JMIR Publications

ABSTRACT

Background:

During the winter and spring of 2020, Covid-19 restrictions forced rapid changes in the organization and provision of mental health services through increased use of digital solutions in therapy.

Objective:

This paper explores therapists’ experiences using video consultation (VC) in the early phase of the Covid-19 restrictions. It also seeks to develop and advance comprehensive knowledge about therapists in specialized mental health services’ experiences of using VC. We explored the following questions through interviews with therapists in mental health care: Which opportunities and challenges appeared when using VC during the Covid-19 lockdown? For whom does VC work and for whom does it not work in the extreme situation of a societal lockdown, in a short-term care-pathway?

Methods:

The study employed a qualitative approach, based on an abductive strategy and hermeneutic-phenomenological methodology. We interviewed therapists and managers in mental health hospital departments via Skype for Business from March to May 2020, using a thematic interview guide aimed at encouraging reflections on the use of VC during Covid-19 restrictions.

Results:

Study findings indicate that the therapists felt there were overall advantages to using VC in circumstances that do not permit in-person consultations. The continuity that video consultations offers the service users was seen as a valuable asset, but the quality of the therapy felt poorer on video than in in-person meetings. Various negative aspects concerning the therapeutic environment, such as lack of safety for the most vulnerable service users and topics deemed unsuitable for VC, lowered the therapists’ overall impression of the service.

Conclusions:

From the therapists’ perspective, the use and implementation of VC during this time was worth the effort that they perceived to be the cost. There is a need for further investigation to build solid and evidence-based knowledge that can contribute to developing tailored services for people in need of mental health care There is also a lack of knowledge when it comes to how therapy on the screen interrupts the relationship between the service users and the therapist and between all involved stakeholders. Further qualitative research is needed, and future studies should focus on service users’ experiences, co-creation between different stakeholders and how to scale up the use of VC while ensuring that the service provided is appropriate, safe and available.