Table 2 Characteristics of included studies
From: Implementation strategies for telemental health: a systematic review
Author (year) | Country | Service Type | Aims | Study design | Participants: staff/ service-users, demographics n (%) or mean (SD) | TMH modalities | Theoretically informed implementation Framework used |
|---|---|---|---|---|---|---|---|
Adler et al. (2013) [20] | USA | Community mental health teams (CMHTs) and outpatient services, Veterans Affairs (VA) service | To examine changes in attitudes and knowledge regarding TMH following a pilot TMH service delivery improvement project and identify barriers and facilitators to its implementation in a VA service | Pre-post pilot training programme | Staff (N = 12) Job title n (%): Psychologists 7 (58), social workers 3 (25), other backgrounds 2 (17) Gender n (%): Male 4 (33), Female 8 (67); Age: mean 44.6 | Video call | None stated |
Baker-Ericzén et al. (2012) [21] | USA | CMHTs and outpatient services | To describe the feasibility and acceptability of using a culturally adapted telemedicine intervention (the Perinatal Mental Health model) to ameliorate the barriers to adequate diagnosis and intervention for maternal depression in Latina women | Feasibility pilot study | Service users (N = 79) Gender n (%): Female 79 (100) Ethnicity n (%): Latina, 79 (100) Age: not recorded (NR) Diagnostic groups n (%): maternal depression 79 (100) | Phone call | None stated |
Chen et al. (2021) [22] | USA | CMHTs and outpatient services, VA service | To describe the implementation of TMH psychology services at a VA TMH hub | Descriptive study | Service users (N = 252) Gender n (%): Male 226 (89.7), Female 26 (10.3), Ethnicity n (%): White non-Hispanic 182 (72.2), Black/African-American 40 (15.9), Hispanic/Latinx 4 (1.6), Asian/Pacific Islander 4 (1.6), Unknown 22 (8.7) Age: mean 49.3 (range 21–88) Diagnostic groups n (%): depression 106 (42), trauma 77 (30.6), substance use 51 (20.2), anxiety 37 (14.7), sleep disorder 25 (9.9), bipolar 20 (7.9), adjustment disorder 20 (7.9), other/unknown 33 (13.1) | Video call | None stated |
Felker et al. (2021) [23] | USA | CMHTs and outpatient services | To describe the development, implementation, and evaluation of a TMH training programme, and consider whether such training programmes remain relevant given the extent of TMH adoption in health care services | Mixed-methods quality improvement project with 2-year follow-up survey | Staff (n = 100) Job title (%): Psychologist (37), social worker (22), not specified (19), psychiatrist (17), nurse (5) Gender n (%) Not Reported (NR) Age: NR | Phone call | Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) methodology a |
Hensel et al. (2020) [24] | Canada | Crisis and emergency mental health services | To report on the perceived barriers surrounding the use of telepsychiatry for emergency assessments and an approach to overcoming those barriers for successful implementation of a programme to increase access to emergency psychiatric assessment | Survey to inform implementation with longitudinal outcome assessment | Staff (N = 111) Job title n (%): Emergency physician 33 (30), psychiatric emergency nurse 14 (13), psychiatrist 33 (30), psychiatry resident 26 (23), physician assistant 2 (2), administrator 3 (3) Gender: Male 64 (58), Female 44 (40), NR 3 (3) | Phone call | None stated |
Lindsay et al. (2015) [25] | USA | CMHTs and outpatient services | To report outcomes of implementation of a video telehealth evidence-based psychotherapy programme for post-traumatic stress disorder and pilot a facilitation strategy for implementation | Implementation feasibility study | Service users (N = 183) Gender n (%): NR Ethnicity n (%): NR Age: NR Diagnostic groups n (%): NR | Video call | Promoting Action on Research Implementation in Health Services Framework with external facilitation as the primary strategy b |
Lynch et al. (2020) [26] | USA | CMHTs and outpatient services | To examine the service utilisation of a complex psychosis (CP) and non-CP cohort attending a largely group-based recovery-oriented behavioural health service before and after conversion to TMH | Retrospective cohort study and service evaluation | Service users (n = 23 (CP participants); n = 41 (non-CP) Gender n (%): Men 17 (74) CP, 20 (49) non-CP. Women 5 (22) CP, 17 (41) non-CP. Non-binary 1 (4) CP, 4 (10) non-CP Ethnicity n (%): CP: White/Caucasian 20 (88) CP, 39 (95) non-CP. Black/African 1 (4) CP, 0 (0) non-CP. Hispanic/Latinx 1 (4) CP, 1 (2.5) non-CP. Asian 1 (4) CP, 1 (2.5) non-CP Age: Mean 32.6 CP, 26.1 non-CP Diagnostic Groups n (%): CP 23 (35.9), non-CP 41 (64.1) | Video call | None stated |
