Currently submitted to: JMIR Formative Research
Date Submitted: Mar 18, 2026
Open Peer Review Period: Mar 24, 2026 - May 19, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
From Crisis to Continuity: Clinicians’ and Clients’ Appraisals of Videoconferencing in Adult Mental Health Care
ABSTRACT
Background:
The COVID-19 lockdown accelerated the adoption of telepsychiatry, including synchronous videoconferencing in adult mental health care. It is still unclear whether videoconferencing works equally well for all user groups. This study examines clinicians’ and clients’ experiences with videoconferencing during the first Dutch lockdown (April 2020) and one year later (April 2021), focusing on the appraisal of online individual (OIT) and online group treatment (OGT) in outpatient adult mental health care, covering first-line (primary) and second-line (specialized) services.
Objective:
To examine the appraisal of OIT and OGT among clients and clinicians in 2020 and 2021, and to explore subgroup differences by gender, age and diagnosis/profession.
Methods:
Two independent cross-sectional surveys were conducted in 2020 (clients: n = 350; clinicians: n = 146) and 2021 (clients: n = 357; clinicians: n = 122) at a Dutch mental health service. Participants evaluated their OIT and OGT experiences using newly developed service-evaluation questionnaires. For the appraisal score, we only used items that explicitly compared videoconferencing with face-to-face (FTF) care; principal axis factoring was used to derive appraisal scores. Hierarchical regression tested the added predictive value of survey year for appraisal of videoconferencing: step 1 included participant variables (gender, age, diagnosis/profession), and step 2 added survey year. Exploratory subgroup analyses examined within-year variation in appraisal by gender, age, and diagnosis/profession.
Results:
Despite a prevailing preference for FTF treatment, clients reported significantly higher appraisal with OIT in 2021 compared to 2020 (B = 0.22, P = .001), while appraisal of OGT did not differ significantly between years. Clinicians reported higher appraisal in 2021 than in 2020 for both OIT (B = 0.69, P < .001) and OGT (B = 1.40, P = .003). Exploratory subgroup analyses based on gender, age, or diagnosis found no meaningful differences in appraisal for either clients or clinicians.
Conclusions:
Appraisal of videoconferencing was higher in 2021 than in 2020, most clearly among clinicians, yet both clients and clinicians still preferred FTF care on average. At present, videoconferencing appears best suited as a complementary option, with relevance for expanding access to mental health care globally in a rapidly changing landscape.
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