Table 1 Study characteristics table
ID | Author | Study Design | Country | Participants | Type of service delivery | Service change | Abstract of Outcomes |
|---|---|---|---|---|---|---|---|
Mental health patients | |||||||
1 | Abate 2021 [31] | Case study | Italy | People with pre-existing diagnosed psychiatric disorders, especially severe or complex ones | Telephone | Remote diagnostics, accessibility of services, flexibility for services, care delivery mode via technology | Reduced burden on hospital care providers; effective and accessible services; challenges in assessment including difficulty in understanding patient's stress symptoms and general condition; difficulties with establishing trust between a specialist and a user |
2 | Adams 2022 [32] | Qualitative | UK | Homeless people, lived experiences of substance use and mental health illness | Telephone/videoconferencing | Operating hours of service provision, accessibility to services, privacy of care providers and patients, flexibility of services, care delivery mode via technology | a) reduced service provision, within working hours; b) negative experiences of participants as they could not access services when needed (prior to COVID negative experience) |
3 | Agyapong 2021 [33] | RCT | Canada | General population | Phone text service | Accessibility to services | This study demonstrated the effectiveness of Text4Hope over six consecutive weeks on various psychological symptomatology, including stress, GAD, MDD, and suicidal ideation or thoughts of self-harm, but not for disturbed sleep symptoms; statistically significant reductions in the prevalence rates for clinically meaningful stress, anxiety and depression as well as statistically significant reductions in mean scores on the PSS-10, GAD-7, and PHQ-9 scales when comparing the baseline and third month assessments in subscribers of Text4Hope) |
4 | Avalone 2021 [34] | Quantitative | US | Mental health patients | Telephone | Accessibility to services, flexibility of services, care delivery mode via technology | a) Higher completion rates in telehealth: outpatient adult mental health clinic telepsychiatry appointments, largely by telephone, were strongly associated with a higher rate of visit completion compared with in-person visits during and prior to the COVID-19 pandemic |
5 | Abdullah 2021 [35] | Qualitative | US | Patients with psychiatric disorders | Telephone | Accessibility to services, privacy of care providers and patients, flexibility of services, care delivery mode via technology | the experiences of both patients and service providers are mixed. Positive include flexibility, low drop-out rate, accessibility. Negatives include lack of privacy for patients, technology problems and care providers isolation |
6 | Barry 2022 [36] | Qualitative | Ireland | Patients with various mental health illness | Face to face /phone | Operating hours of service provision, accessibility to services, flexibility of services | a) flexibility and b) clarity in service provision pathways |
7 | Bean 2022 [37] | Quantitative | US | Patients seeking treatment for co‐occurring mental health and substance use disorder diagnoses | Videoconferencing | Accessibility to services, remote diagnostics and evaluation, flexibility of services, care delivery mode via technology | a) both services are effective in reducing symptoms of depression, anxiety, and stress when delivered in either in‐person or videoconference formats, with no significant difference between the forms of delivery in terms of symptom improvement |
8 | Bulkes 2022 [38] | Quantitative | US | Adults with anxiety and depressive symptoms | Videoconferencing | Remote diagnostics and evaluation, accessibility to services, flexibility of services | a) Increased length of stay in treatment in telehealth, b) remote treatment as a viable alternative to in-person mental health services, specifically as both in-person and remote patients experienced symptom reduction, and both populations reported improvements in quality of life |
9 | Burton 2021 [39] | Qualitative | US | Prison inmates with psychiatric disorders | Videoconferencing | Operating hours of service provision, remote diagnostics and evaluation, accessibility of services | a) high overall satisfaction with telepsychiatry so far; b) care providers have noted that they are often able to provide similar quality of services to patients over video as they are in person, and c) patients appreciate being able to meet with clinicians without coming into close contact with others. d) Clinics seem to run efficiently, as telepsychiatry reduces the time required for custody care providers to escort patients from housing units to treatment areas. e) Waiting rooms appear less congested than before |
10 | Gannon 2021 [40] | Case study | US | Distinct clinical populations, including general child and adolescent, intellectual and developmental disability, geriatric, general adult, addiction medicine, and psychotic disorders | Videoconferencing | Remote diagnostics and evaluation, accessibility to services, privacy of care providers and patients, flexibility of services, care delivery mode via technology | a) attendance increased; b) telehealth is a welcomed alternative; c) patients with anxiety, low mood, trauma, memory impairment, or psychotic spectrum disorders found telehealth less stressful d) for care providers seeing home environment of patients is beneficial (real-time observations) e) mobility of care providers allowed more flexibility and availability f) billing procedures are challenging; g) technology issues: lack of adequate hardware from care providers; h) privacy concerns of care providers |
