Neumann Ariana, König Hans-Helmut, Hajek André
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany, 49 40741054202, 49 4074104026.
JMIR Ment Health. 2025 Jun 13;12:e70925. doi: 10.2196/70925.
Telemental health services effectively address major challenges in mental health care delivery. To maximize the potential of the services, it is essential to facilitate patient use and reduce use disparities. Nevertheless, determinants of patient use of telemental health services have been scarcely investigated thus far.
We aimed to identify determinants of patient use of telemental health services since the onset of the COVID-19 pandemic and in the last 4 weeks.
In December 2023, we conducted a cross-sectional, quota-based (gender and age group) online survey. The sample comprised individuals aged 18 to 74 years, who had been using mental health services since March 2020 (n=2082). Telemental health service use was assessed using items that inquired whether individuals had used the services since March 2020 or currently (in the last 4 weeks). Logistic regressions were computed to test the associations of socioeconomic, access, health, COVID-19-related, psychosocial, and service factors, as well as personality and provider characteristics with patient use.
Younger age, a more positive patient attitude toward telemental health services, a more positive provider attitude toward using the services, and higher provider skills for using the services were positively associated with patient use of telemental health services since the onset of the COVID-19 pandemic. When exclusively looking at current use, positive associations with full-time employment, lower neuroticism, a more positive provider attitude toward the services, and use of the services to avoid stigmatization, long waiting times, or inconvenient scheduling were observed. Access, health, and COVID-19-related factors were not associated with patient use (since the onset of the COVID-19 pandemic and currently).
Beyond socioeconomic factors, personality, and a positive patient attitude toward the services, patient use of telemental health services was associated with a positive provider attitude toward using the services and higher provider skills for using the services, which underscores the need for provider support and training in telemental health care. Furthermore, avoiding stigmatization and higher convenience of the services were associated with patient use, which highlights the substantial potential of the services to address current mental health care challenges.
远程心理健康服务有效应对了心理健康护理提供方面的重大挑战。为了最大限度地发挥这些服务的潜力，促进患者使用并减少使用差异至关重要。然而，到目前为止，患者使用远程心理健康服务的决定因素鲜有研究。
我们旨在确定自新冠疫情爆发以来以及过去4周内患者使用远程心理健康服务的决定因素。
2023年12月，我们开展了一项基于配额（性别和年龄组）的横断面在线调查。样本包括18至74岁、自2020年3月以来一直在使用心理健康服务的个体（n = 2082）。通过询问个体自2020年3月以来或目前（过去4周内）是否使用过这些服务的项目来评估远程心理健康服务的使用情况。计算逻辑回归以检验社会经济、可及性、健康、新冠相关、心理社会和服务因素，以及个性和提供者特征与患者使用之间的关联。
自新冠疫情爆发以来，年龄较小、患者对远程心理健康服务的态度更积极、提供者对使用这些服务的态度更积极以及提供者使用这些服务的技能更高与患者使用远程心理健康服务呈正相关。仅考虑当前使用情况时，观察到与全职工作、较低的神经质、提供者对服务的态度更积极以及为避免污名化、等待时间长或预约不便而使用服务呈正相关。可及性、健康和新冠相关因素与患者使用（自新冠疫情爆发以来以及目前）无关。
除了社会经济因素、个性和患者对服务的积极态度外，患者使用远程心理健康服务还与提供者对使用这些服务的积极态度以及提供者使用这些服务的更高技能相关，这凸显了在远程心理健康护理中对提供者提供支持和培训的必要性。此外，避免污名化和服务更高的便利性与患者使用相关，这突出了这些服务在应对当前心理健康护理挑战方面的巨大潜力。
