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The Pros and Cons of Telemental Health Services

The Pros and Cons of Telemental Health Services
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A young woman rests in bed while conducting a telehealth meeting via an iPadShare on Pinterest
Technology has made mental health services more easily available for some people. Getty Images
  • A new report states that telehealth is making mental health services more available to people in remote communities as well as those who can’t attend face-to-face sessions.
  • Researchers note, however, lack of internet access and knowledge of technology can make telehealth services more difficult for some people.
  • They also note that some people who use telemental health services are less committed and more easily distracted than people who use the services in person.

Virtual counseling sessions for mental health conditions can be effective for some people, but technology limits and other barriers to care must be addressed in order for “telemental” care to be more universally applicable, a new study conclude.

The COVID-19 pandemic accelerated the use of telehealth services, including for mental health, according to researchers from the United Kingdom’s National Institute for Health & Care Research’s Mental Health Policy Research Unit at King’s College London and University College London.

However, the researchers say that experience and research show that the effectiveness of telehealth can be greatly influenced — for good or bad — by factors such as access to private and confidential spaces, the ability to develop therapeutic relationships between doctor and patient, individual preferences and circumstances, and technology issues such as internet connection quality.

“We live in an increasingly digital world, and the COVID-19 pandemic accelerated the role of technology in mental health care,” Katherine Saunders, PhD, MSc, a co-lead study author and a research associate in mental health policy at King’s College, said in a press statement. “Our study found that, while certain groups do benefit from the opportunities elemental health can provide, it is not a one-size-fits-all solution. Receiving telemental health requires access to a device, an internet connection, and an understanding of technology. If real-world barriers to telemental health are ignored in favor of wider implementation, we risk further embedding inequalities into our healthcare system.”

The study, published in the Interactive Journal of Medical Research, found that theuse of telemental health has become increasingly widespread and is particularly valuable for serving people in remote communities and in situations where face-to-face counseling isn’t possible.

“I believe elemental health care is effective with appropriate risk management strategies in place,” said Jodi Tinglingfounder of the Canada-based mental health counseling program Creating New Steps.

“In my experience with providing-internet-based cognitive behavioral therapy during the height of the pandemic, this was a great alternative to traditional face-to-face therapy when there are effective risk management strategies in place,” she told Healthline.

Ideally, said researchers, telemental health interventions delivered via video calls, phone, or text messages, can increase access to care.

However, the study found that delivering mental health care remotely was less beneficial to people without access to the internet or a phone, those experiencing social and economic disadvantages, people with cognitive difficulties, auditory or visual impairments, and those with severe mental health issues.

“Clients with paranoia or severe anxiety whose symptoms might worsen due to lack of trust in the platform, or the technology, would need to work with someone in person,” Sabrina EadsLPC, a therapist at Enteave Counseling in Austin, Texas, told Healthline.

“For those people, we recommend a need to ensure that face-to-face care of equivalent timeliness remains available,” said Sonia JohnsonMSc, the director of the mental health policy research center at King’s College London and a senior author of the study.

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HAS recent study published in the journal JMIR Formative Research found that telehealth can be successfully used for people with suicidal ideation.

The study reported that patients who received both medication and counseling via text messages and video calls were 4 times more likely to have suicidal ideation remission than those in a control group.

Andrea Rowella social worker practicing telehealth in Toronto at a family health team and a private practice, told Healthline that virtual counseling has become more accepted and even preferred over traditional in-person therapy.

“Even though we are now offering a choice between in-person, phone, and video calling to have our sessions, the majority of people are opting willingly to do sessions over the phone,” she said. “People now seem to agree with providers that a telephone or video session is much more convenient.”

However, Rowell said that experience has shown that people can sometimes be less committed to counseling delivered via telehealth, particularly if it is offered at no cost.

“Therapy is all about communication,” she said. “Over the phone, part of a therapist’s role is taken away when therapists can no longer comment on their client’s body language. I recommend video therapy because of the ability to create a face-to-face connection while still making use of the benefits of being in the comfort of your own home… Some barriers of telehealth for mental health can be lowered by the therapist setting expectations from the start that the space needs to be confidential, and that there would be a recommendation to move to in-person if the client would feel more engaged that way.”

Distraction can be another disadvantage to mental health, said Myisha Jacksona mental health counselor and owner of Healing Journey Counseling Center in Monroe, Louisiana.

“There are some patients that try to do therapy at work, driving in the car, or while their small children are home,” she told Healthline. “Therapists must set boundaries and let the client know they must conduct the session in an environment like home or work [where there are] our distractions.”

michelle wagnerthe chief executive officer of the virtual mental health platform Mindstrong, told Healthline that telemental health is crucial for overcoming the nationwide shortage of mental health counselors, which often leads to long and potentially dangerous delays in accessing care.

“Virtual platforms often improve outcomes because access to care is more immediate and engaging,” said Wagner.

“Patients are often more open and at ease in their own homes. Plus, telehealth services don’t keep traditional 9 am to 5 pm, Monday through Friday office hours, and most have options for patients to communicate with their therapists between appointments. This helps therapists manage medications in real time, measure progress, and intervene before a patient is in crisis,” she added.

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