Background: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health, and to debates on its future use in routine mental health care. Objective: To investigate the adoption and impacts of telemental health approaches during the COVID-19 Pandemic, and facilitators and barriers to optimal implementation. Methods: Four databases (PubMed, PsycINFO, CINAHL and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesised using framework synthesis. Results: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. Conclusions: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these.

中文翻译：

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COVID-19 大流行期间远程心理健康的实施、采用和认知：系统评价

背景：在 2020 年初，由于 COVID-19 大流行，精神卫生服务不得不从面对面的护理模式迅速转变为远程提供大部分治疗（通过视频或电话或偶尔的消息）。这给工作人员和患者带来了一些挑战，但也带来了一些好处，例如为行动不便的人或农村地区的人提供便利或增加使用机会。需要了解远程心理健康实施的程度和影响，以及其有效和可接受使用的障碍和促进因素。这既与远程心理健康的未来紧急采用有关，也与有关其未来在常规心理保健中的使用的辩论有关。目标：调查在 COVID-19 大流行期间远程心理健康方法的采用和影响，优化实施的促进因素和障碍。方法：在四个数据库（PubMed、PsycINFO、CINAHL 和 Web of Science）中搜索与远程工作、心理健康护理和 COVID-19 大流行相关的主要研究。还搜索了预印本服务器。使用框架合成来合成研究结果。结果：共有 77 篇论文符合我们的纳入标准。在大多数研究中，在大流行期间可以将大多数接触者转移到远程形式，并且倾向于报告服务用户和临床医生的良好可接受性，至少在远程接触的替代方法中断护理的情况下。然而，也确定了通过这种方式进行最佳护理的一系列障碍。结论：远程心理健康的实施允许在 COVID-19 大流行期间为大多数服务用户提供一些持续支持，并且在紧急情况下具有价值。然而，并非所有服务用户都可以通过这种方式接触到，现在需要更好的证据来证明对治疗关系和护理质量的长期影响，以及对面临数字排斥风险的群体的影响以及如何减轻这些影响。