can be mitigated by ensuring remote consultation through telepsychiatry services where the patients can maintain anonymity and escape the social stigma. Moreover, with the recent progress in using mobile phone and related technologies, telepsychiatry services will not only help the patients to reduce their access to service gap in an affordable way but also the mental health professionals will be able to help more patients. Telepsychiatry interventions can contribute to early diagnosis of mental health issues in population and this can reduce the chances of suicide and other morbidities. In resource limited settings, mental healthcare services aided with technology can overcome the barriers to access to care. In an addition to that, the mental well-being of individuals will enable them to lead an economically productive life with active contribution at workplaces.

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Connected Mental Health: Systematic Mapping Study (Preprint)

10.2196/preprints.19950 ◽

2020 ◽

Author(s):

Nidal Drissi ◽

Sofia Ouhbi ◽

Mohammed Abdou Janati Idrissi ◽

Luis Fernandez-Luque ◽

Mounir Ghogho

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Care Delivery ◽

Systematic Mapping Study ◽

Health Issues ◽

Systematic Mapping ◽

Mental Health Issues ◽

Cohort Groups ◽

Research Type

BACKGROUND Although mental health issues constitute an increasing global burden affecting a large number of people, the mental health care industry is still facing several care delivery barriers such as stigma, education, and cost. Connected mental health (CMH), which refers to the use of information and communication technologies in mental health care, can assist in overcoming these barriers. OBJECTIVE The aim of this systematic mapping study is to provide an overview and a structured understanding of CMH literature available in the Scopus database. METHODS A total of 289 selected publications were analyzed based on 8 classification criteria: publication year, publication source, research type, contribution type, empirical type, mental health issues, targeted cohort groups, and countries where the empirically evaluated studies were conducted. RESULTS The results showed that there was an increasing interest in CMH publications; journals were the main publication channels of the selected papers; exploratory research was the dominant research type; advantages and challenges of the use of technology for mental health care were the most investigated subjects; most of the selected studies had not been evaluated empirically; depression and anxiety were the most addressed mental disorders; young people were the most targeted cohort groups in the selected publications; and Australia, followed by the United States, was the country where most empirically evaluated studies were conducted. CONCLUSIONS CMH is a promising research field to present novel approaches to assist in the management, treatment, and diagnosis of mental health issues that can help overcome existing mental health care delivery barriers. Future research should be shifted toward providing evidence-based studies to examine the effectiveness of CMH solutions and identify related issues.

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Access to Refugee and Migrant Mental Health Care Services during the First Six Months of the COVID-19 Pandemic: A Canadian Refugee Clinician Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105266 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5266

Author(s):

Joseph Benjamen ◽

Vincent Girard ◽

Shabana Jamani ◽

Olivia Magwood ◽

Tim Holland ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Health Care Services ◽

Global Mental Health ◽

Health Issues ◽

Care Services ◽

Mental Health Issues ◽

Virtual Care ◽

Migrant Mental Health

The COVID-19 pandemic has had a major impact on the mental health of refugees and migrants. This study aimed to assess refugee clinician perspectives on mental health care during the COVID-19 pandemic, specifically access to and delivery of community mental health care services. We utilized a mixed methods design. We surveyed members of a national network of Canadian clinicians caring for refugees and migrants. Seventy-seven clinicians with experience caring for refugee populations, representing an 84% response rate, participated in the online survey, 11 of whom also participated in semi-structured interviews. We report three major themes: exacerbation of mental health issues and inequities in social determinants of health, and decreased access to integrated primary care and community migrant services. Clinicians reported major challenges delivering care during the first 6 months of the pandemic related to access to care and providing virtual care. Clinicians described perspectives on improving the management of refugee mental health, including increasing access to community resources and virtual care. The majority of clinicians reported that technology-assisted psychotherapy appears feasible to arrange, acceptable and may increase health equity for their refugee patients. However, major limitations of virtual care included technological barriers, communication and global mental health issues, and privacy concerns. In summary, the COVID-19 pandemic has exacerbated social and health inequities within refugee and migrant populations in Canada and challenged the way mental health care is traditionally delivered. However, the pandemic has provided new avenues for the delivery of care virtually, albeit not without additional and unique barriers.

