JMIR Publications

ABSTRACT

Background:

Although real-time mental health specialist video consultations (MHSVC) have been proposed as an effective care model for treating patients with mental health conditions in primary care, little is known on the integration into routine practice from the perspective of family physicians (FPs) themselves.

Objective:

We aimed to determine the degree to which FPs advocate that MHSVC can be integrated in routine primary care, where most patients with mental health conditions receive treatment.

Methods:

In a cross-sectional qualitative study, we conducted four semi-structured focus groups and three telephone interviews in a sample of 19 FPs from urban and rural districts. We conducted a qualitative content analysis applying the Tailored Implementation in Chronic Diseases framework a combined bottom-up (data-driven) and top-down strategy for deriving key domains.

Results:

FPs indicated that MHSVC are a promising and practical way to address the most pressing challenges in current practice, i.e. to increase accessibility and coordination of specialized care. To facilitate the implementation of future MHSVC models, we compiled a checklist of recommendations that covers 1) buy-in from practices (e.g., emphasizing logistical and psychological relief for the practice), 2) engaging patients (e.g., establishing a trusted patient-provider-relationship), 3) setup and conduct of consultations (e.g., reliable emergency plans), and 4) fostering collaboration between FPs and MHS (e.g., kick-off meetings to build up trust).

Conclusions:

Leveraging the primary care practice as a familiar environment for patients, MHSVC provide timely specialist support and potentially lead to benefits for patients and more efficient processes of care. Integration should account for determinants of practice as described by the FPs. Clinical Trial: German Clinical Trials Register (DRKS00012487)