Lynch et al. (2021) [27] | USA | CMHTs and outpatient services | To use mixed methods to understand the factors that contribute to successful telehealth conversion in a group-based recovery orientated service | Longitudinal cohort of service user utilisation outcomes and qualitative staff survey | Staff (N = 6) Job title n (%): Practicing clinicians 6 (100) Gender n (%): NR Age: NR Service users (N = 72, baseline demographics reported for n = 60 participants) Gender n (%): Male 31 (51.7), Female 23 (38.3), Non-binary 6 (10) Ethnicity n (%): White/Caucasian 55 (91.7), Black/African American 1 (1.7), Hispanic/Latinx 2 (3.4), Asian 2 (3.4) Age: Mean 28.1 Diagnostic groups n (%): psychotic disorder 15 (25), Autism spectrum disorder 15 (25), anxiety disorder 2 (3.4), affective disorder 28 (46.7) | Video call | None stated |
Myers et al. (2021) [28] | USA | CMHTs and outpatient services | To describe how VA Video Connect was implemented with a focus on the challenges of evidence-based practice delivery via TMH and VA Video Connect platforms | Prospective cohort and qualitative staff interview study | Training: Staff: n = 173 completed Job title (%): NR Gender n (%) NR Age: NR Qualitative interviews: Staff: n = 8 Job title (%): NR Gender n (%) NR Age: NR | Video call | Organisational champions c |
Owens & Charles (2016) [29] | UK | CMHTs and outpatient services, Child and Adolescent Mental Health Services (CAMHS) | To test and refine a self-harming SMS text-messaging intervention (TeenTEXT) adapted for adolescents in CAMHS | Qualitative focus group and interview study | Staff (n = 9 qualitative interviews, n = 14 in one focus group) Job title (%): Interviews: Clinician 7 (77.8), Service manager 2 (22.2) Focus group: CAMHS team members 14 (100) Gender n (%) NR Age: NR | Text messages | Normalisation Process Theory d |
Puspitasari et al. (2021a) [30] | USA | CMHTs and outpatient services | To evaluate the feasibility and effectiveness of group-based transitional day programme for adults with transdiagnostic conditions at risk of psychiatric hospitalization that switched from in-person to video teletherapy during COVID-19 | Single arm non-randomised pilot study | Service users (n = 76) Gender n (%): Male 10 (13), Female 65 (83), Transgender women 2 (3), Transgender men 1 (1) Ethnicity n (%): White 68 (90), African American 2 (3), Other 5 (7), NR 1 (1) Age: Mean 36.55 Diagnostic groups n (%): major depressive disorder 52 (68), bipolar disorder 6 (8), anxiety disorder 22 (29), personality disorder 13 (17), substance use disorder 6 (8), schizophrenia 2 (3) | Video call | None stated |
Puspitasari et al. (2021b) [31] | USA | CMHTs and outpatient services, intensive outpatient programme | To describe the process for the rapid adoption and implementation of teletherapy in an intensive outpatient programme for adults with severe mental illness | Pilot feasibility study | Service users (n = 90) Gender n (%): NR Ethnicity n (%): NR Age: NR Diagnostic groups n (%): NR | Video call, phone call | Implementation of teletherapy in the public sector model e |
Sharma et al. (2020) [32] | USA | Child psychiatry department in hospital | To investigate the implementation components involved in transitioning a comprehensive outpatient child and adolescent psychiatry programme to a home based TMH virtual clinic | Pilot Feasibility study | Staff (n = 105) Job title n (%): clinical psychologist 51 (49), psychiatrist 34 (32), neurologist 1 (1), psychiatric nurse practitioner 7 (7) mental health therapist/behaviour analyst 12 (11) Gender n (%): NR Age: NR | Video call, phone call | None stated |
Taylor et al. (2019) [33] | Australia | The Queensland Centre for Perinatal and Infant Mental Health | To investigate the importance of clinical facilitation for the implementation and sustainability of perinatal and infant mental health services | Qualitative staff interview study | Staff (n = 14) Job title n (%): Medical officers, social workers, nurses, mental health clinicians, managers and health promotion workers (breakdown NR) Gender: Male 3 (21), Female 11 (79) Age: Range 26–62 | Video call, email | None stated |