JMIR Publications

ABSTRACT

Background:

Telemental health services effectively address major challenges in mental healthcare delivery. To maximize the potential of the services, it is essential to facilitate patient use and reduce use disparities. Nevertheless, determinants of patient use of telemental health services have been scarcely investigated thus far.

Objective:

We aimed to identify determinants of patient use of telemental health services since the onset of the COVID-19 pandemic and currently.

Methods:

In December 2023, we conducted a cross-sectional, quota-based (gender and age group) online survey. The sample comprised individuals aged 18 to 74 years, who had been using mental health services since March 2020 (n=2,082). Telemental health services use was assessed using items that inquired whether individuals had used the services since March 2020 or currently (in the last four weeks). Logistic regressions were computed to test the associations of socioeconomic, access, health, COVID-19-related, psychosocial, and service factors as well as personality, and provider characteristics with patient use.

Results:

Younger age, a more positive patient attitude towards telemental health services, a more positive provider attitude towards and higher provider skills for using the services were positively associated with patient use of telemental health services since the onset of the COVID-19 pandemic. When exclusively looking at current use, positive associations with full-time employment, lower neuroticism, a more positive provider attitude towards the services, and use of the services to avoid stigmatization, long waiting times, or inconvenient scheduling were observed. Access, health, and COVID-19-related factors were not associated with patient use (since the onset of the COVID-19 pandemic and currently).

Conclusions:

Beyond socioeconomic factors, personality and a positive patient attitude towards the services, patient use of telemental health services was associated with a positive provider attitude towards and skills for using the services, which underscores the need for provider support and training in telemental healthcare. Furthermore, avoiding stigmatization and higher convenience of the services were associated with patient use, which highlights the substantial potential of the services to address current mental healthcare challenges.