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Telehealth mental health services during COVID-19: summary of evidence and clinical practice:

Telehealth mental health services during COVID-19: summary of evidence and clinical practice: Objective: To provide a rapid clinical update on the evidence for telehealth in mental healthcare in the context of the COVID-19 pandemic public health measures. Conclusions: Telehealth has been rapidly implemented in metropolitan and rural settings and the existing evidence base demonstrates that it represents an effective mode of service delivery. Keywords: Telehealth, telemental health, telepsychiatry, videoconferencing, clinician-guided he outbreak of the COVID-19 pandemic has described as synchronous or asynchronous. Synchronous resulted in a major transformation in the way men- treatment is interactive communication that occurs in Ttal health interventions are delivered in Australia. real time, such as telephone and video conferencing, Mental health clinicians and services had to rapidly and is the most similar to face-to-face treatment. transition to largely telehealth delivery to ensure con- Asynchronous treatments include emails, text, faxes, tinuity of care to patients and families. Private psychia- apps and online programmes. Many practitioners trists and allied health practitioners have made a rapid already use asynchronous interventions to check on 2,3 transition to the provision of healthcare via telehealth, patient progress, provide supplementary materials, assisted by new Medicare items. These changes have the online assessments and recommend mental health apps potential to extend the reach and accessibility of mental or online programs. Effectiveness of phone and video- healthcare to all Australians. On the other hand, clini- conferencing-delivered interventions. cians with a strong preference for in-person treatments Research into telemental health provided to children, and those without experience in technology-delivered young people and adults demonstrates that interventions interventions, may find the transition challenging. It is are feasible, acceptable, and as effective as in-person timely to consider some of the issues around the use of 7,8 services. For example, a recent meta-analysis of synchro- telehealth in mental healthcare, including its effective- nous telehealth treatments reported on its effectiveness for ness for common mental health conditions, advantages adults (including veteran populations) with common and disadvantages and recommendations for its imple- mental health disorders (e.g. depression, anxiety, posttrau- mentation and evaluation. matic stress disorder and adjustment disorder). The Telehealth has been described as ‘the next big frontier in the efficient and effective delivery of health care’ (p. 621). Defined as the delivery of psychological and Corresponding author: mental health services via telecommunication technolo- Rebecca E Reay, Academic Unit of Psychiatry and Addiction gies, modalities include telephone-delivered therapy, vid- Medicine, Australian National University Medical School Level eoconferencing, mental health apps and internet-delivered 2 Blg 4, PO Box 11 Woden, ACT 2606 Australia. programs. Furthermore, telehealth interventions can be Email: Rebecca.reay@act.gov.au 514 Reay et al. majority of studies consistently found telephone or vide- effective, useful and acceptable way to deliver treatment. oconferencing therapy was as effective as standard in- The majority of participants who received internet- person treatment and superior to treatment as usual. delivered interventions report they are satisfied or very Both interventions showed clear, consistent evidence of satisfied, describing advantages, such as its accessibility, beneficial effects. Furthermore, the generalisability and convenience, low cost and greater privacy. We have applicability of the results were rated as moderate to heard anecdotal reports that telehealth sessions have sig- high. On the other hand, the evidence base for internet- nificantly reduced the number of missed appointments delivered text-based therapy (via webchat) was promis- and dropouts, potentially increasing treatment adher- ing but inconclusive. ence and the efficiency of mental health services. However, telehealth may be less useful in patients with significant social disadvantage, and severe mental ill- Effectiveness of internet-delivered nesses that impair