Cited by 227Telemedicine and Telehealth ImplementationCOVID-19 and Mental HealthDental Research and COVID-19

COVID-19 and telepsychiatry: Early outpatient experiences and implications for the future

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Chen, Justin A., Chung, Wei-Jean, Young, Sarah K., Tuttle, Margaret C., Collins, Michelle B., Darghouth, Sarah L., Longley, Regina, Levy, Raymond +4 more·2020·General Hospital Psychiatry

Abstract

The COVID-19 pandemic has dramatically transformed the U.S. healthcare landscape. Within psychiatry, a sudden relaxing of insurance and regulatory barriers during the month of March 2020 enabled clinicians practicing in a wide range of settings to quickly adopt virtual care in order to provide critical ongoing mental health supports to both existing and new patients struggling with the pandemic's impact. In this article, we briefly review the extensive literature supporting the effectiveness of telepsychiatry relative to in-person mental health care, and describe how payment and regulatory challenges were the primary barriers preventing more widespread adoption of this treatment modality prior to COVID-19. We then review key changes that were implemented at the federal, state, professional, and insurance levels over a one-month period that helped usher in an unprecedented transformation in psychiatric care delivery, from mostly in-person to mostly virtual. Early quality improvement data regarding virtual visit volumes and clinical insights from our outpatient psychiatry department located within a large, urban, tertiary care academic medical center reflect both the opportunities and challenges of virtual care for patients and providers. Notable benefits have included robust clinical volumes despite social distancing mandates, reduced logistical barrieres to care for many patients, and decreased no-show rates. Finally, we provide clinical suggestions for optimizing telepsychiatry based on our experience, make a call for advocacy to continue the reduced insurance and regulatory restrictions affecting telepsychiatry even once this public health crisis has passed, and pose research questions that can help guide optimal utilization of telepsychiatry as mainstay or adjunct of outpatient psychiatric treatment now and in the future.

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Crossref · 10.1016/j.genhosppsych.2020.07.002

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  • The COVID-19 pandemic caused healthcare systems worldwide to rapidly switch from in-person to telehealth visits.

    “The COVID-19 pandemic imposed the sudden conversion of in-person to telehealth visits in healthcare systems throughout the world (Chen et al., 2020; Torales et al., 2022).”

    From Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study (2022) · cites this paper as Chen et al., 2020

    The ‘Telehealth prior to COVID-19’ section says the pandemic rapidly shifted ambulatory healthcare from mostly in-person to mostly virtual visits in the United States. It does not establish that this occurred in healthcare systems throughout the world; no page numbers are supplied in our copy. (LLM, conf=0.88)

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Authors
Chen, J. A., Chung, W.-J., Young, S. K., Tuttle, M. C., Collins, M. B., Darghouth, S. L., Longley, R., Levy, R., Razafsha, M., Kerner, J. C., Wozniak, J., & Huffman, J. C.
Affiliations
  • Harvard University (US)
  • Massachusetts General Hospital (US)
Corresponding author
Chen, Justin A.
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
2020-09
Volume
66
Pages
89-95
ISSN
0163-8343 (ISSN-L)
OpenAlex
W3040928965
Cited by
227
References
28
Citations by year
2026: 6 · 2025: 11 · 2024: 24 · 2023: 40 · 2022: 52 · 2021: 85 · 2020: 8 · 2012: 1
FWCI
7.73
Type
journal article
Language
en
Open access
Locations
  • General Hospital Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Patient-Centered Outcomes Research Institute
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
Keywords
telepsychiatry, COVID-19 pandemic, virtual care, outpatient psychiatric care, mental health service delivery, insurance coverage barriers, regulatory challenges, no-show rates, quality improvement, social distancing
MeSH terms
COVID-19, Ambulatory Care, Mental Disorders, Humans, Mental Health Services, Pneumonia, Viral, Psychiatry, Telemedicine, Coronavirus Infections, Pandemics

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