Qualitative insights into mental health treatment through telemedicine during the COVID-19 crisis: a natural experiment in community mental health centers.
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Abstract
Background: The COVID-19 pandemic exacerbated existing mental health challenges and introduced new ones, particularly among vulnerable populations such as individuals within the criminal justice system, who disproportionately experienced employment, financial, and housing issues. As mandatory lockdowns and social distancing mandates were implemented, the United States saw unprecedented interruptions to treatment. Telemedicine emerged as a transformative tool in alleviating new and existing treatment barriers. Yet, limited empirical research has examined the impact and implications of telemedicine on mental health treatment in criminal justice populations.
Methods: The timing of this study's data collection overlapped with the spread of COVID-19 in the United States and provided a unique opportunity to examine the impact of telemedicine as part of a natural experiment. Utilizing interviews with 61 community mental health center service providers, this study qualitatively examined service providers' experiences in treating criminal justice-involved individuals with serious mental illness who were receiving mental health treatment through telemedicine.
Results: Service providers expressed satisfaction with telemedicine in addressing client transportation and childcare barriers while increasing engagement. Service providers voiced new concerns regarding clients' confidentiality, digital literacy, and limitations to gathering non-verbal client information during virtual treatment.
Conclusions: Mental health treatment offered through telemedicine mitigates barriers to treatment that disproportionately affect criminal justice clients. Despite its benefits, challenges like access to reliable internet and to internet-enabled devices, confidentiality concerns, and information gathering must be addressed to achieve optimal and equitable mental health treatment through telemedicine. The findings support the continued use of telemedicine in mental health treatment delivery for this population.
期刊介绍：
Health & Justice is open to submissions from public health, criminology and criminal justice, medical science, psychology and clinical sciences, sociology, neuroscience, biology, anthropology and the social sciences, and covers a broad array of research types. It publishes original research, research notes (promising issues that are smaller in scope), commentaries, and translational notes (possible ways of introducing innovations in the justice system). Health & Justice aims to: Present original experimental research on the area of health and well-being of people involved in the adult or juvenile justice system, including people who work in the system; Present meta-analysis or systematic reviews in the area of health and justice for those involved in the justice system; Provide an arena to present new and upcoming scientific issues; Present translational science—the movement of scientific findings into practice including programs, procedures, or strategies; Present implementation science findings to advance the uptake and use of evidence-based practices; and, Present protocols and clinical practice guidelines. As an open access journal, Health & Justice aims for a broad reach, including researchers across many disciplines as well as justice practitioners (e.g. judges, prosecutors, defenders, probation officers, treatment providers, mental health and medical personnel working with justice-involved individuals, etc.). The sections of the journal devoted to translational and implementation sciences are primarily geared to practitioners and justice actors with special attention to the techniques used.
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