cognitive abilities and insight such as interventions (self-guided versus schizophrenia and major neurocognitive disorder; fur- clinician-guided) ther research for this population is needed. Over three decades of research has provided substantial evidence for the effectiveness and acceptability of inter- Addressing barriers to telehealth net-delivered treatments delivered to children, adoles- 9 4 cents and adults. Treatment often consists of online Clinicians largely report positive attitudes towards tele- lessons, printable summaries, homework assignments, health approaches, and attitudes have been shown to email reminders and resources. The most widely studied improve with use, for both clients and clinicians. is cognitive behaviour therapy (iCBT), with strong evi- Clinicians have expressed concerns about its impact on dence that it is as effective as clinician-delivered CBT rapport building, the therapeutic relationship, privacy and for a wide range of mental and physical health con- and safety issues. The reduced non-verbal communica- 9,10 ditions. In contrast, a systematic review found that tions (e.g. inflection, tone, gestures and mannerisms) there was no substantive evidence iCBT was equally ben- can be a deterrent for some. Some therapists are also of eficial to in-person CBT for anxiety disorders. There is the view that it is less effective than in-person therapy good evidence for the efficacy of online-delivered inter- and lack experience or interest in technology-delivered personal psychotherapy, acceptance and commitment interventions. Previously reported concerns about the 13 14 therapy and psychodynamic approaches. Although extra hassle, frustration and technological limitations these approaches can be self-guided, therapist support may be rapidly outdated in a new environment where makes a substantial difference in terms of adherence, comple- the technology has suddenly and necessarily become tion and efficacy. This assistance can include regular more familiar. Given clinicians often serve as ‘gatekeep- texts, emails, private forums, phone, videoconferencing ers’ for its implementation, services must address their or in-person sessions. Furthermore, there is growing evi- concerns in order to improve its acceptance and sustain- dence indicating that ‘second-generation’ self-guided ability. Such an approach should provide guidance on treatments, with enhanced engagement features, can best practice, developing the therapeutic relationship, produce clinical benefits similar to clinician-guided and innovative ways to deliver traditional treatments. 16,17 treatments. There has been a call to integrate inter- Training should also increase clinicians’ comfort and net-delivered services with traditional mental health ser- experience with the new technologies, whilst ensuring vices using a stepped care model. Clients identified as responsive technical support. Importantly, there are being suitable for online interventions could be directed some for whom internet-delivered treatment may not be to self-guided or therapist-guided programs, whilst those suitable, including older persons and those with signifi- deemed unsuitable, or have not responded, are provided cant disadvantage. Providers need to assess each indi- 15 18 with face-to-face interventions or a hybrid approach. vidual’s suitability, including their capacity to access The Department of Health ‘Head to Health’ website pro- technology, severity of symptoms, presence of psychosis vides an easy portal and guide to a wide range of evi- or risks of harm. dence-based online programmes for consumers and providers. Telehealth evaluation Various models for telehealth evaluation have been pro- Attitudes towards telehealth posed in the Australasian setting. Different stakeholders A systematic review into clinician satisfaction with tele- may have very different outcome priorities. For exam- health in mental healthcare (using videoconferencing) ple, a psychiatric hospital may seek earlier discharge and showed overall attitudes were largely positive. The avoidance of readmission, a patient may be focused on findings were observed across different populations, usability and convenience, and a health service may be locations (e.g. home, schools, crisis centres) and types of concerned by the time and workforce needed to set up services (psychotherapy, assessment and medication the technology and availability of scarce equipment. management). Therapists