Clinicians’ perceptions of telephone-delivered mental health services

Publication Date26 December 2019
Date26 December 2019
AuthorMicaela Mercado,Virna Little
SubjectHealth & social care,Mental health,Mental health education
Cliniciansperceptions of telephone-
delivered mental health services
Micaela Mercado and Virna Little
Purpose The adoption of telephone-delivered mental health services (TDMHS) for scaling
collaborative care or addressing access to mental health services in routine primary care practice is
gradual despite the needs of the population. Although there are multi-level factors associated with
efficient implementation of collaborative care, there is limited understanding of clinicians’ perceptions,
experiences and acceptability providing mental health treatment exclusively over the telephone. The
purpose of thispaper is to explore behavioral health clinicians’delivery of mental health services overthe
telephonewithin primary care settings.
Design/methodology/approach This qualitative study explored behavioral health professionals’
perceptions and experiences providing remote, TDMHS.Convenience sampling was used to recruit 11
clinicians in New York, California and Arizona who provided collaborative care services to patients
exclusively over the telephone. Semi-structured interviews were conducted, and analyzed using
qualitativecontent analysis methods.
Findings Three main themes and associatedsubthemes emerged from the analyses. The first theme
was participants’ perceptions of TDMHS prior to implementation relating to patient characteristics,
patient engagement and comparison to in-person therapy. The second main theme identified was
participants’experiences implementing TDMHSwith subthemes relating to benefits, quality of care,gaps
in care and concerns implementing TDMHS. The final theme that emerged from the analysis was
participants’perceived acceptability of TDMHSby patients.
Research limitations/implications The small samplesize limits the generalizability of these findings.
Practical implications Mental health servicesdelivered over the telephone are perceivedas feasible
and acceptableby behavioral health clinicians.
Originality/value This study contributesto gaps in research about behavioral healthclinicians’ beliefs,
uptakeand acceptability toward mental healthservices delivered exclusivelyover the telephone.
Keywords Access to mental health care, Behavioural health, Behavioural health clinician,
Collaborative care
Paper type Research paper
Telephone-delivered mental health service (TDMHS) is one modality used for
implementing collaborative care. Collaborative care is an evidence-based practice
for identifying and treating patients with depression and anxiety within an integrated
primary care settings, involving the primary care provider (PCPs), a behavioral care
manager, a psychiatric consultant and the client (Kroenke and Unutzer, 2017;Blackmore
et al.,2018
). A key method for expanding collaborative care beyond the physical
constraints of a primary care office is the telephone. Today, the ubiquitous use of mobile
phones by patients facilitates collaborative care expansion to underserved areas,
especially when patients do not have access to psychiatric services or when PCPs lack
resources for mental health consultation for their patients (Hilty et al., 2006, 2013). As a
modality, TDMHS has the potential to reach segments of the population that cannot access
care in a timely or consistent manner (Gifford et al.,2012). This is evident for patients in
need of treatment who live in remote areas where TDMHS does not require reliable
Micaela Mercado and
Virna Little are both based
at Concert Health, Phoenix,
Arizona, USA.
Received 12 August 2019
Revised 11 September 2019
Accepted 6 December 2019
The authors declare conflict of
interest with respect to
employment by organization.
The authors did not receive
financial support for this study.
PAGE104 jTHE JOURNAL OF MENTAL HEALTH TRAINING, EDUCATION AND PRACTICEjVOL. 15 NO. 2 2020, pp. 104-113, ©Emerald Publishing Limited, ISSN 1755-6228 DOI10.1108/JMHTEP-08-2019-0039

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