JMIR Publications

ABSTRACT

Background:

The Covid-19 pandemic saw telehealth rapidly become the primary way to receive mental health care. International research has validated many of the benefits and challenges of telehealth known pre-pandemic for specific population groups. However, if telehealth is to assume prominence in future mental health service delivery, greater understanding is needed about its capacity to provide psychosocial support for people with complex and enduring mental health conditions.

Objective:

Focusing on an Australian community-managed provider of psychosocial intervention and support, this qualitative study aimed to understand the service user and worker experience of psychosocial support via telehealth through the COVID­19 pandemic.

Methods:

This research was jointly developed, and conducted by people with lived experience of mental ill health and/or distress, mental health service providers, and university-based researchers. Semi structured interviews conducted between August and November 2020 explored participant experiences of receiving or providing psychosocial support via telehealth platforms including telephone, text, and video conferencing. Qualitative data was analysed thematically, quantitative data was collated and analysed using descriptive statistics.

Results:

Twenty service users and eight workers completed individual interviews via telephone or video conferencing platform. Sixty percent (n=12) of service users received psychosocial support services by telephone, 30% (n=6) by videoconferencing, and 10% (n=2) through a blend of telephone and videoconferencing. Of note, 55% (n=11) of service user participants stated a future preference for in-person psychosocial support services, 30% (n=6) preferred to receive a mixture of in-person and telehealth, and 15% (n=3) elected telehealth only. Two meta- themes emerged as integral to worker and service user experience of telehealth during the pandemic: (1) creating safety and comfort, and (2) a whole new way of working. The first meta-theme comprises sub-themes relating to a sense of safety and comfort while using telehealth; including trusting in the relationship, and having and exercising choice and control. The second meta-theme contains sub-themes reflecting key challenges and opportunities associated with the shift from in-person psychosocial support to telehealth.

Conclusions:

Overall, our findings highlighted that most service users experienced telehealth positively, but this was dependent on them continuing to get the support they needed in a way that was safe and comfortable. Whilst access difficulties of a subgroup of service users should not be ignored, most service users and workers were able to adapt to telehealth by focusing on maintaining the relationship and using choice and flexibility to maintain service delivery. Although most research participants expressed a preference for a return to in person psychosocial support, or hybrid in-person and telehealth models, there was a general recognition that intentional use of telehealth could contribute to flexible and responsive service delivery. Notably, challenges to telehealth provision of psychosocial support identified in this study are yet to be fully understood.