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Telepsychiatry in Adolescents and Adults during COVID-19
Submission Deadline: September 30, 2022 (Open) Submit Now
Vincenzo Prisco, PhD
Department of Psychiatry ASL Salerno, University Federico II, Naples, Italy
Research interests: telepsychiatry; adolescents; young adults; teleconsultation.
About This Topic
The coronavirus disease 2019 (COVID-19) pandemic has been spreading across Italy for about two years. The outbreak of COVID-19 is severely affecting mental health worldwide, although individual response may vary. On March 9th, 2020, the Italian Government implemented several emergency containment measures, including self-isolation and social distancing. These measures have a strong impact on the population's daily life and may negatively affect psychological well-being. In fact quaratine for coronavirus has serious psychological side effects, such as depression and anxiety that are more likely to occur and worsen. Furhermore quarantine reduces the availability of psychiatric and psychological interventions. The evidence for telepsychiatry is growing in particular for adolescent population. Telepsychiatry uses telecommunication to transmit medical informations to a psychiatrist. Live interactive consultation (video-call) appears to be the best way in which patient and physician can interact in real time, and the Italian youth population manifested interest in using this technology. Providing psychiatric treatment and support may reduce the burden of comorbid mental health conditions, helping patients to cope with acute or chronic diseases. Services could include counseling and psychiatric help for patients, supervision of learned skills, psychological training aimed to maintain results achieved and psychoeducation, etc.
Psychiatrists should reduce their outpatient visits to urgent cases only, such as psychomotor agitation, suicidal attempts or serious psychiatric diseases. In these cases a proper personal protective equipment and an emphasis on social distancing could be very useful. A new type of psychiatric intevention that is feasible and accessible is urgently needed.
A growing body of literature suggests that the use of telepsychiatry to provide mental health services has the potential to remove geographic barriers between patients and providers and improves quality care. It has increased the volume of patients that physicians can reach and diagnose, as well as allowing them to treat patients.
Medical staff should guarantee teleconsultations and therapeutic continuity for patients affected by chronic mental disorders. However, the use of telepsychiay may have some limits. In fact only a few studies evaluated the cost-effectiveness of telepsychiatry interventions. Similarly to the implementation of new technologies in other fields, the application of current literature lacks of comprehensive overviews on effectiveness, costs and accuracy of telesychiatry, in particular in adolescent population. Another limit is the lack of studies conducted in less technologically developed areas, as there may be additional setup costs and training required before telepsychiatry systems can be developed. The majority of studies originate from developed nations, especially Europe, and further studies are needed to examine the efficacy of telepsychiatry in developing and underdeveloped nations in Asia and Africa, which are lacking in psychiatric services. Moreover, some studies showed that the main barriers to the implementation of mental health video consultations from the patients' perspective were the lack of face-to-face contact.
Physical contact would be impossible and the psichiatrist would miss several aspects of the body language, even with facial expressions and gestures being visible. Despite further studies are needed, considering the risk-benefit ratio telepsychiatry could be a useful tool, effective to substitute face-to-face consultations during this pandemic period. To best establish telepsychiatry in the inpatient setting, certain practice guidelines should be considered to ensure the highest quality patient care. Definite protocols are needed to ensure high-quality video sessions and clinical photographs and information must be transmitted using secure software and networks, protecting patient privacy and establishing relationships with primary care teams, to ensure trust in consulting advice and ensuring an appropriate patient follow-up.
telepsychiatry, adolescents, young adults, teleconsultation, Covid- 19
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