Patients' and providers' experiences with video consultations used in the treatment of older patients with unipolar depression: A systematic review
Open accessAbstract
Accessible Summary: What is known on the subject?: Depression is the most common cause of mental illness amongst older people. As a result of the growth of the older population, it is expected that an increasing number of older people will need treatment. Depression can be effectively treated—but fewer than half of those who are affected receive treatment. Barriers to receiving treatment are lack of resources and trained healthcare providers, social stigma, incorrect diagnoses and long distances to treatment facilities. There is an increased need for alternative ways of treating patients with depression. The use of video consultations has shown to be a viable option for delivering mental health care to older patients. Use of video consultations allows patients to receive treatment in their own homes. None of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression. This paper provides knowledge regarding the use of video consultations, especially for older people with depression. What this paper adds to existing knowledge?: No previous review has sought to understand the use of video consultations in mental health care to older patients with depression. The results show that video consultations support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible. An initial scepticism from participants quickly disappeared when video consultations were experienced in action. The challenges associated with the use of video consultations seem to consist of technical problems and lack of support from staff. What are the implications for practice?: Mental health practitioners should consider the use of video consultations because it can support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible. Introduction: Depression is the leading cause of mental illness amongst an ageing population and fewer than half of those who are affected receive treatment. There is an increased need for alternative ways of treating patients; the use of video consultations has been shown to be a viable option for delivering mental health care. However, none of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression and providers. Aim: To conduct a systematic review of the existing literature focusing on patients' and providers' experiences of video consultations for depression. Method: Eight scientific databases were searched. In all, 3,537 articles were identified and, of these, 21 peer‐reviewed articles were included in this review. Results: The results show that video consultations support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible. Any initial scepticism quickly disappeared when video consultations were experienced in action. The challenges seem to consist of technical problems and lack of support from staff. Discussion: The experiences and satisfaction of older people with depression seem to be positive, although methodological limitations and deficiencies of the reviewed articles should be considered. More qualitative research is needed, and future studies should focus on specific diagnoses and providers' experiences. Implications for practice: Video consultations support mental health practice, especially as a useful alternative when face‐to‐face therapy is not possible.
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Patient attendance was a relevant implementation outcome in 4 reviews.
“Relevant outcomes included assessment comparability (n=2 reviews), fidelity to intervention and competence of therapists (n=1) [38], patient adherence to intervention (n=3) [21,24,28], patient attendance (n=4) [21,25,30,38], safety (n=2) [24,38], and technical difficulties (n=3) [24,25,38].”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Implementation outcomes were reported in eight reviews.
“Implementation outcomes were reported in eight reviews [21,24,25,27,28,30,32,38].”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Therapeutic alliance was a relevant acceptability outcome in 6 reviews.
“therapeutic alliance (n=6) [24,25,30,31,34,38]”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Four studies in a review of older adults with depression reported mistrust in technology.
“A review of older adults with depression found that four studies reported mistrust in technology [25]”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Some patient groups, such as older female adults and veterans, were found to feel more comfortable talking to therapists face to face.
“However, some patient groups were found to feel more comfortable talking to therapists face to face, if possible, such as older female adults [25] or veterans [38].”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Patient satisfaction was a relevant acceptability outcome in 7 reviews.
“patient satisfaction (n=7) [21,25,28-31,38]”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Technical difficulties was a relevant implementation outcome in 3 reviews.
“Relevant outcomes included assessment comparability (n=2 reviews), fidelity to intervention and competence of therapists (n=1) [38], patient adherence to intervention (n=3) [21,24,28], patient attendance (n=4) [21,25,30,38], safety (n=2) [24,38], and technical difficulties (n=3) [24,25,38].”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Convenience was a relevant acceptability outcome in 3 reviews.
“convenience (n=3) [25,30,31]”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Acceptability outcomes were reported in 10 reviews.
“Acceptability outcomes were reported in 10 reviews [20,21,24,25,28-31,34,38].”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Initial skepticism between service users and providers tended to dissipate following positive experiences of videoconferencing.
“A review of older people noted that initial skepticism between both service users and providers tended to dissipate following positive experiences of videoconferencing”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
High satisfaction or equivalence was true in substance use disorders, depression, PTSD, older adults, ethnic minorities, and carers of patient populations with dementia.
“This was true in substance use disorders [30], depression [21,25,28,29], PTSD [38], older adults [25], ethnic minorities [21], and carers of patient populations with dementia [31]”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
A report of reduced skepticism following positive experiences suggests that induction sessions and other methods of familiarizing patients with technology and making it accessible may improve acceptability and uptake.
“For example, a report of reduced skepticism following positive experiences [25], if confirmed, suggests that induction sessions and other methods of familiarizing patients with technology and making it accessible to them may improve acceptability and uptake.”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
With appropriate support and access to technology, patients who had not previously used computers reported positive experiences of video calls.
“with appropriate support and access to technology, patients who had not previously used computers reported positive experiences of video calls [25].”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
Patients reported benefits of added convenience of therapy sessions at home via remote interventions for both depression and substance use disorders.
“Patients reported the benefits of added convenience of therapy sessions at home via remote interventions for both depression [25,31] and substance use disorders [30].”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
On the basis of one review suggesting videoconferencing interventions can be comparable with face-to-face sessions, and another review finding high levels of patient satisfaction, therapeutic alliance, attendance, and convenience, effective remote intervention delivery may be feasible for older adults.
“On the basis of one review [20] suggesting that videoconferencing interventions can be comparable with face-to-face sessions, and another review [25] finding high levels of patient satisfaction, therapeutic alliance, attendance, and convenience, this review suggests that effective remote intervention delivery may be feasible for older adults.”
From Implementation of Telemental Health Services Before COVID-19: Rapid Umbrella Review of Systematic Reviews (2021) · cites this paper as [25]
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- Authors
- Christensen, L. F., Moller, A. M., Hansen, J. P., Nielsen, C. T., & Gildberg, F. A.
- Affiliations
- University of Southern Denmark (DK)
- Research Unit for Telepsychiatry and E‐mental Health University of Southern Denmark Odense Denmark
- Department of Regional Health Research Faculty of Health Sciences University of Southern Denmark Odense Denmark
- Corresponding author
- Christensen, Lone Fisker
- Venue
- Journal of Psychiatric and Mental Health Nursing
- Publisher
- Wiley
- Published
- 2019-11-26
- Volume
- 27
- Issue
- 3
- Pages
- 258-271
- ISSN
- 1351-0126 (ISSN-L)
- 1365-2850
- OpenAlex
- W2987026033
- Cited by
- 61
- References
- 54
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 11 · 2023: 11 · 2022: 15 · 2021: 9 · 2020: 3
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Psychiatric and Mental Health Nursing (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (acceptedVersion, other-oa)
- Funders
- Helsefonden
- Jascha Fonden
- Beckett-Fonden
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Demography › Technology Use by Older Adults
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- video consultation, telemedicine, major depressive disorder, older adults, patient satisfaction, provider experiences, access to mental health care, barriers to treatment, technical challenges, staff support, home-based therapy, mental health stigma, depression remission
- MeSH terms
- Aged, Attitude of Health Personnel, Depressive Disorder, Humans, Mental Health Services, Referral and Consultation, Patient Satisfaction, Telemedicine
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