Understanding Capacity to Treat First Episode Psychosis with a Hybrid Telemental Health Delivery Model: A Needs Assessment of Ohio Community Mental Health Centers.
Brian P O'Rourke, Jennifer L Hefner, Nicholas J K Breitborde, Vicki L Montesano, Kraig Knudsen, Tory H Hogan
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引用次数: 0
Abstract
Coordinated specialty care (CSC) is considered the gold-standard treatment for individuals experiencing first episode psychosis (FEP). However, CSC teams are resource-intensive, motivating the development of a hybrid delivery approach where community mental health centers (CMHCs) collaborate with an academic medical center to deliver a mix of in-person and virtual services. To inform the development of this hybrid approach, a needs assessment was conducted, evaluating the existing capacity of Ohio CMHCs to treat FEP and identifying barriers to expanded use of telemental health. CMHC administrators throughout Ohio whose agencies primarily provide mental health services were surveyed using a novel instrument. A concurrent mixed methods approach combined multivariable analysis of cross-sectional survey data with thematic coding of responses to open-ended questions. The 56 responding CMHCs on average offered 10.96 of 17 services associated with CSC for FEP. Agency size was positively associated with number of service offerings, but rurality was not. Most agencies perceived gaps in their care for patients with FEP, particularly rural CMHCs. 75% believed that telemental health service expansion would benefit patients. Thematic analysis revealed three success factors for expanded telemental health usage: adapting care to virtual assessment, ensuring patient access, and adjusting workflows for virtual delivery. Responding CMHCs generally agreed that care for individuals with FEP could be improved and saw potential in expanded use of virtual services. Hybrid models may represent a valuable opportunity to overcome conventional barriers to CSC availability, but their development must account for current CMHC resource infrastructure and workflows.
期刊介绍:
The aim of Administration and Policy in Mental Health and Mental Health Services is to improve mental health services through research. This journal primarily publishes peer-reviewed, original empirical research articles. The journal also welcomes systematic reviews. Please contact the editor if you have suggestions for special issues or sections focusing on important contemporary issues. The journal usually does not publish articles on drug or alcohol addiction unless it focuses on persons who are dually diagnosed. Manuscripts on children and adults are equally welcome. Topics for articles may include, but need not be limited to, effectiveness of services, measure development, economics of mental health services, managed mental health care, implementation of services, staffing, leadership, organizational relations and policy, and the like. Please review previously published articles for fit with our journal before submitting your manuscript.