Background: During the COVID-19 pandemic, we saw telehealth rapidly become the primary way to receive mental health care. International research has validated many of the benefits and challenges of telehealth known beforehand for specific population groups. However, if telehealth is to assume prominence in future mental health service delivery, greater understanding of its capacity to be used to provide psychosocial support to people with complex and enduring mental health conditions is needed. Objective: We focused on an Australian community-managed provider of psychosocial intervention and support. We aimed to understand service user and worker experiences of psychosocial support via telehealth throughout the COVID-19 pandemic. Methods: This study was jointly developed and conducted by people with lived experience of mental ill health or distress, mental health service providers, and university-based researchers. Semistructured interviews were conducted between August and November 2020 and explored participant experiences of receiving or providing psychosocial support via telehealth, including telephone, text, and videoconferencing. Qualitative data were analyzed thematically; quantitative data were collated and analyzed using descriptive statistics. Results: Service users (n=20) and workers (n=8) completed individual interviews via telephone or videoconferencing platform. Service users received psychosocial support services by telephone (12/20, 60%), by videoconferencing (6/20, 30%), and by both telephone and videoconferencing (2/20, 10%). Of note, 55% (11/20) of service user participants stated a future preference for in-person psychosocial support services, 30% (6/20) preferred to receive a mixture of in-person and telehealth, and 15% (3/20) elected telehealth only. Two meta-themes emerged as integral to worker and service user experience of telehealth during the pandemic: (1) creating safety and comfort and (2) a whole new way of working. The first meta-theme comprises subthemes relating to a sense of safety and comfort while using telehealth; including trusting in the relationship and having and exercising choice and control. The second meta-theme contains subthemes reflecting key challenges and opportunities associated with the shift from in-person psychosocial support to telehealth. Conclusions: Overall, our findings highlighted that most service users experienced telehealth positively, but this was dependent on them continuing to get the support they needed in a way that was safe and comfortable. While access difficulties of a subgroup of service users should not be ignored, most service users and workers were able to adapt to telehealth by focusing on maintaining the relationship and using choice and flexibility to maintain service delivery. Although most research participants expressed a preference for a return to in-person psychosocial support or hybrid in-person and telehealth models, there was a general recognition that intentional use of telehealth could contribute to flexible and responsive service delivery. Challenges to telehealth provision of psychosocial support identified in this study are yet to be fully understood.

中文翻译：

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通过远程医疗通过 COVID-19 大流行获得心理社会支持的心理健康服务用户和工作者体验：定性研究

背景：在 COVID-19 大流行期间，我们看到远程医疗迅速成为接受心理健康护理的主要方式。国际研究已经验证了特定人群事先已知的远程医疗的许多好处和挑战。然而，如果远程医疗要在未来的精神卫生服务提供中占据突出地位，就需要更深入地了解其为患有复杂而持久的精神健康状况的人提供社会心理支持的能力。目标：我们专注于澳大利亚社区管理的社会心理干预和支持提供者。我们的目标是在整个 COVID-19 大流行期间通过远程医疗了解服务用户和员工的心理社会支持体验。方法：这项研究是由有精神疾病或痛苦经历的人、精神健康服务提供者和大学研究人员共同开发和进行的。半结构化访谈于 2020 年 8 月至 11 月期间进行，探讨了参与者通过远程医疗（包括电话、短信和视频会议）接受或提供社会心理支持的经历。定性数据进行了专题分析；使用描述性统计对定量数据进行了整理和分析。结果：服务使用者（n=20）和工人（n=8）通过电话或视频会议平台完成个人访谈。服务使用者通过电话（12/20，60%）、视频会议（6/20，30%）以及电话和视频会议（2/20，10%）获得社会心理支持服务。值得注意的是，55% (11/20) 的服务用户参与者表示未来更喜欢面对面的社会心理支持服务，30% (6/20) 的人更喜欢接受面对面和远程医疗的混合，15% (3 /20) 仅选择远程医疗。在大流行期间，出现了两个元主题，成为远程医疗工作者和服务用户体验不可或缺的一部分：(1) 创造安全和舒适；(2) 一种全新的工作方式。第一个元主题包括与使用远程医疗时的安全感和舒适感相关的子主题；包括信任关系以及拥有并行使选择和控制权。第二个元主题包含反映与从面对面的社会心理支持转变为远程医疗相关的关键挑战和机遇的子主题。结论：总体而言，我们的调查结果强调，大多数服务用户对远程医疗的体验是积极的，但这取决于他们继续以安全和舒适的方式获得所需的支持。虽然不应忽视一部分服务用户的获取困难，但大多数服务用户和工作人员能够通过专注于维护关系并利用选择和灵活性来维持服务提供来适应远程医疗。尽管大多数研究参与者表示更喜欢恢复面对面的社会心理支持或面对面和远程医疗的混合模式，但人们普遍认为，有意使用远程医疗有助于提供灵活和响应迅速的服务。本研究中确定的远程医疗提供心理社会支持所面临的挑战尚未完全了解。