Background: In the context of the COVID-19 pandemic, many behavioral health services have transitioned to teletherapy to continue delivering care for patients with mental illness. Studies that evaluate the outcome of this rapid teletherapy adoption and implementation are pertinent. Objective: This single-arm, nonrandomized pilot study aimed to assess the feasibility and initial patient-level outcomes of a psychiatric transitional day program that switched from an in-person group to a video teletherapy group during the COVID-19 pandemic. Methods: Patients with transdiagnostic conditions who were at risk of psychiatric hospitalization were referred to the Adult Transitions Program (ATP) at a large academic medical center in the United States. ATP was a 3-week intensive outpatient program that implemented group teletherapy guided by cognitive and behavioral principles delivered daily for 3 hours per day. Feasibility was assessed via retention, attendance rate, and rate of securing aftercare appointments prior to ATP discharge. Patients completed standardized patient-reported outcome measures at admission and discharge to assess the effectiveness of the program for improving quality of mental health, depression, anxiety, and suicide risk. Results: Patients (N=76) started the program between March and August of 2020. Feasibility was established, with 70 of the 76 patients (92%) completing the program and a mean attendance of 14.43 days (SD 1.22); also, 71 patients (95%) scheduled at least one behavioral health aftercare service prior to ATP discharge. All patient-level reported outcomes demonstrated significant improvements in depression (95% CI –3.6 to –6.2; Cohen d=0.77; P<.001), anxiety (95% CI –3.0 to –4.9; Cohen d=0.74; P<.001), overall suicide risk (95% CI –0.5 to –0.1; Cohen d=0.41; P=.02), wish to live (95% CI 0.3 to 1.0; Cohen d=0.39; P<.001), wish to die (95% CI –0.2 to –1.4; Cohen d=0.52; P=.01), and overall mental health (95% CI 1.5 to 4.5; Cohen d=0.39; P<.001) from admission to discharge. Conclusions: Rapid adoption and implementation of a group-based teletherapy day program for adults at risk of psychiatric hospitalization appeared to be feasible and effective. Patients demonstrated high completion and attendance rates and reported significant improvements in psychosocial outcomes. Larger trials should be conducted to further evaluate the efficacy and effectiveness of the program through randomized controlled trials.

中文翻译：

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针对患有严重精神疾病的成年人开展的基于团体的远程治疗精神病日计划的可行性和初步结果：在COVID-19的背景下进行的开放，非随机试验

背景：在COVID-19大流行的背景下，许多行为健康服务已经过渡到远程治疗，以继续为精神疾病患者提供护理。有关评估这种快速的远程疗法的采用和实施的结果的研究是相关的。目的：这项单臂，非随机的前瞻性研究旨在评估在COVID-19大流行期间从个人小组转为视频远程治疗小组的精神科过渡日计划的可行性和初始患者水平的结果。方法：有精神病住院风险的具有转诊条件的患者被转诊至美国一家大型学术医疗中心的成人过渡计划（ATP）。ATP是一个为期3周的密集门诊计划，该计划在每天3小时，每天交付的认知和行为原则的指导下实施了小组远程治疗。通过保留率，出勤率和在ATP出院前就诊后的安全保证率来评估可行性。患者在入院和出院时完成了标准化的患者报告结局指标，以评估该计划对改善心理健康，抑郁，焦虑和自杀风险的质量的有效性。结果：患者（N = 76）在2020年3月至8月之间开始了该计划。确定了可行性，在76名患者中，有70名（92％）完成了该计划，平均出勤时间为14.43天（SD 1.22）。另外，有71名患者（95％）在ATP出院前安排了至少一次行为健康的后期护理。所有患者水平报告的结局均显示抑郁症（95％CI –3.6至–6.2； Cohen d = 0.77；P <.001），焦虑（95％CI –3.0至–4.9； Cohen d = 0.74；P < .001），总体自杀风险（95％CI –0.5至–0.1； Cohen d = 0.41；P = .02），希望存活（95％CI 0.3至1.0； Cohen d = 0.39；P<.001），希望死亡（95％CI -0.2至-1.4; Cohen d = 0.52; P = .01）和整体精神健康（95％CI 1.5至4.5; Cohen d = 0.39; P <.001 ）从入院到出院。结论：对于有精神病住院风险的成年人，快速采用和实施基于小组的远程治疗日计划似乎是可行和有效的。患者表现出很高的完成率和出勤率，并报告了社会心理结果的显着改善。应该进行更大的试验，以通过随机对照试验进一步评估该计划的有效性和有效性。