Teletherapy with serious mental illness populations during COVID-19: telehealth conversion and engagement

ABSTRACT

The COVID-19 pandemic completely changed daily lives and psychotherapy clinical operations. Treatment engagement with serious mental illness (SMI) populations is inherently challenging. COVID-19 may pose more challenges to treatment engagement with SMI populations due to the rapid change to telehealth and exacerbation of symptoms. SMI patients may be less likely to convert to telehealth or stay engaged in treatment compared to non-SMI patients during COVID-19. Nevertheless, treatment engagement via teletherapy is vital to supporting the vulnerable SMI populations during this stressful pandemic. In this study, we compared teletherapy conversion and utilization rates between SMI and general populations in an outpatient psychiatric clinic (n = 816) during COVID-19. We found no differences in telehealth conversion for patients with SMI (52%) and non-SMI (48%), suggesting equivalent adoption of teletherapy among SMI and non-SMI populations. Beyond conversion, we found that the SMI group had a significantly greater number of teletherapy visits compared to non-SMI patients, indicating that SMI group utilized teletherapy regularly after conversion. There were no group differences in new patients beginning therapy via telehealth, which shows that the SMI group was not more deterred to seek help. Our findings inform the feasibility of telehealth for serious mental illness populations during the pandemic.

KEYWORDS:

• COVID-19
• teletherapy
• engagement
• serious mental illness
• high-risk

Acknowledgement

We are grateful to Sunita Stewart for her feedback and suggestions.

Disclosure statement

This is to acknowledge that we have no financial interest or benefit that has arisen from the direct applications of our research.

We have no conflicts of interest to disclose.

Additional information

Notes on contributors

Adriana S. Miu

Adriana Miu, Ph.D., is an assistant professor in the Department of Psychiatry at UT Southwestern Medical Center. She specializes in treating early psychosis and sexual trauma. Her research interests include social-cognitive factors such as growth mindset and hostile attribution bias.

Hoa T. Vo

Hoa Vo, Ph.D., is an Assistant Professor in the Department of Psychiatry at UT Southwestern Medical Center. She specializes in treating substance use disorders in adolescents and adults. Her research interests include predictors, gender factors, and psychosocial interventions for substance use and co-occurring disorders in youths and adults.

Jayme M. Palka

Jayme Palka, B.S., is a biostatistician in Translational Neuroscience in the Department of Psychiatry at UT Southwestern Medical Center. She has specialization in advanced statistical analysis and modeling.

Christopher R. Glowacki

Christopher Glowacki, Psy.D., is an Assistant Professor in the Department of Psychiatry at UT Southwestern Medical Center. He specializes in treating depression, anxiety, trauma, emotional dysregulation, and interpersonal issues.

Reed J. Robinson

Reed Robinson, Ph.D., ABPP, is an Assistant Professor in the Department of Psychiatry at UT Southwestern Medical Center, the Director of Psychological Services for the Division of Psychology, and the Clinical Director of the UT Southwestern Outpatient Psychiatry Clinic. He specializes in cognitive behavioral therapy for anxiety, depression, and PTSD