scholarly journals Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory

10.2196/23660 ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. e23660
Author(s):  
Markus W Haun ◽  
Isabella Stephan ◽  
Michel Wensing ◽  
Mechthild Hartmann ◽  
Mariell Hoffmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Diffusion Of Innovations ◽  
Significant Proportion ◽  
The United States ◽  
Diffusion Of Innovations Theory ◽  
Early Adopters ◽  
Adopter Categories

Background Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. Objective This mixed method preimplementation study aims to assess GPs’ intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). Methods Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. Results This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, P<.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. Conclusions A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.

scholarly journals Intent to Adopt Video-Based Integrated Mental Health Care and the Characteristics of its Supporters: Mixed Methods Study Among General Practitioners Applying Diffusion of Innovations Theory (Preprint)

2020 ◽  
Author(s):  
Markus W Haun ◽  
Isabella Stephan ◽  
Michel Wensing ◽  
Mechthild Hartmann ◽  
Mariell Hoffmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
General Practitioners ◽  
Diffusion Of Innovations ◽  
Significant Proportion ◽  
The United States ◽  
Diffusion Of Innovations Theory ◽  
Early Adopters ◽  
Adopter Categories

BACKGROUND Most people with common mental disorders, including those with severe mental illness, are treated in general practice. Video-based integrated care models featuring mental health specialist video consultations (MHSVC) facilitate the involvement of specialist mental health care. However, the potential uptake by general practitioners (GPs) is unclear. OBJECTIVE This mixed method preimplementation study aims to assess GPs’ intent to adopt MHSVC in their practice, identify predictors for early intent to adopt (quantitative strand), and characterize GPs with early intent to adopt based on the Diffusion of Innovations Theory (DOI) theory (qualitative strand). METHODS Applying a convergent parallel design, we conducted a survey of 177 GPs and followed it up with focus groups and individual interviews for a sample of 5 early adopters and 1 nonadopter. We identified predictors for intent to adopt through a cumulative logit model for ordinal multicategory responses for data with a proportional odds structure. A total of 2 coders independently analyzed the qualitative data, deriving common characteristics across the 5 early adopters. We interpreted the qualitative findings accounting for the generalized adopter categories of DOI. RESULTS This study found that about one in two GPs (87/176, 49.4%) assumed that patients would benefit from an MHSVC service model, about one in three GPs (62/176, 35.2%) intended to adopt such a model, the availability of a designated room was the only significant predictor of intent to adopt in GPs (β=2.03, SE 0.345, <i>P</i>&lt;.001), supporting GPs expected to save time and took a solution-focused perspective on the practical implementation of MHSVC, and characteristics of supporting and nonsupporting GPs in the context of MHSVC corresponded well with the generalized adopter categories conceptualized in the DOI. CONCLUSIONS A significant proportion of GPs may function as early adopters and key stakeholders to facilitate the spread of MHSVC. Indeed, our findings correspond well with increasing utilization rates of telehealth in primary care and specialist health care services (eg, mental health facilities and community-based, federally qualified health centers in the United States). Future work should focus on specific measures to foster the intention to adopt among hesitant GPs.

scholarly journals Rates and Associated Factors of Secondary Mental Health Care Utilisation among Ex-Military Personnel in the United States: A Narrative Review

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 18 ◽  
Author(s):  
Katharine Mark ◽  
Dominic Murphy ◽  
Sharon Stevelink ◽  
Nicola Fear
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
Mental Health Care ◽  
Military Personnel ◽  
Mental Health Problems ◽  
The United States ◽  
Health Care Utilisation ◽  
Narrative Review ◽  
Care Utilisation

Little is known about ex-serving military personnel who access secondary mental health care. This narrative review focuses on studies that quantitatively measure secondary mental health care utilisation in ex-serving personnel from the United States. The review aimed to identify rates of mental health care utilisation, as well as the factors associated with it. The electronic bibliographic databases OVID Medline, PsycInfo, PsycArticles, and Embase were searched for studies published between January 2001 and September 2018. Papers were retained if they included ex-serving personnel, where the majority of the sample had deployed to the recent conflicts in Iraq or Afghanistan. Fifteen studies were included. Modest rates of secondary mental health care utilisation were found in former military members—for mean percentage prevalence rates, values ranged from 12.5% for at least one psychiatric inpatient episode, to 63.2% for at least one outpatient mental health appointment. Individuals engaged in outpatient care visits most often, most likely because these appointments are the most commonly offered source of support. Post-traumatic stress disorder, particularly re-experiencing symptoms, and comorbid mental health problems were most consistently associated with higher mental health care utilisation. Easily accessible interventions aimed at facilitating higher rates of help seeking in ex-serving personnel are recommended.

The Digital Revolution in Behavioral Health

2019 ◽  
Vol 26 (1) ◽  
pp. 102-111 ◽  
Author(s):  
Michael J Hasselberg
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Behavioral Health ◽  
Digital Health ◽  
Behavioral Health Care ◽  
The United States ◽  
Care Providers ◽  
Digital Revolution ◽  
The University

BACKGROUND: Technology is disrupting every modern industry, from supermarkets to car manufacturing, and is now entering the health care space. Technological innovations in psychiatry include the opportunity for conducting therapy via two-way video conferencing, providing electronic consultations, and telementoring and education of community health care providers. Use of mobile health applications is also an expanding area of interest and promise. OBJECTIVE: The purpose of this article is to review the evolution and pros and cons of technology-enabled health care since the digital movement in psychiatry began more than 50 years ago as well as describe the University of Rochester’s innovative digital behavioral health care model. METHODS: A review of the literature and recent reports on innovations in digital behavioral health care was conducted, along with a review of the University of Rochester’s model to describe the current state of digital behavioral health care. RESULTS: Given the lack of access to care and mental health professional shortages in many parts of the United States, particularly rural areas, digital behavioral health care will be an increasingly important strategy for managing mental health care needs. However, there are numerous hurdles to be overcome in adopting digital health care, including provider resistance and knowledge gaps, lack of reimbursement parity, restrictive credentialing and privileging, and overregulation at both the state and federal levels. CONCLUSIONS: Digital health innovations are transforming the delivery of mental health care services and psychiatric mental health nurses can be on the forefront of this important digital revolution.

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