JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has been associated with increased psychological distress, signaling the need for increased mental health services in the context of stay-at-home policies.

Objective:

The present study aimed to characterize how mental health practitioners have changed their practices during the pandemic. The authors hypothesized that mental health practitioners would increase tele-mental health services and that certain provider types would be better able to adapt to tele-mental health than others.

Methods:

The study surveyed 903 practitioners, primarily psychologists/doctoral-level providers, social workers/master’s-level providers, and neuropsychologists employed in academic medical centers or private practices. Differences among providers were examined using Bonferroni-adjusted chi-square tests and one-way Bonferroni-adjusted ANCOVAs.

Results:

Mental health practitioners were able to rapidly adjust their practices, predominantly by shifting to tele-mental health services (80.8%) and providing therapeutic services to treat COVID-19-related concerns (67.1%). Neuropsychologists were less likely, and psychologists/doctoral-level providers and social workers/master’s-level providers were more likely than expected to transition to tele-mental health (p < .001). Trainees tended to be relatively “protected,” seeing fewer patients (p = .012) and working remotely more than licensed providers (p = .026). Despite lower rates of easy access to IT services (p < .001), private practice providers reported lower tele-mental health implementation difficulty than providers in other settings (p < .001). Despite differences in tele-mental health uptake based on provider type, level, and setting, 59.6% of respondents were interested in continuing to provide such services in the future.

Conclusions:

The context of COVID-19 has led to widespread change in the mental health field, with all but 2% of providers in this study making practice adjustments, the most prominent of which was a transition from in-person to remote/virtual appointments (i.e., from 20% prior to the pandemic to 80% of providers early in the pandemic). This highlights the continued need for coordinated efforts among various stakeholders (e.g., clinicians, insurance companies, legislators) to permit continued mental health services during social distancing. Although the majority of practitioners reported providing additional services related to COVID-19, only a small subset endorsed offering such services to medical providers. This offers an implication for future practical directions, as frontline workers seek treatment for the psychological impact of the pandemic. Finally, despite differences in tele-mental health uptake based on provider type, level, and setting, the majority of providers were interested in continuing to provide such services in the future. This offers a potential avenue by which to expand clinical services to those in need via tele-mental health even beyond the COVID-19 pandemic.