reported telehealth was an Four helpful dimensions for evaluation include patient 515 Australasian Psychiatry 28(5) 6. Cooper SE, Campbell LF and Smucker Barnwell S. Telepsychology: a primer for coun- control, clinician quality of care, organisation sustaina- seling psychologists. Couns Psychol 2019; 47: 1074–1114. bility and technology capability or capacity. These should be linked to robust measures that are specific to 7. Gloff NE, LeNoue SR, Novins DK, et al. Telemental health for children and adolescents. Int Rev Psychiatry 2015; 27: 513–524. the situation or setting in which the technology is used. Further research is needed on the acceptance, adherence 8. Osenbach JE, O'Brien KM, Mishkind M, et  al. Synchronous telehealth technologies in and effectiveness of telehealth for mental healthcare in psychotherapy for depression: a meta-analysis. Depress Anxiety 2013; 30: 1058–1067. real-world settings, particularly with patients who have 9. Vigerland S, Lenhard F, Bonnert M, et al. Internet-delivered cognitive behavior therapy complex and severe mental illness. for children and adolescents: a systematic review and meta-analysis. Clin Psychol Rev 2016; 50: 1–10. 10. Carlbring P, Andersson G, Cuijpers P, , et  al.Internet-based vs. face-to-face cognitive Conclusions and future directions behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cogn Behav Ther 2018; 47: 1–18. As telehealth becomes more commonly used in mental healthcare, it will be important to evaluate its relative 11. O’Kearney R, Kim S, Dawson RL, et  al. Are claims of non-inferiority of internet and computer-based cognitive-behavioural therapy compared with in-person cognitive- outcomes and effectiveness. Mental health professionals behavioural therapy for adults with anxiety disorders supported by the evidence from have different skill sets, and research into effectiveness head-to-head randomised controlled trials? A systematic review. Aust NZ J Psychiat of telehealth will also need to be targeted within profes- 2019; 53: 851–865. sions. Accordingly, developments of specific professional 12. Donker T, Bennett K, Bennett A, et  al. Internet-delivered interpersonal psychotherapy training and competencies for provision of care will be versus internet-delivered cognitive behavioral therapy for adults with depressive symp- needed. Telehealth technology also needs ongoing toms: randomized controlled noninferiority trial. J Med Internet Res 2013; 15: e82. research, given the challenges to cybersecurity that have 13. Ivanova E, Lindner P, Ly KH, et  al. Guided and unguided acceptance and commitment been noted. Telehealth is complementary to existing therapy for social anxiety disorder and/or panic disorder provided via the internet and a care and thus evidence is needed into how it may inte- smartphone application: a randomized controlled trial. J Anxiety Disord 2016; 44: 27–35. grate with face-to-face mental healthcare as well as other 14. Johansson R, Frederick RJ and Andersson G. Using the internet to provide psychody- digital mental health services. namic psychotherapy. Psychodyn Psychiatry 2013; 41: 513–540. 15. Andrews G, Cuijpers P, Craske MG, et al. Computer therapy for the anxiety and depres- Disclosure sive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS The authors report no conflict of interest. The authors alone are responsible for the content One 2010; 5: e13196. and writing of the paper. 16. Dear BF, Fogliati VJ, Fogliati R, et al. Treating anxiety and depression in young adults: a randomised controlled trial comparing clinician-guided versus self-guided Internet- Funding delivered cognitive behavioural therapy. Aust NZ J Psychiat 2018; 52: 668–679. The authors received no financial support for the research, authorship, and/or publication of 17. Salomonsson S, Santoft F, Lindsäter E, et al. Predictors of outcome in guided self-help this article. cognitive behavioural therapy for common mental disorders in primary care. Cogn Behav Ther. Epub ahead of print 22 October 2019. DOI: 10.1080/16506073.2019.1669701 ORCID iDs 18. Erbe D, Eichert HC, Riper H, et al. Blending face-to-face and internet-based interventions for the treatment of mental disorders in adults: systematic review. J Med Internet Res Rebecca E Reay https://orcid.org/0000-0001-9497-5842 2017; 19: e306. Jeffrey CL Looi https://orcid.org/0000-0003-3351-6911 19. Department of Health. Head to health website. Canberra, Australia. https://headto- Philip Keightley https://orcid.org/0000-0001-9753-3097 health.gov.au (accessed 14 May 2020). 