JMIR Publications

ABSTRACT

Background:

Mental health and addictions services increasingly recommend offering both virtual and in-person care modalities. Understanding when virtual care is appropriate requires careful consideration of individual needs and recognition of potential tensions among clients, caregivers, and clinicians to balance varying perspectives and considerations.

Objective:

To explore how varying perspectives on virtual and in-person mental health care can be balanced to support shared decision-making in child and adolescent mental health and addictions services.

Methods:

We conducted semi-structured interviews with clients, caregivers, clinicians, and staff across child and adolescent mental health and addictions services. We coded data using the Consolidated Framework for Implementation Research (CFIR), and performed thematic analysis to identify core themes, focusing on areas where the perspectives of participants converged or diverged on key aspects of service delivery.

Results:

Participants’ perspectives diverged or converged across CFIR and outcome domains in terms of 1) trade-offs between advantages and disadvantages of care modalities, reflecting divergent views on the best choices for different scenarios; 2) the importance of client-centered care, which all participants agreed was essential to service delivery; and 3) equity of access to services, a shared priority across participants groups.

Conclusions:

A transparent, balanced approach in selecting mental health care modalities is necessary to respect and address diverse and sometimes divergent needs of clients, caregivers, and clinicians. Shared decision-making that communicates the therapeutic value of each modality while accommodating accessibility and personal preferences may support equitable, client-centered care.