Navigating the Digital Age: Telemental Health Services and Remote Work Environments
Over the past few years, and particularly since the beginning of the COVID-19 pandemic, many aspects of our lives have moved online, can be accessed remotely, and/or offered in a hybrid format [1], including many workplaces, social and health care services, and education opportunities.
One important development has been the expansion of telemental health services. Telemental health is a term that describes mental health care and education that is provided virtually, using technologies like phone and video calls, online messaging, and mobile apps. With the emergence of telemental health, many people have questions such as… Is it as effective as in-person therapy? Are there situations in which telemental health shouldn’t be used? Many people also have more general questions such as, what are the benefits and drawbacks of this surge in digital and hybrid services? In this blog post, we’ll explore these important questions regarding digitized services and remote environments.
First, let’s discuss Telemental Health.
Accessibility is the primary advantage of providing mental health and wellness services remotely. Telemental health can greatly increase access to mental health care for people facing several barriers to in-person mental health care:
Schedule: Telemental health care may provide more flexibility in scheduling than in-person mental health care [2].
Location: Telemental health may bring the mental health and community-boosting benefits of both individual and group-based mental health care to people who live in remote locations with few local mental health professionals, who travel or move frequently, and who struggle to leave their homes or visit providers’ offices due to physical or mental health conditions, disabilities, and inaccessible office spaces [3, 4, 5].
Stigma: Telemental health care may increase access to mental health care for people who have concerns about being seen and judged for visiting a mental health professional in-person [3].
Continuity: Flexibility in scheduling and location may enable telemental health clients to access care more often than they could in person. Further, the ability to access previous sessions’ materials at any time by watching recordings of video calls, re-reading texts or emails, and accessing online materials also empowers clients to benefit from telemental health care outside of scheduled sessions [2].
How effective is telemental health?
Research indicates that telemental health care provides similar results and is an effective alternative to in-person therapy for certain mental health concerns and populations [6]. For example, Cognitive Behavioural Therapy (CBT; the current gold standard in evidence-based therapy for most mental health concerns, including depression and anxiety) and Exposure and Response Prevention (the most supported therapy for OCD) achieve similar and significant short-term reductions in mental health symptoms whether they are delivered in-person or via telemental health [3]. However, some research also suggests that in-person therapy may outperform telemental health in the long term and recommends that telemental health may be best used to enhance, rather than replace, in-person mental health care [3].
In another study, children and adolescents visited psychiatrists more often, visited emergency departments less often, and were hospitalized less often in the year after they accessed telemental health consultations [7]. Telemental health may therefore reduce the burden on emergency services, making mental health care more affordable overall, and increase usage of in-person mental health care services [3].
However, it is important to always remember that differences between clients, providers, treatment modalities, and format in telemental health services may all lead to different outcomes [5]. As telemental health care continues to grow in popularity and researchers continue to study its effectiveness for different populations and interventions, a greater understanding of the efficacy of telemental health relative to in-person therapy is likely to emerge.
What are some of the challenges associated with telemental health?
While telemental health care may increase access to effective mental health care, there are several considerations that impact its potential:
Technology: While young clients report that technology does not interfere with their experience of telemental health care [2,5], accessing the technology, wifi, and cellular data needed to engage in telemental health care may be challenging for some providers and clients. This is especially true for older populations and residents of rural areas [4].
Privacy: Technology use may also bring concerns about privacy and confidentiality for both clients and providers [2]. It is imperative that therapists use secure platform to provide telemental health services (which they likely will need to pay for) and research the minimum privacy standards for their practice.
Payment: Insurance companies may be less likely to cover telemental health care than in-person mental health care, and virtual billing can be a challenge [6]. It can also be time consuming and confusing for clients to figure out if their insurance provides coverage for telemental health services.
Legal regulations: To date, legal regulators have had a hard time keeping pace with the development of telemental health technologies. In certain geographic areas, there may not be sufficient regulations, policies, or legal regulations to adequately address the privacy, security, and data collection concerns that occur with telemental health. This may lead to feelings of uncertainty for prospective clients and providers [6], and some providers feel uncomfortable about providing, or do not, provide telemental health services while regulations are still under development
Remote relationships: Finally, telemental healthcare providers have expressed concern about the ability to develop effective therapeutic relationships with their remote clients [1,2]. Clients have also cited communication barriers and less personal connection as disadvantages [2]. Despite these challenges, participants in group-based telemental health interventions have still reported a sense of trust, support, rapport and connection with their facilitators and group members [5].