20. Connolly SL, Miller CJ, Lindsay JA, et  al. A systematic review of providers’ attitudes References toward telemental health via videoconferencing. Clin Psychol Sci Pract 2020; 00: 1. Australian Medical Association. Patients embrace telehealth – COVID-19 reforms must e12311. be made permanent. https://ama.com.au/media/ (accessed 18 May 2020). 21. Santesteban-Echarri O, Piskulic D, Nyman RK, et al. Telehealth interventions for schiz- ophrenia-spectrum disorders and clinical high-risk for psychosis individuals: a scoping 2. Looi JCL and Pring W. Private metropolitan telepsychiatry in Australia during Covid-19: review. J Telemed Telecare 2020; 26: 14–20. current practice and future developments. Australas Psychiatry 2020; 25: 508–510. 3. Australian Government Department of Health. Australians embrace telehealth to save lives 22. Myers KM, Vander Stoep A, McCarty CA, et  al. Child and adolescent telepsychiatry: during COVID-19. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/ variations in utilization, referral patterns and practice trends. J Telemed Telecare 2010; australians-embrace-telehealth-to-save-lives-during-covid-19 (accessed 20 April 2020). 16: 128–133. 23. Cowan KE, McKean AJ, Gentry MT, et al. Barriers to use of telepsychiatry: clinicians as 4. Varker T, Brand RM, Ward J, et al. Efficacy of synchronous telepsychology interventions gatekeepers. Mayo Clin Proc 2019; 94: 2510–2523. for people with anxiety, depression, posttraumatic stress disorder, and adjustment dis- order: a rapid evidence assessment. Psychol Serv 2019; 16: 621–635. 24. Institute for Broadband-enabled Society (IBES). A unified approach for the evaluation 5. Nelson E, Bui T and Velasquez SE. Telepsychology: research and practice overview. Child of telehealth implementations in Australia. University of Melbourne, 2013. http://net- Adolescent Psychiatr Clin North Am 2011; 20: 67–78. workedsociety.unimelb.edu.au (accessed 16 May 2020). http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australasian Psychiatry SAGE

Telehealth mental health services during COVID-19: summary of evidence and clinical practice:

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References (48)

Publisher
SAGE
Copyright
Copyright © 2022 by The Royal Australian and New Zealand College of Psychiatrists
ISSN
1039-8562
eISSN
1440-1665
DOI
10.1177/1039856220943032
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Abstract

Objective: To provide a rapid clinical update on the evidence for telehealth in mental healthcare in the context of the COVID-19 pandemic public health measures. Conclusions: Telehealth has been rapidly implemented in metropolitan and rural settings and the existing evidence base demonstrates that it represents an effective mode of service delivery. Keywords: Telehealth, telemental health, telepsychiatry, videoconferencing, clinician-guided he outbreak of the COVID-19 pandemic has described as synchronous or asynchronous. Synchronous resulted in a major transformation in the way men- treatment is interactive communication that occurs in Ttal health interventions are delivered in Australia. real time, such as telephone and video conferencing, Mental health clinicians and services had to rapidly and is the most similar to face-to-face treatment. transition to largely telehealth delivery to ensure con- Asynchronous treatments include emails, text, faxes, tinuity of care to patients and families. Private psychia- apps and online programmes. Many practitioners trists and allied health practitioners have made a rapid already use asynchronous interventions to check on 2,3 transition to the provision of healthcare via telehealth, patient progress, provide supplementary materials, assisted by new Medicare items. These changes have the online assessments and recommend mental health apps potential to extend the reach and accessibility of mental or online programs. Effectiveness of phone and video- healthcare to all Australians. On the other hand, clini- conferencing-delivered interventions. cians with a strong preference for in-person treatments Research into telemental health provided to children, and those without experience in technology-delivered young people and adults demonstrates that interventions interventions, may find the transition challenging. It is are feasible, acceptable, and as effective as in-person timely to consider some of the issues