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The Use of a Telemedicine Model and its Logistics to Reach as Many European Refugees as Possible

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.116 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S20-S20

Author(s):

D. Mucic

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Best Practice ◽

Health Care Systems ◽

Treatment Options ◽

Cross Cultural ◽

Treatment Team ◽

Care Needs ◽

National Boundaries

Current refugee crisis challenges mental health care systems all over the Europe. There is a number of research describing difficulties in dealing with cross-cultural patients. Access to relevant care as well as its availability are often limited due to: a) lack of respective qualified resources b) linguistically, cultural and even racial barriers in addressing of mental health care needs of cross-cultural patient population. By use of various e-Mental health applications, primarily videoconference, we may improve assessment and/or treatment of refugees and asylum seekers on distance e.g. Arabic speaking psychiatrist located in Sweden would be able to assess and/or treat refugees from Syria located in Germany). Specialized centers for treatment of refugees would also be able to get second-opinion service from remote experts and use it in order to confirm or re-consider diagnosis as well as the treatment options. Establishment of international network of cross-cultural experts enables to:– Improve the mental health care across national boundaries by providing psychiatric consultations to other countries within EU– Conduct International Treatment Team with Select Skills (e.g. Sign Language and Many Foreign Languages Staff)– Provide Distance Supervision and Staff Consultation– Provide Psycho Education of caregivers– Improve Distance Learning via Case Conferencing and Best Practice Demonstration Across the National Boundaries– Create Data Base over cross-cultural and other select skills professionals within EUDisclosure of interestThe author has not supplied his declaration of competing interest.

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Connected Mental Health: Systematic Mapping Study

Journal of Medical Internet Research ◽

10.2196/19950 ◽

2020 ◽

Vol 22 (8) ◽

pp. e19950

Author(s):

Nidal Drissi ◽

Sofia Ouhbi ◽

Mohammed Abdou Janati Idrissi ◽

Luis Fernandez-Luque ◽

Mounir Ghogho

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Care Delivery ◽

Systematic Mapping Study ◽

Health Issues ◽

Systematic Mapping ◽

Mental Health Issues ◽

Cohort Groups ◽

Research Type

Background Although mental health issues constitute an increasing global burden affecting a large number of people, the mental health care industry is still facing several care delivery barriers such as stigma, education, and cost. Connected mental health (CMH), which refers to the use of information and communication technologies in mental health care, can assist in overcoming these barriers. Objective The aim of this systematic mapping study is to provide an overview and a structured understanding of CMH literature available in the Scopus database. Methods A total of 289 selected publications were analyzed based on 8 classification criteria: publication year, publication source, research type, contribution type, empirical type, mental health issues, targeted cohort groups, and countries where the empirically evaluated studies were conducted. Results The results showed that there was an increasing interest in CMH publications; journals were the main publication channels of the selected papers; exploratory research was the dominant research type; advantages and challenges of the use of technology for mental health care were the most investigated subjects; most of the selected studies had not been evaluated empirically; depression and anxiety were the most addressed mental disorders; young people were the most targeted cohort groups in the selected publications; and Australia, followed by the United States, was the country where most empirically evaluated studies were conducted. Conclusions CMH is a promising research field to present novel approaches to assist in the management, treatment, and diagnosis of mental health issues that can help overcome existing mental health care delivery barriers. Future research should be shifted toward providing evidence-based studies to examine the effectiveness of CMH solutions and identify related issues.

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COVID-19, psychosocial issues, politics, and public mental health care

South African Journal of Psychology ◽

10.1177/00812463211015750 ◽

2021 ◽

Vol 51 (2) ◽

pp. 293-303

Author(s):

Anthony L Pillay ◽

Anne L Kramers-Olen

Keyword(s):

Mental Health ◽

South Africa ◽

Health Care ◽

Mental Health Care ◽

Health Care Systems ◽

Mental Health Policy ◽

Public Mental Health ◽

The Public ◽

Care Systems ◽

Public Mental Health Care

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.

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