Institute for Community Living, New York City (Tse, LaStella, Chow, Kingman, Pearlman, Wang); New York University School of Medicine, New York City (Tse); New York University Silver School of Social Work, New York City (Chow); Department of Biostatistics, Columbia University Mailman School of Public Health, New York City (Valeri); New York State Psychiatric Institute, New York City (Dixon); Columbia University Vagelos College of Physicians and Surgeons, New York City (Dixon). Benjamin G. Druss, M.D., M.P.H., served as decision editor on the manuscript.
Psychiatr Serv. 2021 Jun;72(6):654-660. doi: 10.1176/appi.ps.202000623. Epub 2021 May 7.
The authors examined the acceptability and feasibility of telehealth services shortly after their rapid introduction into a community behavioral health agency as part of the response to the COVID-19 pandemic.
Individuals receiving services during May 8-18, 2020, from behavioral health programs that had introduced telehealth in March 2020, were invited to participate in a survey regarding their perceptions of the telehealth services. Ordinal logistic regressions were used to test for differences in survey responses in three ways: between program types, between the 2020 sample and a 2018 sample, and between individuals reported by staff to be distressed or not distressed by the COVID-19 pandemic.
Of 1,482 survey respondents, >80% reported that their ability to connect to staff, receive support, and get an appointment was at least as great as before the pandemic. Among 80% of respondents indicating interest in continuing remote services after the pandemic ended, 83% preferred a mix of remote and face-to-face services. From February 2020 to April 2020, total service utilization remained stable for treatment, outreach, and housing programs. In addition, mental health-related hospital utilization did not increase.
The findings of this study suggest that telehealth, including telephone-based services, is an acceptable and even preferred service delivery mode for clients with severe mental illness. Continued investigation into the optimal dosing of face-to-face versus remote services in various settings is needed to inform service practice during and after the COVID-19 pandemic.
作者研究了在 COVID-19 大流行期间，作为应对措施的一部分，将远程医疗服务迅速引入社区行为健康机构后不久，该服务的可接受性和可行性。
2020 年 3 月引入远程医疗的行为健康项目在 2020 年 5 月 8 日至 18 日期间接受服务的个人被邀请参与一项关于他们对远程医疗服务看法的调查。有序逻辑回归用于测试三种方式的调查结果差异：在项目类型之间，在 2020 年样本和 2018 年样本之间，以及员工报告的因 COVID-19 大流行而感到困扰或不困扰的个体之间。
在 1482 名调查受访者中，超过 80%的人表示他们与工作人员联系、获得支持和预约的能力至少与大流行前一样大。在表示有兴趣在大流行结束后继续远程服务的 80%的受访者中，83%的人更喜欢远程和面对面服务的混合。从 2020 年 2 月到 2020 年 4 月，治疗、外展和住房项目的总服务利用率保持稳定。此外，与心理健康相关的住院利用率并未增加。
本研究的结果表明，远程医疗，包括基于电话的服务，是接受严重精神疾病患者的可接受的甚至是首选的服务提供模式。需要在各种环境中进一步调查面对面服务与远程服务的最佳剂量，以为 COVID-19 大流行期间和之后的服务实践提供信息。