around the use of 7,8 services. For example, a recent meta-analysis of synchro- telehealth in mental healthcare, including its effective- nous telehealth treatments reported on its effectiveness for ness for common mental health conditions, advantages adults (including veteran populations) with common and disadvantages and recommendations for its imple- mental health disorders (e.g. depression, anxiety, posttrau- mentation and evaluation. matic stress disorder and adjustment disorder). The Telehealth has been described as ‘the next big frontier in the efficient and effective delivery of health care’ (p. 621). Defined as the delivery of psychological and Corresponding author: mental health services via telecommunication technolo- Rebecca E Reay, Academic Unit of Psychiatry and Addiction gies, modalities include telephone-delivered therapy, vid- Medicine, Australian National University Medical School Level eoconferencing, mental health apps and internet-delivered 2 Blg 4, PO Box 11 Woden, ACT 2606 Australia. programs. Furthermore, telehealth interventions can be Email: Rebecca.reay@act.gov.au 514 Reay et al. majority of studies consistently found telephone or vide- effective, useful and acceptable way to deliver treatment. oconferencing therapy was as effective as standard in- The majority of participants who received internet- person treatment and superior to treatment as usual. delivered interventions report they are satisfied or very Both interventions showed clear, consistent evidence of satisfied, describing advantages, such as its accessibility, beneficial effects. Furthermore, the generalisability and convenience, low cost and greater privacy. We have applicability of the results were rated as moderate to heard anecdotal reports that telehealth sessions have sig- high. On the other hand, the evidence base for internet- nificantly reduced the number of missed appointments delivered text-based therapy (via webchat) was promis- and dropouts, potentially increasing treatment adher- ing but inconclusive. ence and the efficiency of mental health services. However, telehealth may be less useful in patients with significant social disadvantage, and severe mental ill- Effectiveness of internet-delivered nesses that impair cognitive abilities and insight such as interventions (self-guided versus schizophrenia and major neurocognitive disorder; fur- clinician-guided) ther research for this population is needed. Over three decades of research has provided substantial evidence for the effectiveness and acceptability of inter- Addressing barriers to telehealth net-delivered treatments delivered to children, adoles- 9 4 cents and adults. Treatment often consists of online Clinicians largely report positive attitudes towards tele- lessons, printable summaries, homework assignments, health approaches, and attitudes have been shown to email reminders and resources. The most widely studied improve with use, for both clients and clinicians. is cognitive behaviour therapy (iCBT), with strong evi- Clinicians have expressed concerns about its impact on dence that it is as effective as clinician-delivered CBT rapport building, the therapeutic relationship, privacy and for a wide range of mental and physical health con- and safety issues. The reduced non-verbal communica- 9,10 ditions. In contrast, a systematic review found that tions (e.g. inflection, tone, gestures and mannerisms) there was no substantive evidence iCBT was equally ben- can be a deterrent for some. Some therapists are also of eficial to in-person CBT for anxiety disorders. There is the view that it is less effective than in-person therapy good evidence for the efficacy of online-delivered inter- and lack experience or interest in technology-delivered personal psychotherapy, acceptance and commitment interventions. Previously reported concerns about the 13 14 therapy and psychodynamic approaches. Although extra hassle, frustration and technological limitations these approaches can be self-guided, therapist support may be rapidly outdated in a new environment where makes a substantial difference in terms of adherence, comple- the technology has suddenly and necessarily become tion and efficacy. This assistance can include regular more familiar. Given clinicians often serve as ‘gatekeep- texts, emails, private forums, phone, videoconferencing ers’ for its implementation, services must address their or in-person sessions. Furthermore, there is growing evi- concerns in order to improve its acceptance and sustain- dence indicating that ‘second-generation’ self-guided ability. Such an approach should provide guidance on treatments, with enhanced engagement features, can best practice, developing the therapeutic relationship, produce clinical benefits similar to clinician-guided and innovative ways to deliver traditional treatments. 