Evaluation of transition to telehealth models at Barwon Health mental health services

Deakin Health Economics, Quality and Patient Safety

Exploring the rapid implementation and uptake of mental health telehealth services during the COVID 19 pandemic

Challenge

The emergence of the COVID-19 pandemic has catapulted telehealth as a substitute to traditional delivery models in many areas of health, including in mental health. However, historically the uptake of telehealth in mental health has been low. This presents a critical challenge at a time when key leaders nationally are calling for an expansion of mental health services as a means to address the current and developing mental health needs of Australian people

Solution

This evaluation will explore the rapid implementation and uptake of mental health telehealth services at Barwon Health during the COVID-19 pandemic and seek to understand the development, uptake and acceptability of a telehealth service across both clinician and consumer groups.

Impact

The currently available results provide local data and knowledge on telehealth implementation. While the data suggests that telephone was the most frequently used mode of contact over video conferencing within the Barwon Health Mental Health Drug and Alcohol Services, the qualitative data will provide additional detail on the barriers to the use of video conferencing. This should be beneficial to Barwon Health management and to similar health services. Telehealth has already been widely implemented through private and public mental health providers due to COVID-19. Our results may assist in refining telehealth use with public mental health services.

Partners

Steve Moylan, Principal Investigator Barwon Health

Melissa O’Shea, Co-Investigator Deakin Psychology

Mary Lou Chatterton, Co-Investigator Deakin Health Economics

Elijah Marangu, Co-Investigator Deakin Quality & Patient Safety

Gayle Boschert, Co-Investigator Barwon Health

Amy Langbein, Co-Investigator Barwon Health/Deakin University

Cathy Mihalopoulos, Co-Investigator Deakin Health Economics

Kate Morrissy, Deakin Institute for Health Transformation

David Tucker, Office of the DVCR, Deakin University

Update: May 2021

The preliminary results from the analysis of the service use data showed there was a significant drop in the total number of mental health contacts during the first lockdown period (April/May 2019) compared to the same period in 2019 (17,360 contacts in 2020 versus 20,023 in 2019). Moving into the second lockdown period (July/August 2020) the total number of contacts increased and was not significantly different compared to the same period in 2019 (20,907 contacts in 2020 versus 21,805 in 2019).

The service use data also showed that during the first and second lockdowns there was a shift primarily from face to face to telephone contacts although there was a small increase in video/audio conferencing. Face to face contacts in April/May 2020 were only 24% of total contacts in comparison to 55% of total contacts in 2019. Telephone contacts increased to approximately 70% of total contacts in 2020 compared to 45% of all contacts in the same period of 2019. Video and audio conferencing increased from 0% in 2019 to 5% in 2020.The second lockdown (July/August 2020) followed similar trends with 33% face to face contacts, 62% telephone contacts and 3% through video/audioconferencing.

In a brief online survey of health services users, with 27 responses in total, over 90% reported positively regarding:

1) quality of connection,

2) overall experience and

3) personal comfort with using telehealth.

Interestingly, a large proportion (96%) said they would use telehealth again. Similarly, a brief online survey of providers/clinicians with 88 responses showed that sixty-eight percent rated the technical quality of the telehealth consult positively, and 94% said they were able to achieve the assessment or treatment goals in the session.

The qualitative data is currently being coded and analysed. This information will provide detail on the specific barriers and facilitators in the provision of mental health care during the rapid telehealth implementation. 

While the final results of the study are yet to be published, due to the topical nature of COVID-19 related projects the research team was asked to present its findings at a number of international forums, including an international webinar series.

The team was also invited to present at the 6th International Conference on Medical and Health Sciences (ICMH) ‘Essential Health Services in Times of COVID-19 and beyond…” held virtually and hosted in Bhutan  on 19 November 2020.  

Project details:

There is strong agreement that the COVID-19 pandemic will give rise to significant mental health impacts. The pandemic has heightened people’s fears for their own health and wellbeing, and exacerbated underlying mental health vulnerabilities. Social distancing measures to suppress the spread of COVID-19 have led to degradation of social and health supports, with consequent negative impacts on vulnerable people, especially those with mental illness (Zhou, Snowswell, Harding, & Bambling, 2020).

In addition, measures to combat the pandemic have seen significant rises in unemployment and economic strain for large sections of the population, with people already disadvantaged being disproportionately impacted. Unfortunately, this coincides with a range of potential barriers to accessing mental health care as mental health services adapt to social distancing measures. As such, the emergence of the COVID-19 pandemic has catapulted telehealth as a substitute to traditional delivery models in many areas of health including in mental health.

Historically, the uptake of telehealth in mental health has been low and this presents a critical challenge at a time when key leaders nationally are calling for an expansion of mental health services as a means to address the current and developing mental health needs of Australian people.

Telehealth services are desirable because they can contribute to increased accessibility, improved patient experience of care and improved cost efficiency of service delivery.

This evaluation will explore the rapid implementation and uptake of mental health telehealth services at Barwon Health during the COVID 19 pandemic. It will seek to understand the development, uptake and acceptability of a telehealth service across both clinician and consumer groups. 

It is anticipated that this study will generate new understanding and intelligence on the facilitators and barriers to uptake of telehealth services at Barwon Health, specifically, and integration of telehealth into models of care in regional public mental health services more broadly.