11 | Glancy 2020 [41] | Qualitative | Ireland | Individuals with severe chronic and enduring mental health illnesses | Face to face/ videoconferencing | Care delivery mode via technology | a) physical isolation helped patients to have more space for reflection; b) self-awareness improved; c) sense of camaraderie was created |
12 | Guinart 2020 [42] | Quantitative | US | Patients in psychiatric centres | Videoconferencing | Remote diagnostics and evaluation, privacy of care providers and patients, flexibility of services, care delivery mode via technology | a) high levels of satisfaction with telepsychiatry services; b) the option of telepsychiatry should remain tailored to individual patient needs and be the result of shared decision; c) subjects were more likely to strongly agree to consider using telepsychiatry in the future when using video; d) lack of closeness; e) fear of reduction in the doctor’s ability to detect subtle signs of body language, nonverbal cues, and/or physical signs of disease could be some of the reasons behind this preference |
13 | Haderlein 2022 [43] | Qualitative | US | VA Primary Care-Mental Health Integration patients: veterans | Electronic consults, video consultations and messaging via the electronic health record | Accessibility to services | a) veterans who attended an initial PC-MHI mental health visit via telehealth were less likely to receive same-day primary care compared to veterans who initiated care in person; b) White veterans, and Hispanic veterans were more represented among telehealth patients than in-person patients, while women and Black veterans were less represented among telehealth patients than in-person patients; c) the PC-MHI model is designed to serve as an entry point into mental health services, with the intent to increase patient access to VA mental health care |
14 | Juan 2021 [44] | Qualitative | UK | People with pre-existing mental health conditions | Telephone and videoconferencing | Remote diagnostics and evaluation, accessibility to services, care delivery mode via technology | a) patients appreciated remote care options during the height of the pandemic when other forms of care were not possible; b) remote care was mainly seen as an option to allow access to care in extreme circumstances, rather than an alternative of comparable quality to face-to-face care; c) Other variables influencing remote care experiences were the relationship with the care provider, including whether they had met face-to-face in the past, and ease of use or access to necessary technology; f) Overall, participants stressed the need to provide alternatives for people who could not access or did not feel comfortable with telemental healthcare |
15 | Milosevic 2022 [45] | Quantitative | Canada | Outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/ agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive–compulsive disorder | Videoconferencing | Care delivery mode via technology | a) Significantly more sessions were attended by participants in the videoconference versus face-to-face GAD groups; b) Treatment dropout did not differ significantly between groups; c) a small but significant positive effect of face-to-face treatment on reduction in symptom severity over time, relative to videoconference treatment ( only the GAD group showed greater symptom improvement in the face-to-face format); d) Effect sizes (Cohen’s d) for treatment were mostly comparable between face-to-face and videoconference delivery, with videoconferencing tending to have slightly lower effects than face-to-face e) improved functional impairment over the course of treatment |
16 | Molino 2022 [46] | Case study | US | Patients with social anxiety disorder | Videoconferencing | Accessibility to services, flexibility of services | a) possibility that a transition to CBT via telehealth affected the potential trajectory of progress: symptom measure scores decreased; b) the telehealth helped to address acute stressors as they arose; c) the telehealth provided the patient with an opportunity to start attending support group as she did not need to physically travel to the clinic |
17 | Pinciotti 2022 [47] | Quantitative | US | Veterans with obsessive–compulsive disorder (OCD) | Videoconferencing, internet-based CBT (recorded sessions) | Accessibility to services, care delivery mode via technology | a) telehealth improved access to specialized mental health services for some individuals who may otherwise have been unable to access them |
18 | Puspitasari 2021 [48] | Qualitative | US | Patients with serious mental illness (adults living with an SMI, such as bipolar disorder or recurrent major depression, are at increased risk for substance abuse, homelessness, and death by suicide) | Videoconferencing | Remote diagnostics and evaluation, care delivery mode via technology | demonstrated the feasibility and initial effectiveness of ATP, a program that was rapidly switched to a video teleconferencing format during the COVID-19 pandemic. a) the completion rate was higher than typical completion rates for psychiatric IOP or PHP programs b)the average number of days completed by patients was 14.43 (SD 1.22), which indicated that the majority of patients only missed approximately 1 day in the three-week program c) patients' symptoms improved from admission to discharge; d) both the shared and differing content across the tracks were similarly effective in reducing distress and improving quality of life |