16,17 treatments. There has been a call to integrate inter- Training should also increase clinicians’ comfort and net-delivered services with traditional mental health ser- experience with the new technologies, whilst ensuring vices using a stepped care model. Clients identified as responsive technical support. Importantly, there are being suitable for online interventions could be directed some for whom internet-delivered treatment may not be to self-guided or therapist-guided programs, whilst those suitable, including older persons and those with signifi- deemed unsuitable, or have not responded, are provided cant disadvantage. Providers need to assess each indi- 15 18 with face-to-face interventions or a hybrid approach. vidual’s suitability, including their capacity to access The Department of Health ‘Head to Health’ website pro- technology, severity of symptoms, presence of psychosis vides an easy portal and guide to a wide range of evi- or risks of harm. dence-based online programmes for consumers and providers. Telehealth evaluation Various models for telehealth evaluation have been pro- Attitudes towards telehealth posed in the Australasian setting. Different stakeholders A systematic review into clinician satisfaction with tele- may have very different outcome priorities. For exam- health in mental healthcare (using videoconferencing) ple, a psychiatric hospital may seek earlier discharge and showed overall attitudes were largely positive. The avoidance of readmission, a patient may be focused on findings were observed across different populations, usability and convenience, and a health service may be locations (e.g. home, schools, crisis centres) and types of concerned by the time and workforce needed to set up services (psychotherapy, assessment and medication the technology and availability of scarce equipment. management). Therapists reported telehealth was an Four helpful dimensions for evaluation include patient 515 Australasian Psychiatry 28(5) 6. Cooper SE, Campbell LF and Smucker Barnwell S. Telepsychology: a primer for coun- control, clinician quality of care, organisation sustaina- seling psychologists. Couns Psychol 2019; 47: 1074–1114. bility and technology capability or capacity. These should be linked to robust measures that are specific to 7. Gloff NE, LeNoue SR, Novins DK, et al. Telemental health for children and adolescents. Int Rev Psychiatry 2015; 27: 513–524. the situation or setting in which the technology is used. Further research is needed on the acceptance, adherence 8. Osenbach JE, O'Brien KM, Mishkind M, et  al. Synchronous telehealth technologies in and effectiveness of telehealth for mental healthcare in psychotherapy for depression: a meta-analysis. Depress Anxiety 2013; 30: 1058–1067. real-world settings, particularly with patients who have 9. Vigerland S, Lenhard F, Bonnert M, et al. Internet-delivered cognitive behavior therapy complex and severe mental illness. for children and adolescents: a systematic review and meta-analysis. Clin Psychol Rev 2016; 50: 1–10. 10. Carlbring P, Andersson G, Cuijpers P, , et  al.Internet-based vs. face-to-face cognitive Conclusions and future directions behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cogn Behav Ther 2018; 47: 1–18. As telehealth becomes more commonly used in mental healthcare, it will be important to evaluate its relative 11. O’Kearney R, Kim S, Dawson RL, et  al. Are claims of non-inferiority of internet and computer-based cognitive-behavioural therapy compared with in-person cognitive- outcomes and effectiveness. Mental health professionals behavioural therapy for adults with anxiety disorders supported by the evidence from have different skill sets, and research into effectiveness head-to-head randomised controlled trials? A systematic review. Aust NZ J Psychiat of telehealth will also need to be targeted within profes- 2019; 53: 851–865. sions. Accordingly, developments of specific professional 12. Donker T, Bennett K, Bennett A, et  al. Internet-delivered interpersonal psychotherapy training and competencies for provision