COVID-19 sparks 12-fold increase in remote delivery of mental health
care across the US

Date:
September 2, 2020
Source:
Virginia Commonwealth University
Summary:
The COVID-19 pandemic has spurred a remarkable number of
psychologists across the United States to shift to delivering mental
health care to patients remotely, according to a national study.



FULL STORY ==========================================================================
The COVID-19 pandemic has spurred a remarkable number of psychologists
across the United States to shift to delivering mental health care to
patients remotely, according to a national study led by researchers at
Virginia Commonwealth University.


==========================================================================
The study, "The COVID-19 Telepsychology Revolution: A National Study
of Pandemic-Based Changes in U.S. Mental Health Care Delivery," which
was published in the journal American Psychologist, involved a survey
of 2,619 licensed psychologists across the country and found that the
amount of clinical work performed via telepsychology had increased
12-fold since the pandemic began.

Prior to the pandemic, psychologists reported performing 7.07% of their clinical work with telepsychology. During the pandemic, that number has
soared to 85.53%. And 67.32% of psychologists reported conducting all
of their clinical work with telepsychology, the study found.

"I was shocked to see how quickly telepsychology was adopted," said lead
author Brad Pierce, a doctoral student in the Department of Psychology in
the College of Humanities and Sciences. "The shift from 7% of clinical
work to more than 85% represents a lot of heavy lifting in a very short
time. There was a concerted effort among the community to identify
and remove long-standing barriers. Psychologists sought out additional training, equipment was purchased, and policies were adjusted at every
level to facilitate telehealth and telepsychology." Pierce is part of
the Social Justice in Disability and Health Lab at VCU, which aims to understand and dismantle barriers to psychological services confronted by underserved groups with disabilities and chronic health conditions. As
part of that work, the lab has conducted studies into the adoption of telepsychology and its potential to address disparities in health care.

"I was proud of the mental health care community's response to
COVID-19 when the need for physical distancing became apparent," Pierce
said. "People still need psychological services, and the community rolled
up their sleeves and got to work. Our team recognized a revolution
was taking place and we wanted to gain insight about these changes
as they were occurring." After the pandemic ends, the study found,
many psychologists anticipate they will continue to treat patients
remotely. According to the study, psychologists projected they would
continue to perform 34.96% of their clinical work with telepsychology.



==========================================================================
"I'm hopeful that these trends show that psychology as a field is able
to adapt to the needs of both providers and patients," said co-author
Grace McKee, Ph.D., a Mid-Atlantic Mental Illness Research Education
and Clinical Center Advanced Psychology Fellow at the Central Virginia
VA Health Care system, and who is affiliated with the Department of
Psychology at VCU. "Of course the initial wave of telepsychology during
the pandemic has been out of necessity, but our findings suggest to me
that there are benefits to continue offering it in the future even when
it is safe to attend in person." Telepsychology can be more convenient
for both providers and patients, McKee said, particularly for people
who may have difficulty attending in person - - whether because of
financial or transportation limitations, conflicts with work schedules, responsibilities like caring for children or family members, or mobility
issues due to illness or disability.

At the same time, she said, many psychologists and patients may prefer
in- person treatment, and many patients lack access to the technology
and to a private, safe space needed to use telepsychology.

"I think the flexibility to offer both in-person and telepsychology
services is critical in being able to meet patients' needs and making psychological services more accessible," McKee said.

While the researchers found a significant shift to telepsychology,
the trend was not uniform across the profession.



========================================================================== Psychologists working in outpatient treatment facilities saw particularly
high increases, with a more than 26-fold increase in telepsychology use
during the pandemic, the study found. Meanwhile, psychologists working
in Veterans Affairs medical centers only reported a sevenfold increase,
likely due in part to the high rates of telepsychology use in VA medical centers before the pandemic.

A larger increase in the adoption of telepsychology was seen among women,
among psychologists who had access to training in telepsychology and
supportive organizational policies, and among psychologists who worked in settings specializing in relationship issues, anxiety and women's issues.

"Historically, women have tended to provide the bulk of child care. We
think it's possible that women psychologists with children may have
needed to use telepsychology at higher rates in order to continue to
provide child care in the home, especially when most schools and day
cares were closed," McKee said.

"In contrast, men may have had the ability to continue some degree of
in-person clinical work, particularly if they had a partner who was
able to provide child care." The lowest increases in telepsychology
were found among psychologists working in rural areas and in settings
that specialized in treating antisocial personality disorder, performing testing and evaluation, and treating rehabilitation populations.

Paul Perrin, Ph.D., an associate professor in the Department of Psychology
and director of the Social Justice in Disability and Health Lab,
said the study documents a "literal revolution in mental health care
delivery taking place before our eyes amidst the COVID-19 pandemic."
"No other event in modern history has altered to this extent the
landscape of psychological service provision," said Perrin, who is also
a co-author of the study and a jointly appointed research psychologist
at the Central Virginia Veterans Affairs Health Care System. "Many of
the barriers to telepsychology use that have been touted for years
have now been dramatically lessened or even fully removed, and we
are seeing an unprecedented rollout of technology-based mental health treatment. The field of psychology has put forth a substantial effort
to adapt to the demands of the pandemic and unmet mental health needs
that are being uncovered across the U.S." Perrin noted one important limitation of the study: It reflects the rapid and widespread adoption
of telepsychology, but does not reveal the extent to which that shift
is meeting the mental health care needs of patients, particularly groups
of people that experience disparities in health care.

"I believe that much more needs to be done in terms of bringing
evidence-based practice to populations often marginalized in traditional
mental health care," Perrin said. "The practice of telepsychology assumes
a lot of things like patient access to technology, internet or telephone,
and even to payment options for telepsychology. Despite the potential
of telepsychology to rise to some of the mental health needs laid bare
during the pandemic, there are still many limitations and barriers to
its use that need to be worked out." In addition to Pierce, McKee and
Perrin, the study's authors also include VCU psychology doctoral students Carmen Tyler and Jack Watson.


========================================================================== Story Source: Materials provided
by Virginia_Commonwealth_University. Original written by Brian
McNeill. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Bradford S. Pierce, Paul B. Perrin, Carmen M. Tyler, Grace
B. McKee, Jack
D. Watson. The COVID-19 telepsychology revolution: A national
study of pandemic-based changes in U.S. mental health care
delivery.. American Psychologist, 2020; DOI: 10.1037/amp0000722 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/09/200902161705.htm

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