19 | Roncero 2020 [49] | Qualitative | Spain | Patients, service providers of The Salamanca Psychiatry Department (PS) | Telephone | Remote diagnostics and evaluation, accessibility to services, operating hours of service provision | a) Psychiatry service was carried out in three main aspects: generalizedimplementation of telemedicine, physical shutdown of the resources, and reorganization of human resources with those professionals who were not off work due to COVID nor were included in the COVID teams. b) The usage of tele-medicine in an extensive way, with around 9000 calls in 8 weeks, was successful in all the resources; c) patients have remained stable and their subjective perception of the support given was hardly lesser than with conventional hospitalization; d) accessibility: telemedicine can be a very relevant resource in the attention to geographically distant patients, urgent and pre-emptive |
20 | Saunders and Allen, 2021 [50] | Case study | UK | For adults with chronic physical health problems and either persistent subthreshold depressive symptoms or mild to moderate depression | Telephone | Accessibility to services | a) maintaining therapeutic homework was a challenge; b) monitoring behavioural work over the phone was difficult; c) The F2F sessions had focused on setting up behavioural goals, many of which could not be completed due to the pandemic, so resetting these goals led to some repeated work. The cognitive work on the other hand, worked well over the phone and was largely unchanged by phone delivery; d) Access: A move to telephone delivery meant sessions were still accessible. c) despite the change in modality, sessions were also able to remain largely reminiscent of how they had been during F2F delivery. (For example, email was utilized to deliver worksheets before and after sessions and this allowed AB to follow along with the CBT in a similar manner to how she had in F2F sessions.) e) digital divide between populations |
21 | Skime 2022 [51] | Quantitative | US | Adults with SMI who were recently discharged from psychiatric hospitalization or were at risk of psychiatric hospitalization | Videoconferencing | Accessibility to services, care delivery mode via technology | a) Patients were satisfied with the TMH ATP, and IOP, with most reporting that they would recommend these services to a friend or family member; b) “hybrid” model of care, which allows for both approaches (depending upon the patient’s choice and availability of stable internet services in their area) may be a viable alternative; c) TMH services are important in reaching patients that are geographically distanced from mental health facilities |
22 | Yahara 2021 [52] | Case study | Japan | Patients with mild cognitive impairment (MCI) | iVR reminiscence session | Accessibility to services, care delivery mode via technology | a) iVR reminiscence session may transiently reduce anxiety in the late elderly with MCI without causing serious side effects, which may also reduce the burden of caregiving for their families; b) the effectiveness of remote iVR reminiscence may be comparable to that of face-to-face iVR reminiscence; c) decrease in STAI scores after remote iVR reminiscence session, and his satisfaction level was higher than that of the final face-to-face iVR reminiscence session |
23 | Zimmerman 2021 [53] | Quantitative | US | Acute psychiatric patients who require a higher level of care | Videoconferencing | Remote diagnostics and evaluation, accessibility to services, flexibility of services | a) delivering treatment using a virtual, telehealth platform was as effective as treating patients in person; b) patients were satisfied with the initial diagnostic evaluation and were optimistic at admission that treatment would be helpful; c) Both treatment groups reported a significant reduction in symptoms and suicidality from admission to discharge and reported a significant improvement in functioning, coping ability, positive mental health, and general well-being; d) a greater length of stay and greater likelihood of staying in treatment until completion in the virtually treated patients; e) attendance rates: a lower “no show” rate for telehealth visits during the pandemic compared to in-person visits; e) treatment completion rate was significantly higher in the telehealth cohort |
24 | Zimmerman 2022 [54] | Mixed-method | US | Patients with psychiatric disorder | Videoconferencing | Remote diagnostics and evaluation, accessibility to services, flexibility of services | a) telehealth platform was as effective as treating patients in-person; b) patients were satisfied with the initial diagnostic evaluation and were optimistic at admission that treatment would be helpful; c) Both treatment groups reported a significant reduction in symptoms from admission to discharge, and both groups reported a significant improvement in functioning, coping ability, positive mental health, and general well-being; d) a slightly higher proportion of patients completed treatment in the telehealth program e) a greater length of stay and greater likelihood of staying in treatment until completion in the virtually treated patients |
Mental health care providers | |||||||
