Abstract
Aim: The aim of this dissertation was to undertake an integrative review exploring mental health patients' and clinicians' perceptions of tele-health video conferencing. This review occurs in a decade in which technological advances have seen marked improvements in video conferencing with significant evolutions in video image clarity, sound quality and data transfer rates, whilst the costs of hardware and software have reduced. The demand for mental health care and these technological improvements, has resulted in increasing use of video conferencing to deliver health care. More recently, the pressures of the COVID 19 pandemic have further accelerated the use of tele-mental health (TMH), making it timely to explore how this rapidly evolving technology is perceived by mental health patients and clinicians.
With the rapid evolution of video conferencing technology, it is important that a contemporary systematic review of literature be conducted to give a current understanding of the use of this technology. To obtain a breadth of understanding of this modality, the review has included the perspectives of both mental health clinicians and patients, on the basis that exploring the understandings of TMH from the point of view of both principal stakeholders offers the greatest opportunity to better understand the delivery of mental health care using this modality. Ultimately this review intends to inform the application of TMH and the best practice for utilising synchronous video conferencing by mental health clinicians and patients.
Method: The Johanna Briggs Institute (JBI) Integrative review protocol (Aromataris and Munn, 2017) was used to guide the review of qualitative and quantitative primary research from January 2015 to December 2019. The analysis of articles was conducted using a reflexive Thematic Analysis approach (Braun and Clarke, 2006) to explore concepts and patterns within the data extracted.
Results: Of the 1003 studies detected in the search of electronic databases, 28 individual articles met the inclusion and quality criteria. From these articles the author identified four separate themes of accessibility', efficacy', resourcing' and variances in user perspectives of tele-health'.
Discussion: The findings showed that the use of tele-health, in the form of synchronous video conferencing, is perceived by both clinicians and patients as having some distinct advantages in overcoming physical distance between clinicians and patients and the stigma related to accessing mental health in person. These advantages appear to be more significant when using home-based tele-health and for patients living rurally. When evaluating the use of tele-health, such advantages should be weighed against the perception that TMH can have efficacy limitations for some populations and that to achieve its potential benefits requires adequate resourcing, training and leadership. The researcher notes the variability in perception of TMH between patients and clinicians and non-users of tele-health and current users and that this variance highlights the importance of including all these perspectives to more fully evaluate the use of TMH. The literature was noted to be disappointingly sparse regarding the of perceptions of the need for culturally safe TMH and opportunities that this could offer indigenous populations.