Virtual Mental Health Care in the Veterans Health Administration's Immediate Response to Coronavirus Disease-19
Virtual Mental Health Care in the Veterans Health Administration's Immediate Response to Coronavirus Disease-19
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DOI：
10.1037/amp0000751
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发表时间：
2021-01-01
影响因子：
16.4
通讯作者：
Schnurr, Paula P.
中科院分区：
文献类型：
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作者：
Rosen, Craig S.;Morland, Leslie A.;Schnurr, Paula P.
2019冠状病毒病（COVID-19）大流行增加了全球人口对心理护理的需求，并为获得服务创造了新的障碍。医院的精神卫生设施和其他诊所面临的挑战是，既要为处于严重压力下的人群提供持续护理，又要尽量减少有传播病毒风险的亲自就诊。退伍军人健康管理局（VHA）是美国最大的综合医疗保健系统，在1，286个地点提供护理。VIIA在美国疫情爆发后的第一周迅速扩大了远程健康方法的使用，确保了2019冠状病毒病爆发后精神健康服务的连续性。VHA于2020年4月为退伍军人提供了近120万次电话和视频接触，与疫情前的2019年10月至2020年2月期间相比，亲自访问减少了约80%。截至2020年6月，与疫情前相比，VHA使用直接到户视频的接触增加了11倍，电话接触增加了5倍。本文讨论了关于远程健康的有效性的研究，在COVID-19之前促进远程健康系统使用的VHA政策，以及VHA在疫情爆发的头几个月迅速扩大远程健康使用的行动。主要的挑战和经验教训，从VHA的经验和供应商和医疗保健系统的影响，关于使用远程健康，以满足患者的精神卫生保健需求在大流行期间进行了讨论。
The coronavirus disease 2019 (COVID-19) pandemic has increased the need for psychological care in the global population and has created new barriers to accessing services. Hospitals. mental health facilities, and other clinics face the challenge of providing continued care to a population that is under severe stress, while minimizing in-person visits that risk spreading the virus. The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,286 sites. VIIA ensured the continuity of mental health services after the COVID-19 outbreak by rapidly expanding its use of telemental health methods in the first weeks after the U.S. pandemic outbreak. VHA provided nearly 1.2 million telephone and video encounters to veterans in April 2020 and reduced in-person visits by approximately 80% when compared with the October 2019 to February 2020 period before the pandemic. By June 2020, VHA had an 11-fold increase in encounters using direct-to-home video and a fivefold increase in telephone contacts relative to before the pandemic. This article discusses research on the effectiveness of telemental health, VHA policies before COVID-19 that facilitated the use of telemental health system-wide, and VHA's actions that rapidly scaled use of telemental health during the first months of the outbreak. Key challenges and lessons learned from VHA's experience and implications for providers and health care systems regarding the use of telemental health to meet patients' mental health care needs during the pandemic are also discussed.