Beyond Telemental Health: Remote and Hybrid Work Cultures
Our lives are becoming increasingly digital. Extending beyond telemental health care, remote and hybrid environments have also been integrated into our work lives. In 2023, 46% of employers saw decreases in office space needs and 59% were already planning to reduce their work space by half [7]. Understanding how to harness the benefits, and navigate the challenges of digital and remote work is crucial for effectively promoting our own, and others, mental health and well-being. Research indicates that flexible scheduling, which remote and hybrid work settings often offer, improves factors like productivity, connection and company culture [7], indicating that these environments have benefits for workplaces and employees. However, 43% of employees report that the hardest part about working remotely is not feeling included in meetings [7], indicating that these environments also have unique drawbacks, such as challenges to workplace culture.
WellIntel Talks’ newest Speaker, Lauren Hotchkiss (MA), is an expert in remote and hybrid workplaces. Her talk addresses remote/hybrid workplace culture and provides research-backed approaches to promoting diversity and autonomy in remote/hybrid work environments, and addressing their challenges like feelings of isolation and difficulties maintaining a sense of community and cohesion.
In her talk Cultivating Individual and Organizational Wellness in Remote Work, Lauren equips employees and leaders to understand the benefits of remote/hybrid cultures, recognize the unique demands and challenges that accompany remote work, develop individual skills and resources to buffer stress and isolation, and implement evidence-based strategies for building psychological health and safety in remote cultures.
At WellIntel Talks, we aim to ensure that the community has access to evidence-based, high-quality mental health and wellness information. Our qualified and diverse experts in the field of mental health and wellbeing are available for corporate events, lunch and learn sessions, or training sessions. Our wellness speakers can cover everything from mental wellbeing to harnessing motivation to positive body image to optimizing brain health! To view our wide selection of different talks and topics, you can visit our website here!
Written By:
Jordan Beck, BA., WellIntel Talks Volunteer
Lauren Hotchkiss, MA., Industrial Organizational Psychology Specialist & Expert Speaker
References:
[1] Molfenter, T., Heitkamp, T., Murphy, A. A., Tapscott, S., Behlman, S., & Cody, O. J.. (2021). Use of Telehealth in Mental Health (MH) Services During and After COVID-19. Community Mental Health Journal, 57(7), 1244–1251. https://doi.org/10.1007/s10597-021-00861-2
[2] Petersen, D., Salazar, B., & Kertz, S. J.. (2020). Therapist and Treatment-Seeking Students’ Perceptions of Telemental Health. Journal of Technology in Behavioral Science, 5(2), 113–120. https://doi.org/10.1007/s41347-019-00116-8
[3] Aboujaoude, E., Salame, W., & Naim, L.. (2015). Telemental health: A status update. World Psychiatry, 14(2), 223–230. https://doi.org/10.1002/wps.20218
[4] Watanabe, J., Teraura, H., Nakamura, A., & Kotani, K.. (2023). Telemental health in rural areas: a systematic review. Journal of Rural Medicine, 18(2), 50–54. https://doi.org/10.2185/jrm.2022-059
[5] Lau, N., Colt, S. F., Waldbaum, S., O'Daffer, A., Fladeboe, K., Yi-Frazier, J. P., Mccauley, E., & Rosenberg, A. R.. (2021). Telemental Health For Youth With Chronic Illnesses: Systematic Review. JMIR Mental Health, 8(8), e30098. https://doi.org/10.2196/30098
[6] Toulany, A., Kurdyak, P., Gandhi, S., Fu, L., Grewal, S., Kulkarni, C., Saunders, N., Vigod, S., Guttmann, A., Chiu, M., & Pignatiello, A.. (2022). Health System-Level Evaluation of Tele-Mental Health Services Among Children and Adolescents in Ontario, Canada. The Canadian Journal of Psychiatry, 67(6), 462–469. https://doi.org/10.1177/07067437211043395
[7] Sugarman, D. E., & Busch, A. B.. (2023). Telemental health for clinical assessment and treatment. BMJ, e072398. https://doi.org/10.1136/bmj-2022-072398
[8] Bartram, F., (n.d.). HR Statistics, Data & Trends. People Managing People. Accessed on January 20, 2024. https://peoplemanagingpeople.com/personal-development/hr-career/hr-statistics/