25 | Liberati 2021 [55] | Qualitative | UK | Adults with mental health difficulties under the care of secondary mental health services who either accessed support, including inpatient and community mental health services, during the pandemic, or needed services but did not access them | Telephone and videoconferencing | Remote diagnostics and evaluation, accessibility to services, flexibility of services, care delivery mode via technology | a) sustaining capacity and enabling access to secondary mental health services; b) flexibility offered by remote care, particularly in the context of reduced access to face-to-face service provision. Disadvantages: c) consultations by telephone and video restricted therapeutic relationships compared with in-person contact, particularly where patients and care providers could not build on a bond already formed face to face |
26 | Watts 2020 [56] | RCT | Canada | Patients with generalized anxiety disorder | Videoconferencing | Accessibility to services, care delivery mode via technology | a) the use of video conferencing for telepsychotherapy did not negatively affect the establishment of quality working alliance in this sample of individuals with GAD; b) telepsychotherapy via videoconferencing may allow for the development of a significantly higher working alliance than conventional psychotherapy, at least from the perspective of clients suffering from GAD; c) clients rated the quality of the working alliance more positively than psychotherapists in the telepsychotherapy via videoconference condition; |
27 | Humer 2020 [57] | Quantitative | Austria | All licenced Austrian psychotherapists | Telephone, videoconferencing, email | Care delivery mode via technology | The experiences of psychotherapists with remote psychotherapy were better than their expectations but not totally comparable to face-to-face psychotherapy with personal contact |
28 | Feijt 2020 [58] | Qualitative | Netherlands | Practicing mental health care professionals | Video/telephone, chat sessions, e-mail, and e-health modules | Remote diagnostics and evaluation, accessibility to services, flexibility of services, care delivery mode via technology | a) the large majority of practitioners started using online tools on a daily basis; b) technological issues and limitations are frequently experienced, and practitioners feel insufficiently supported by their organizations in terms of technological support and hardware; c) miss the richness of nonverbal cues that are normally available in face-to-face sessions and important in establishing rapport with clients; d) Some clients lack the digital skills to work with the software, and sometimes the client’s home environment does not offer the required privacy needed for online treatment; e) beneficial in practical sense for care providers and patients; f) Distance created helps some patients as they become less inhibited in their expressions; g) higher adherence to treatment |
29 | Parikh 2021 [59] | Quantitative | US | Social workers, psychiatrists, residents, nurse practitioners/physician assistants | Videoconferencing | Privacy of care providers and patients, care delivery mode via technology | a) satisfaction and interest in continuing telepsychiatry was strikingly high; b) Just over two-thirds of providers reported that video visits allowed good interaction with patients as well as an effective approach to evaluate patients; c) Almost 70% of respondents felt their video visit appointments were the same or better than in-person appointments; d) nearly 80% of respondents were comfortable providing telepsychiatry |
30 | Pruitt 2022 [60] | Quantitative | US | Behavioural health and medical care providers who interact with individuals who may be at risk for suicide | Videoconferencing | Care delivery mode via technology | a) respondents are willing to provide suicide prevention services through telehealth; b) providers perceive suicide prevention services through telehealth as effective as face-to-face care |
31 | Sugarman 2021 [61] | Quantitative | US | Mental health/substance use disorder clinicians | Videoconferencing | Privacy of care providers and patients, flexibility of services, care delivery mode via technology | a) prevented sharp disruptions in care; b) clinical issues did not significantly impact patient care; c) clinicians generally agreed that that they could establish rapport with patients and treat their patients’ needs well through telehealth; d) however, agreement with these statements was consistently lower for group therapy, family therapy, and initial assessment visits; e) a decrease in no-shows and cancellations, f) and that they were able to see more patients, more frequently with telehealth care |
Mental health care providers and patients | |||||||
32 | Svistova 2022 [62] | Qualitative | US | Mental health service providers and representatives from Medicaid managed care organizations | Texts, videoconferencing, telephone | Accessibility to services, care delivery mode via technology | a) telehealth appeared to work well for youth and was reported to improve parental responsiveness and engagement in mental health care due to its convenience; b) decrease in appointment cancellations and no-show rates as one of the unintended consequences related to telehealth use; c) accessibility; d) engagement and involvement of family |
33 | Weiskittle 2022 [63] | Quantitative | US | Clinicians working with veterans | Telephone or videoconferencing | Flexibility of services, care delivery mode via technology | a) Veterans enjoyed the groups and desired to participate again in the future; b) technology challenges; c) The telephone modality was described as challenging when Veterans were more functionally impaired, but was preferred over having no intervention at all |