Through our Small Grants Program launched in 2020, we allocated nearly $100,000 to a terrific set of diverse proposals from faculty, staff and trainees on a wide range of topics. Suzanne Meller, MPH, MSW, LSWAIC, and Dror Ben-Zeev, PhD, completed their “Attitudes, readiness and adoption of digital health in community mental health centers during the COVID-19 pandemic” project this month.
The purpose of their study was to explore facilitators and barriers aiding community mental health centers in implementing technology-assisted care during the COVID-19 pandemic. The team interviewed six key informants and surveyed 28 clinicians from three community mental health centers in Washington state. Interviews focused on technology-assisted care implementation efforts and factors that facilitated adoption. Surveys focused on clinician beliefs and experience with technology-assisted care in addition to training needs.
The team found that in the context of a rapid shift to virtually delivered services across the healthcare sector due to COVID-19, barriers remain to implementing digital health in community mental health settings. External facilitators such as regulation relaxations together with internal facilitators such as supervisor encouragement of digital mental health use among clinicians enabled many services to change over to digital/telehealth. However, individual clinician beliefs about the quality of the therapeutic relationship and lack of access to resources created a mixed implementation environment that has hampered the roll-out digital mental health overall. For community mental health centers to be successful in their implementation efforts, these barriers must be addressed locally and adapted to fit staff and client needs.
Below is their final report.
Summary of the work completed
The purpose of this study was to explore facilitators and barriers aiding community mental health centers in implementing technology-assisted care during the COVID-19 pandemic. Six key informants were interviewed and 28 clinicians were surveyed from three community mental health centers in Washington state. Interviews focused on technology-assisted care implementation efforts and factors that facilitated adoption. Surveys focused on clinician beliefs and experience with technology-assisted care in addition to training needs.
Following data collection, the Project Lead and a post-doctoral fellow completed qualitative analysis of the interviews, and quantitative analysis of the surveys. Using a mixed-methods analysis, the study results were written up and are currently under second review at a peer-reviewed academic journal.
The intended outcome was partially met. While three community mental health clinics were recruited into the study and six interviews were completed, only 28 surveys were completed from community mental health clinics. This reflected the diversity of size of clinics in terms of staffing. For example, at one of the rural community clinics recruited into the study, there were only six full-time staff members. This resulted in a smaller sample size for the surveys than anticipated.
What did you learn because of this work?
In the context of a rapid shift to virtually delivered services across the healthcare sector due to COVID-19, barriers remain to implementing digital health in community mental health settings. External facilitators such as regulation relaxations together with internal facilitators such as supervisor encouragement of digital mental health use among clinicians enabled many services to change over to digital/telehealth. However, individual clinician beliefs about the quality of the therapeutic relationship and lack of access to resources created a mixed implementation environment that has hampered the roll-out digital mental health overall. In order for community mental health centers to be successful in their implementation efforts, these barriers must be addressed locally and adapted to fit staff and client needs.
What future activities might result from this award?
The findings from this study may be used to guide telehealth utilization in community mental health clinics, especially in the context of training community mental health providers in evidence-based practices in telehealth use. This study will generate data that can inform implementation strategies for digital health in the real-world context and can lend itself to formal testing of digital mental health implementation such as a NIMH grant from the Division of Services Research and Clinical Epidemiology Branch.
