Virtual Care - Here to Stay
Dr. Suneeta Monga, Associate Psychiatrist-in-Chief at The Hospital for Sick Children and member of the Edwin S.H. Leong Centre for Healthy Children, provides an update on her work focused on virtual interventions for the delivery of mental health care.
With the onset of the COVID-19 pandemic, our research group was interested in understanding how clinicians were experiencing the shift to virtual care at the onset of the pandemic. If you can recall back to pre-pandemic times, virtual care was minimal, and most patients and families would attend all appointments in-person. With that aim in mind, our research group surveyed a diverse group of mental health clinicians on their perspectives around the adoption of virtual care practices within a short time-period at the start of the pandemic. A total of 117 clinicians from The Hospital for Sick Children (45%) and from the community (SickKids CCMH; 55%) completed the Clinician Virtual-Care Experience survey. This survey asked clinicians about their experiences in rapidly pivoting to adopt virtual-care practices in the delivery of mental health services to children, adolescents, and their families. The survey assessed, among other things, the ease of technology use, client/patient-provider interaction quality and clinician well-being. Although 70% of clinicians reported that they had not previously done any virtual care prior to the onset of the pandemic, more than 80% felt it was easy to operate the virtual platforms. Only 42% however felt that virtual care was as effective as in-person healthcare delivery, highlighting limitations in building rapport and when delivering difficult or unexpected feedback.
This paper was published in Early Intervention in Psychiatry (see Romanchych et al. 2021).
In a second phase of the project, our research group conducted a pre-post feasibility study to assess whether virtual-care delivery of mental health interventions was acceptable and feasible with regard to recruitment and retention, participation barriers (inclusive of SDH barriers), child and parent acceptability, and adherence. This pilot study recruited a sample of 20 youth participants who reported overall feasibility and acceptability of the virtual care delivery. Youth participants reported that from a time management perspective, virtual care was easily incorporated into their daily routines. As expected, although participants were overall in favour of virtual care, they also noted concern around connecting with the therapist, and expressed some preference for in-person care. Further, in-person care was especially seen as preferable as the pandemic restrictions eased and participants felt more comfortable to attend in-person therapy sessions.
Virtual care has been very beneficial; however, youth, families and clinicians still see merits to have some in-person sessions when delivering mental health care.