JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic threatens to impact mental health, while disrupting access to care, due to physical distance measures and to the unexpected pressure on public health services. Telemental health (TM) was rapidly implemented to deliver healthcare services.

Objective:

The aims of this study were: i) to present state-of-the-art TM research; ii) to survey mental health providers about care delivery during the pandemic; iii) to assess patient satisfaction with TM.

Methods:

Document clustering was applied to map research topics within TM research. A survey was circulated among mental health providers. Patient satisfaction was investigated through a meta-analysis of studies retrieved from Web of KnowledgeSM and Scopus® comparing satisfaction scores between TM and face-to-face (FtF) interventions for mental health disorders. Hedges’ g was used as effect size measure. Effect sizes were pooled using a random-effect model. Sources of heterogeneity and bias were sought.

Results:

Evidence about TM has been accumulating since 2000’, especially regarding service implementation, depressive/anxiety disorders, post-traumatic stress disorder, and special populations. Research was concentrated in a few countries. The survey (n=174 respondents from Italy, n=120 international) confirmed that, after the onset of COVID-19 outbreak, there was a massive shift from FtF to TM delivery of care. However, respondents held skeptical views about TM, and did not feel sufficiently trained and satisfied. Meta-analysis of 29 studies (n=2143) showed that patients would be equally satisfied with TM as compared to FtF (Hedges’ g=-0,001, 95% CI: -0,116-0,114, p=0,985, Q=43,83, I2=36%, p=0,029), if technology-related issues were minimized.

Conclusions:

Mental health services equipped with TM will be more able to successfully cope with public health crises. Both providers and patients need to be actively engaged in digitization, to re-shape their reciprocal trust around technological innovations. Clinical Trial: The protocol was registered in PROSPERO [registration number: CRD42020192299].