The application of e-mental health in response to COVID-19: A review and bibliometric analysis (Preprint)
BACKGROUND The COVID-19 pandemic and its mitigation measures such as shelter-in-place orders, social isolation, restrictions on freedoms, unemployment, financial insecurity and disrupted routines, have led to unprecedented declines in mental health worldwide and concomitant escalating demands for mental health services. Under the circumstances, e-mental health programs and services have rapidly become the “new normal”. OBJECTIVE To assess current trends and evidence gaps in the e-mental health literature published in relation to the COVID-19 pandemic via a scoping review and bibliometric analysis. METHODS A search of four academic databases (Ovid MEDLINE, EMBASE, PsychINFO, CINAHL) published from 31st December 2019 to 31st March 2021 using keywords for e-mental health and COVID-19. Article information was extracted relevant to the review objective including journal, type of article, keywords, focus and corresponding author. Information was synthesised by coding these attributes, then summarised through descriptive statistics and narrative techniques. Article influence was examined from Altmetric and CiteScore data, and a network analysis was conducted on article keywords. RESULTS A total of 356 publications were included in the review. Articles on e-mental health quickly thrived early in the pandemic, with most articles being non-empirical, chiefly commentaries or opinions (n = 225, 63.2%). Empirical publications emerged later and becoming more frequent as the pandemic progressed. The United States contributed the most articles (n = 160, 44.9%), though a notable number came from middle-income countries (n = 59, 16.6). Articles were spread across 165 journals, and were of above-average-influence (almost half of the articles were in the top 25% of outputs scores by Altmetric and the average CiteScore across articles was 4.22). The network analysis of author supplied keywords identified key topic areas, including specific: mental health disorders; e-health modalities; issues and challenges; and populations of interest. These were further explored via full-text analysis. Applications of e-mental health during the pandemic overcame, or were influenced by system, service, technology, provider and patient factors. CONCLUSIONS COVID-19 has accelerated applications of e-mental health. Sustained adoption of e-mental health will require evidence to support the implementation of the required technologies across system and service infrastructure alongside evidence of the relative effectiveness of e-mental health in comparison to traditional modes of care. CLINICALTRIAL N/A