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      Perspectives of Young Adults on Receiving Telepsychiatry Services in an Urban Early Intervention Program for First-Episode Psychosis: A Cross-Sectional, Descriptive Survey Study

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          Abstract

          Background

          Limited knowledge exists on telepsychiatry in specialized services for first-episode psychosis (FEP), despite its potential for improving service access and engagement.

          Objective

          To explore access and use of technology, obstacles to attending clinic appointments, and perspectives of young adults with FEP on using telepsychiatry as part of outpatient services.

          Methods

          A cross-sectional, descriptive survey study was conducted between July and October 2017 with young adults between the ages of 18 and 38 recruited from a specialized program for FEP in an urban Canadian setting. Data were analysed using descriptive statistics and content analysis.

          Results

          Among 51 participants (mean age = 26.1, SD = 4.2; 59% male; 20% experiencing housing instability), more than half (59%, n = 30) rarely or never used mainstream video chat (e.g., Facetime). The majority (78%, n = 40) reported obstacles to attending appointments, with several (37%, n = 19) identifying two or more. Almost half (49%, n = 25) were very favorable towards telepsychiatry and a quarter (25%, n = 13) were somewhat favorable. Participants expressed several concerns about telepsychiatry, including loss of human contact and confidentiality.

          Conclusions

          To our knowledge, this is a first study on the perspectives of individuals with FEP about telepsychiatry. Despite experiencing obstacles to attending appointments and expressing receptivity towards telepsychiatry, participants did not have access to these services. It is important to provide education to clinicians on the potential of telepsychiatry to improve service access. Also, more research is needed on when, where, and how telepsychiatry can be integrated into existing care while addressing patient and clinician concerns.

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          Most cited references11

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          A systematic review of patient acceptance of consumer health information technology.

          A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation.
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            Telepsychiatry: videoconferencing in the delivery of psychiatric care.

            Jay Shore (2013)
            The provision of psychiatric treatment via live interactive videoconferencing, frequently termed telepsychiatry, is a viable option for psychiatrists to provide care to individual patients, populations, and communities faced with limited access and to move the point of care delivery into patients' living environments. Psychiatric providers new to videoconferencing should not be intimidated by the technology or its encompassing logistics, but they do need to develop an awareness of the salient regulatory, administrative, and clinical issues that arise in the practice of videoconferencing-based telepsychiatry. This article provides an overview of the current evidence base in telepsychiatry and reviews administrative and clinical issues in videoconferencing-based treatment. These points are then highlighted in a case example.
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              Telehealth interventions for schizophrenia-spectrum disorders and clinical high-risk for psychosis individuals: A scoping review

              Despite its increased use in mental health, both health care provision by telehealth and research are in the early stages. Videoconferencing, a telehealth subfield, has been mainly used for the medication management and delivery of psychological treatments for mood, adjustment and anxiety disorders, and to a lesser extent for psychotic disorders. The focus of this scoping review is on studies using videoconferencing for intervention for individuals with a diagnosis of schizophrenia-spectrum disorder and those who may be considered to be in the very early stages of psychosis (clinical high risk). The aim of this review is to assess the feasibility, acceptability and clinical benefits of videoconferencing interventions and compare them with face-to-face interventions for this population. A scoping review of peer-reviewed original research on the use of videoconferencing for intervention purposes in individuals with a schizophrenia-spectrum disorder or at clinical high risk. Out of 13,750 citations, 60 articles were retrieved for detailed evaluation, resulting in 14 eligible studies ( N = 439 individuals). There was no study reporting on videoconferencing interventions for individuals at clinical high risk. All the studies reported that videoconferencing implementation was feasible, and most of them described high acceptance by individuals with a schizophrenia-spectrum disorder. However, selection bias of studies was high, and overall methodological quality was poor. Videoconferencing interventions seem feasible for participants with schizophrenia-spectrum disorder who showed high acceptance of this intervention modality.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                03 March 2020
                2020
                : 11
                : 117
                Affiliations
                [1] 1 School of Rehabilitation, University of Montreal , Montreal, QC, Canada
                [2] 2 Youth Mental Health and Technology Lab, University of Montreal Hospital Research Centre , Montreal, QC, Canada
                [3] 3 PEPP Montreal and ACCESS Open Minds, Douglas Mental Health University Institute , Montreal, QC, Canada
                [4] 4 Department of Psychiatry, Centre Hospitalier Université de Montréal (CHUM) , Montreal, QC, Canada
                [5] 5 Axe Neurosciences, University of Montreal Hospital Research Centre (CRCHUM) , Montreal, QC, Canada
                [6] 6 Department of Psychiatry, Université de Montréal , Montreal, QC, Canada
                Author notes

                Edited by: Heleen Riper, Vrije Universiteit Amsterdam, Netherlands

                Reviewed by: Deepak Kumar, University of Delhi, India; Naira Topooco, Linköping University, Sweden; Christiaan Vis, VU University Amsterdam, Netherlands

                *Correspondence: Shalini Lal, shalini.lal@ 123456umontreal.ca

                This article was submitted to Child and Adolescent Psychiatry, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2020.00117
                7065530
                32194457
                19b4b678-7bec-4dfc-a990-9285117fd449
                Copyright © 2020 Lal, Abdel-Baki, Sujanani, Bourbeau, Sahed and Whitehead

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 05 February 2019
                : 10 February 2020
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 19, Pages: 8, Words: 4337
                Categories
                Psychiatry
                Brief Research Report

                Clinical Psychology & Psychiatry
                information and communication technologies,mhealth,e-mental health,mental health services,psychiatry,telemedicine,homeless,video

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