Table 3 Outcomes Identified after changes implemented in mental health services table
Name of Outcome | Studies | Outcomes Reported | Examples |
|---|---|---|---|
Care access (Includes Care access and Stress management when accessing care) | N = 21 [care access, n = 19 [31,32,33, 35,36,37,38,39, 42,43,44, 46, 49, 51, 55, 56, 58, 61, 62]; stress management, n = 9 [35, 38,39,40, 42, 46, 50, 51, 62] | Care access was one of the most prominent outcomes. It included removing barriers to accessing care such as time, money spent on travelling to and from a clinic, physical difficulty of travelling, safety issues and waiting times in clinics | 1. By removing barriers such as time and money spent on travelling to and from clinic, patients and care providers were able to accommodate treatment considering individual needs [46] |
Satisfaction with telehealth | N = 21 [26,27,28,29,30,31,32,33, 37, 38, 41,42,43,44, 46,47,48,49,50,51, 56, 59] | Studies reported patients’ and care providers' satisfaction with care delivered in a remote format (patients = 15 studies; care providers = 6 studies) where both patients and care providers rated their overall assessment of mental health services delivered via telehealth | 1. Twelve studies demonstrated high satisfaction rates among patients and care providers highlighting that the care delivered was of appropriate standard followed by positive overall experiences [31, 37, 39,40,41, 52, 56, 58,59,60,61,62] 2. Nine studies reported heterogenous views and experiences of patients and care providers showing no significant differences in experiences of using care pre-pandemic and during the pandemic to mixed satisfaction rates depending on individual circumstances [35, 38, 42, 44, 49, 53,54,55, 63]. None of the included studies reported complete dissatisfaction with telehealth |
Comparability of telehealth with face-to-face care | N = 15 [32, 38, 43, 45, 47,48,49, 51,52,53,54, 57, 59, 60, 62] | Studies reported a comparison between face-to-face services and telehealth. Comparative analysis was based on patients and/or care providers’ experiences, personal observations and views, effectiveness results and other factors | 1. 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 [43]; 2. Effectiveness of remote iVR reminiscence may be comparable to that of face-to-face iVR reminiscence [52] |
Treatment effectiveness | Treatment effectiveness refers to success in treatment outcomes of mental health services or positive results during treatment | 1. Four studies reported that telehealth was effective in care delivery and treatment and led to improvement of patients’ symptoms [31, 33, 46, 60]; 2. A small but significant positive effect of face-to-face treatment on reduction in symptom severity over time, relative to videoconference treatment [45] | |
Continuity of care | Continuity of care included patients remaining in care without dropping out of treatment for longer | 1. Significantly more sessions were attended by participants in the videoconference versus face-to-face GAD groups [45] 2. A decrease in appointment cancellations and no-show rates is one of the unintended consequences related to telehealth use [62] | |
Relationships between patients and care providers (includes relationships and interactions between patients and care providers) | Experiences of relationships between patients and care providers were mixed and ranged from improved and well-established rapport between patients and clinicians to disconnected and impersonal care experiences | 1. The positive experiences described increased frequency of contacts and strengthened contact ties between patients and care providers as a response to patient’s needs to ensure continuity of care [44]. 2. The introduction of additional assistance and support has been well received by patients. The latter was often related to care provider turnover which potentially deteriorated due to COVID-19. In the new realms of more disjointed care patients found a need to repeat their stories which often made them “relive” that experience over again [25] | |
Remote detection and diagnostics in patients | Remote detection and diagnostics in patients include assessment of patients’ symptoms, conditions or overall state by telehealth methods including telephone calls, online platforms, text messages | 1. In studies where patients had access to technology required, assessment was seen as a positive outcome as it allowed patients to stay relaxed in a comfortable environment of their homes whereas care providers were able to assess their home environment safety, detect and evaluate signs of abuse and neglect, allow for evaluation of physical symptoms, including signs of acute substance withdrawal [37, 46]. 2. The self-disclosure of patients was reported as an important factor which brought new insights into assessment and examination [28] | |
Privacy | Privacy regulations changed in order to maintain confidentiality and anonymity requirements of both patients and care providers in telehealth | 1. In five studies, privacy regulations were difficult to follow due to lack of private space among patients (in a study by Abdullah et al. [33], patients were reported to have sessions in a closet, bathroom and car). 2. Lack of private space for telehealth was sometimes addressed by using text services as an alternative to avoid a pause treatment [29] | |
Treatment length | Studies highlighted that the number of days in completing a course of treatment was increased in comparison to face-to-face treatment as telehealth was often more time-consuming than in-person therapy | 1. Although remote therapy was reported to be more demanding and tiring for patients [28] in a study by Bulkes et al. [46] patients in telehealth attended treatment for six hours per five days a week whereas patients in in-person treatment completed three hours per five days per week which in total meant that patients receiving remote treatment stayed 2.8 days longer in treatment than patients seen in person | |
Work-life balance | N = 1 [59] | Work-life balance is related to experiences of keeping personal life and work separate. This outcome was experienced by care providers | 1. One study reported that due to difficulty of maintaining privacy regulations, care providers struggled to separate personal life from work [27] |