of care will be versus internet-delivered cognitive behavioral therapy for adults with depressive symp- needed. Telehealth technology also needs ongoing toms: randomized controlled noninferiority trial. J Med Internet Res 2013; 15: e82. research, given the challenges to cybersecurity that have 13. Ivanova E, Lindner P, Ly KH, et  al. Guided and unguided acceptance and commitment been noted. Telehealth is complementary to existing therapy for social anxiety disorder and/or panic disorder provided via the internet and a care and thus evidence is needed into how it may inte- smartphone application: a randomized controlled trial. J Anxiety Disord 2016; 44: 27–35. grate with face-to-face mental healthcare as well as other 14. Johansson R, Frederick RJ and Andersson G. Using the internet to provide psychody- digital mental health services. namic psychotherapy. Psychodyn Psychiatry 2013; 41: 513–540. 15. Andrews G, Cuijpers P, Craske MG, et al. Computer therapy for the anxiety and depres- Disclosure sive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS The authors report no conflict of interest. The authors alone are responsible for the content One 2010; 5: e13196. and writing of the paper. 16. Dear BF, Fogliati VJ, Fogliati R, et al. Treating anxiety and depression in young adults: a randomised controlled trial comparing clinician-guided versus self-guided Internet- Funding delivered cognitive behavioural therapy. Aust NZ J Psychiat 2018; 52: 668–679. The authors received no financial support for the research, authorship, and/or publication of 17. Salomonsson S, Santoft F, Lindsäter E, et al. Predictors of outcome in guided self-help this article. cognitive behavioural therapy for common mental disorders in primary care. Cogn Behav Ther. Epub ahead of print 22 October 2019. DOI: 10.1080/16506073.2019.1669701 ORCID iDs 18. Erbe D, Eichert HC, Riper H, et al. Blending face-to-face and internet-based interventions for the treatment of mental disorders in adults: systematic review. J Med Internet Res Rebecca E Reay https://orcid.org/0000-0001-9497-5842 2017; 19: e306. Jeffrey CL Looi https://orcid.org/0000-0003-3351-6911 19. Department of Health. Head to health website. Canberra, Australia. https://headto- Philip Keightley https://orcid.org/0000-0001-9753-3097 health.gov.au (accessed 14 May 2020). 20. Connolly SL, Miller CJ, Lindsay JA, et  al. A systematic review of providers’ attitudes References toward telemental health via videoconferencing. Clin Psychol Sci Pract 2020; 00: 1. Australian Medical Association. Patients embrace telehealth – COVID-19 reforms must e12311. be made permanent. https://ama.com.au/media/ (accessed 18 May 2020). 21. Santesteban-Echarri O, Piskulic D, Nyman RK, et al. Telehealth interventions for schiz- ophrenia-spectrum disorders and clinical high-risk for psychosis individuals: a scoping 2. Looi JCL and Pring W. Private metropolitan telepsychiatry in Australia during Covid-19: review. J Telemed Telecare 2020; 26: 14–20. current practice and future developments. Australas Psychiatry 2020; 25: 508–510. 3. Australian Government Department of Health. Australians embrace telehealth to save lives 22. Myers KM, Vander Stoep A, McCarty CA, et  al. Child and adolescent telepsychiatry: during COVID-19. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/ variations in utilization, referral patterns and practice trends. J Telemed Telecare 2010; australians-embrace-telehealth-to-save-lives-during-covid-19 (accessed 20 April 2020). 16: 128–133. 23. Cowan KE, McKean AJ, Gentry MT, et al. Barriers to use of telepsychiatry: clinicians as 4. Varker T, Brand RM, Ward J, et al. Efficacy of synchronous telepsychology interventions gatekeepers. Mayo Clin Proc 2019; 94: 2510–2523. for people with anxiety, depression, posttraumatic stress disorder, and adjustment dis- order: a rapid evidence assessment. Psychol Serv 2019; 16: 621–635. 24. Institute for Broadband-enabled Society (IBES). A unified approach for the evaluation 5. Nelson E, Bui T and Velasquez SE. Telepsychology: research and practice overview. Child of telehealth implementations in Australia. University of Melbourne, 2013. http://net- Adolescent Psychiatr Clin North Am 2011; 20: 67–78. workedsociety.unimelb.edu.au (accessed 16 May 2020).

Journal

Australasian PsychiatrySAGE

Published: Jul 28, 2020

Keywords: Telehealth; telemental health; telepsychiatry; videoconferencing; clinician-guided

There are no references for this article.