Telemedicine got a tremendous boost during Covid when Americans were isolating in their homes and many doctors were afraid to see patients face-to-face. In addition, many people were stressed from social isolation with kids attending schools online while parents tried to work from home. As a result, mental health services also went online. Experts are now assessing how well this worked. It works well in some instances but less-well in others. This from Healthline:
Virtual counseling sessions for mental health conditions can be effective for some people, but technology limits and other barriers to care must be addressed in order for “telemental” care to be more universally applicable, a new study concludes.
The study, published in the Interactive Journal of Medical Research, found that the use of telemental health has become increasingly widespread and is particularly valuable for serving people in remote communities and in situations where face-to-face counseling isn’t possible.
Telehealth Zoom calls, phone calls and even text messages can increase access to mental health services. As you would expect, telehealth has its limitations. Not everyone is a candidate for online counseling just as not every medical condition lends itself to telemedicine.
However, the study found that delivering mental health care remotely was less beneficial to people without access to the internet or a phone, those experiencing social and economic disadvantages, people with cognitive difficulties, auditory or visual impairments, and those with severe mental health issues.
“Clients with paranoia or severe anxiety whose symptoms might worsen due to lack of trust in the platform, or the technology, would need to work with someone in person,” Sabrina Eads, LPC, a therapist at Enteave Counseling in Austin, Texas, told Healthline.
“For those people, we recommend a need to ensure that face-to-face care of equivalent timeliness remains available,” said Sonia Johnson, MSc, the director of the mental health policy research center at King’s College London and a senior author of the study.
Indeed, most people preferred talking to a counselor over video call or the phone. I mean, who wants to drive across town then sit in a waiting room for your 30 minute session?
“Even though we are now offering a choice between in-person, phone, and video calling to have our sessions, the majority of people are opting willingly to do sessions over the phone,” she said. “People now seem to agree with providers that a telephone or video session is much more convenient.”
So what are the downsides of telephone or online counseling? Sometimes taking the easy way out means the patient is less committed to the therapy. They may even be more distracted than if they’re in a therapist’s office. Nor is the therapist able to assess a patient’s body language. The following comment is rather amusing:
“There are some patients that try to do therapy at work, driving in the car, or while their small children are home,” she told Healthline. “Therapists must set boundaries and let the client know they must conduct the session in an environment like home or work [where there are] no distractions.”
Wow! I guess that sort of removes some of the benefits of teletherapy if neither therapists nor patients can multitask while driving. OK, my take is that telemedicine is in its infancy. Over time medical providers will discover various techniques to increase the effectiveness of online counseling. I read an article a few years ago about mental health counseling over email or a type of online chat, where the conversations were archived for later use. It sounds rediculous but the article went on to say that one benefit was patients could later revisit what was discussed and that seemed to improve the effectiveness of counseling.