Patients and Clinicians Concurrent Views on Using Video Consultations in Mental Health Outpatient Services: Qualitative Analysis (Preprint)

Abstract

Over the last decade, there has been an increase in the evidence base supporting the efficacy of video consultations (VC) in mental health services. Furthermore, the COVID-19 pandemic has also demonstrated the potential of virtual treatment. Despite these promising results and conducive conditions for VC, several studies have highlighted that the uptake and implementation of VC continues to be slow, even post-pandemic. In order to facilitate and strengthen the implementation of VC and exploit its potential as a useful tool for mental health disorder treatment, there is a need for a deeper understanding of the issues and experiences of implementing and using VC as a treatment modality in clinical practice.

To investigate patients' and clinicians' experiences and attitudes toward using VC in clinical practice.

Qualitative interviews were conducted with patients (n=10) and clinicians (n=4) who participated in weekly virtual treatment over two months within a mental health outpatients services in Denmark. Data from these semi-structured interviews with patients and focus group interviews with clinicians were explored through thematic analysis.

Common themes constructed from the patient interviews yielded two main themes; (1) Adjusting to the practicality of the VC format and (2) The practice of therapy using VC. Patients experienced that using VC was easy and convenient, increased their treatment engagement, and helped establish and maintain a therapeutic alliance. The thematic analysis conducted on clinicians' experience with VC yielded three themes; (1) A change of mindset from resistance to one of acceptance, (2) The contact is different on video, and (3) A new way of working. Clinicians experienced their initial concerns and resistance towards VC implementation gradually diminishing, and gaining clinical experience using VC is a prerequisite for a successful VC implementation in mental health services.

Both patients and clinicians experienced that VC enhanced access to treatment and could be meaningfully integrated into clinical practice. This study also found clinicians expressed initial concerns and some resistance towards VC, but this diminished with the utilization of VC. Future research is needed to facilitate clinicians' use of VC in clinical practice.