Covid-19 saw large chunks of healthcare moved into the virtual realm as providers and governments attempted to introduce social distancing to limit the spread of the virus. The transformation of service provision overcame many of the fears often expressed about telehealth, and indeed highlighted how quickly transformation can occur in healthcare when the urge is sufficient.
What’s more, the evidence is mounting that both providers and patients are supportive of the move and would quite like to keep it in place once the social distancing measures ease. Recent research from the University of Michigan shows that this support extends to sensitive services, such as mental health.
The researchers highlight that prior to the pandemic, just 26 video sessions were undertaken in six months, compared to over 30,000 sessions in person. This all changed in spring 2000 when consultations had to be done virtually, and the study suggests that the convenience of seeing a provider from home has been hugely valued by patients.
Virtual therapy
The researchers conducted a survey of several hundred patients who had appointments at the University of Michigan mental health facility. Around 83% of these consultations were done via video chat.
“We went from not getting much traction with telepsychiatry, and encountering a lot of reluctance among providers and patients, to having nearly all our care delivered virtually, and offering help to those who need it,” the researchers say. “These data suggest an opportunity to turn the experience of the pandemic into an opportunity to improve access to mental health care and improve the continuity of care. But policy and reimbursement decisions will be important.”
Nearly all of the participants in the study said that their virtual visit went as well as they had expected, or even better. Indeed, when the patients were children, their parents said that the video format was more engaging for them.
Flexible mental health care
The results also suggest that attendance rates might also have gone up with the virtual consultations. The authors highlight that before the pandemic, cancellation and no-show rates were around 25%, but this was reduced significantly with telehealth.
It’s not clear precisely why this is, but the researchers suggest the convenience of the technology means it was easier to get time off work or to arrange child care, while transportation was obviously no longer an issue.
The researchers believe a combined approach is likely to be used in future, with a mixture of phone, virtual, and face-to-face consultations offered depending on the circumstances.
“For the first visit with a new patient, we try to avoid using phone as it limits the initiation of the provider-patient therapeutic alliance, reduce communication cues, and limits the mental status exam that includes observing patient facial expressions, interactions, and movement,” they say. “Depending on the complexity of the patient’s situation, we may need to do a physical examination from time to time, to assess their balance and mobility, and check for medication side effects to name a few.”
