JMIR Publications

ABSTRACT

Background:

Mental health care providers have widely adopted telemedicine since the beginning of the COVID-19 pandemic. Some providers have reported difficulties implementing telemedicine and are still determining its sustainability. Recommendations, best practices, and guidelines have been published for telemedicine-based mental health care (i.e., telemental care or TMH) but have yet to be synthesized.

Objective:

Through our scoping review of practice guidelines, we aimed to identify themes of TMH guidelines and clinical recommendations published during the first two years of the COVID-19 pandemic, the importance of those topics based on the frequency of mentions per resulting article, and the types of guidelines published for providers during that time.

Methods:

Authors searched Pubmed/MEDLINE and ScienceDirect for articles using the PRISMA-ScR on TMH practice published from January 2020 to March 2022. We included articles during screening if they were available in English and provided recommendations, best practices, or guidelines for TMH. We excluded duplicates, articles unrelated to telehealth, brief editorial introductions, and those not fully available. We applied the Healthcare Provider Taxonomy of the National Uniform Claim Committee to article titles and abstracts to identify records relevant to mental health. The authors used content and thematic analysis to identify critical themes.

Results:

Of the 818 articles yielded, we excluded 218 during our title and abstract screening. From the remaining 600 articles, we excluded 104 duplicates and were left with 64 after the application of the taxonomy. We excluded eight of these articles due to the inability to find the full papers or irrelevance to the topic. Content and thematic analysis provided three main themes–along with subthemes and topics–of facilitators, concerns, and changes advised. The majority of articles called for further research (41/56) and for telemental education and innovation in some form (35/56) regarding changes advised. Sixteen articles included specific types of guidelines, recommendations, or checklists for providers.

Conclusions:

Results of the scoping review highlight the need for further research at larger scales to develop effective guidelines and protocols for successful therapy plans. Additionally, a consideration of health inequities within populations during telemental care implementation and research would ensure ethical implementation of telemental care. The subthemes of changes advised appear to be interconnected and draw on themes, subthemes, and topics found in concerns and facilitators.