“Pouring their heart out in Sainsbury’s”: qualitative study of young people’s, parents’ and mental health practitioners’ experiences of adapting to remote online mental health appointments during COVID-19

BMC Psychiatry

Research

Jane Derges¹  Myles-Jay Linton¹  Helen Bould²  Bethany Cliffe³  Lucy Biddle⁴  Paul Moran⁴  Rachael Gooberman-Hill⁵ 

[1] Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK;Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK;Centre for Academic Mental Health, Bristol University Medical School, Oakfield House, Oakfield Road, Bristol, UK;Gloucestershire Health and Care NHS Foundation Trust, Gloucester, UK;Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK;Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK;The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK;Population Health Sciences, Bristol University Medical School, Canynge Hall, 39 Whatley Road, Bristol, UK;The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK;Centre for Academic Mental Health, Bristol University Medical School, Oakfield House, Oakfield Road, Bristol, UK;Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK;Translational Health Sciences, Bristol University Medical School, Learning and Research Building, Southmead Hospital, Bristol, UK;Elizabeth Blackwell Institute, University of Bristol, Royal Fort House, Bristol, UK;

关键词: Adolescents;    Young adults;    Telemental health;    Telepsychiatry;    Qualitative;    COVID-19;    Mental health services;   

DOI  :  10.1186/s12888-023-05126-8

 received in 2023-06-15, accepted in 2023-08-21,  发布年份 2023

来源: Springer

【 摘 要 】

Background During the COVID-19 pandemic, technologies such as videoconferencing were used to deliver mental health appointments remotely online. For many people, this was a change from previous methods of mental healthcare receipt and delivery. We aimed to explore in-depth how practitioners, young people and parents in the UK experienced this transition.MethodsWe used qualitative methods to collect data, triangulating between free-text online survey data (n = 38), focus groups (n = 5) (3 young adult groups (total n = 11); 2 practitioner groups (total n = 7)), and semi-structured interviews (practitioners n = 8; parents n = 4). Data were analysed using reflexive thematic analysis.ResultsParticipants held mixed views about remote appointments, which were encompassed within the five themes of: home as clinic; disrupted therapeutic relationships; difficulties with engagement; uncontained risk; and scope of care provision. While appointments at home could be regarded as more comfortable, naturalistic and accessible, it was also recognised that remoteness compromised practitioner control with consequences for their ability to monitor patient engagement, manage risk and ensure confidentiality when others were present in the home. This could create an additional burden for parents as they tried to facilitate appointments but felt unsupported in this role. Relatedly, remoteness was seen to hinder interpersonal communication, formation of trust, communication of empathy and opportunities to observe body language, all of which were deemed important to building and maintaining effective therapeutic relationships. Despite this, others thought the anonymity of a remote exchange may allow earlier disclosure. There was disagreement as to whether remote provision narrowed or expanded the scope of practice.ConclusionsWhile some had positive views of remote mental health appointments, others found them challenging. Findings highlight key areas requiring attention and mitigation in future offerings of remote provision, namely: risk management, parental burden, and problematic engagement.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023