The Design, Implementation, and Acceptability of a Telehealth Comprehensive Recovery Service for People With Complex Psychosis Living in NYC During the COVID-19 Crisis.
The Design, Implementation, and Acceptability of a Telehealth Comprehensive Recovery Service for People With Complex Psychosis Living in NYC During the COVID-19 Crisis.
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DOI：
10.3389/fpsyt.2020.581149
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发表时间：
2020
影响因子：
4.7
通讯作者：
Saperstein A
中科院分区：
文献类型：
--
作者：
Lynch DA;Medalia A;Saperstein A
COVID-19危机和随后的居家令给支持治疗复杂精神病患者的康复导向行为健康服务（RS）的传播带来了前所未有的挑战。这些人群通常采用面对面药物治疗和/或RS治疗，目的是缓解症状，提高生活满意度和增加社区参与。与COVID-19相关的社会距离措施要求在护理管理方面迅速转变，而远程医疗法规的放宽使人们能够灵活地以不同的方式处理RS。必须学习RS远程医疗实施经验，以便RSs能够继续为这些弱势和有需要的人群提供护理。本文描述了成功的远程医疗转换纽约为基础，大学附属RS服务成人严重精神疾病（SMI; n = 64）。结果重点关注CP参与者子集的远程医疗接受率（n = 23）。社会服务中心继续提供服务，包括接收、护理协调、团体心理治疗、技能培训小组、个人技能指导和职业/教育支持。CP子样本的远程医疗转换率表明，90%的CP患者接受远程医疗会议，并在虚拟格式中维持他们的具体治疗计划。在远程保健转换前后的六周期间，会诊出勤率和取消/未到诊率的平均值比较显示，服务利用率没有显著差异。RSs在CP治疗中发挥着至关重要的作用，即使在COVID-19危机消退之后，远程医疗也可能被证明是一种可行的医疗服务形式。将考虑内部和外部治疗环境中有助于成功转向远程保健的多种因素，以及临床医生和患者遇到的挑战。
The COVID-19 crisis and subsequent stay-at-home orders have produced unprecedented challenges to the dissemination of recovery oriented behavioral health services (RS) that support the treatment of those with complex psychosis (CP).This population has typically been managed with in-person pharmacotherapy and/or RS, with the goals of relieving symptoms, improving life satisfaction and increasing community engagement. COVID-19 related social distancing measures have required rapid shifts in care management, while easing of telehealth regulations has allowed for flexibility to approach RS differently. It is essential to learn from the RS telemedicine implementation experience, so that RSs can maintain care for this vulnerable and needy population. This paper describes the successful telehealth conversion of a NYC-based, university affiliated RS that serves adults with severe mental illnesses (SMI; n = 64). Results focus on the telehealth acceptance rates of the subset of participants with CP (n = 23). The RS continued providing services including intake, care coordination, group psychotherapies, skills training groups, individual skills coaching, and vocational/educational supports. The telehealth conversion rates of the CP subsample indicated that 90% of CP patients accepted telehealth sessions and maintained their specific treatment plans in the virtual format. Mean comparisons between session attendance and cancellations/no-shows during the six-week period before and after telehealth conversion showed no significant differences in service utilization. RSs play an essential role in the treatment of CP and telehealth may prove to be a viable format of care delivery even after the COVID-19 crisis subsides. The multiple factors in the inner and outer treatment setting that contributed to successful conversion to telehealth will be considered along with the challenges that clinicians and patients encountered.
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