Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA.
Center for m2Health, Palo Alto University, Palo Alto, California, USA.
Int J Eat Disord. 2020 Jul;53(7):1155-1157. doi: 10.1002/eat.23300. Epub 2020 May 25.
The unprecedented COVID-19 crisis presents an imperative for mental health care systems to make digital mental health interventions a routine part of care. Already because of COVID-19, many therapists have rapidly moved to using telehealth in place of in-person contact. In response to this shift, Waller and colleagues compiled a series of expert recommendations to help clinicians pivot to delivering teletherapy to address eating disorders during COVID-19. However, numerous barriers still impede widespread adoption and implementation of digital interventions. In this commentary, we aim to extend the recommendations for clinicians offered by Waller and colleagues by presenting a roadmap of the systems- and policy-level requirements that are needed. We advocate for addressing barriers associated with training, licensing, safety, privacy, payment, and evaluation, as these factors have greatly limited use of these promising interventions. We also indicate that longer-term goals should include introducing truly innovative digital mental health practices, such as stepped-care models and simultaneously providing preventive and self-management services in addition to clinical services, into the health care system. Now is the time to catalyze change and comprehensively address the barriers that have prevented widespread delivery of these efficacious digital services to the millions of people who would benefit.
前所未有的 COVID-19 危机迫切要求精神卫生保健系统将数字心理健康干预作为常规护理的一部分。由于 COVID-19，许多治疗师已经迅速转向使用远程医疗来代替面对面的接触。针对这一转变，Waller 及其同事汇编了一系列专家建议，以帮助临床医生转变为提供远程治疗，以解决 COVID-19 期间的饮食障碍。然而，许多障碍仍然阻碍了数字干预措施的广泛采用和实施。在这篇评论中，我们旨在通过提出系统和政策层面所需的要求路线图，扩展 Waller 及其同事为临床医生提供的建议。我们主张解决与培训、许可、安全、隐私、支付和评估相关的障碍，因为这些因素极大地限制了这些有前途的干预措施的使用。我们还指出，长期目标应包括将真正创新的数字心理健康实践，如阶梯式护理模式，并同时提供预防和自我管理服务，以及临床服务，引入医疗保健系统。现在是时候推动变革了，全面解决那些阻止这些有效数字服务广泛提供给数百万受益人群的障碍了。
