Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 8:11:581149.
doi: 10.3389/fpsyt.2020.581149. eCollection 2020.

The Design, Implementation, and Acceptability of a Telehealth Comprehensive Recovery Service for People With Complex Psychosis Living in NYC During the COVID-19 Crisis

David A Lynch  1 , Alice Medalia  1 , Alice Saperstein  2
Affiliations

The Design, Implementation, and Acceptability of a Telehealth Comprehensive Recovery Service for People With Complex Psychosis Living in NYC During the COVID-19 Crisis

David A Lynch et al. Front Psychiatry. .

Abstract

Introduction: 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.

Method: 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).

Results: 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.

Discussion: 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.

Keywords: COVID-19; complex psychosis; comprehensive recovery service; implementation; telehealth.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Percentage of actively enrolled CP participants prior to and after telehealth conversion (n = 23).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Killaspy H. The ongoing need for local services for people with complex mental health problems. Psychiatr Bull (2014) 38(6):257–9. 10.1192/pb.bp.114.048470 - DOI - PMC - PubMed
    1. Brown E, Gray R, Monaco SL, O’Donoghue B, Nelson B, Thompson A, et al. The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research. Schizophr Res (2020). 10.1016/j.schres.2020.05.005 - DOI - PMC - PubMed
    1. Druss BG. Addressing the COVID-19 pandemic in populations with serious mental illness. JAMA Psychiatry (2020). 10.1001/jamapsychiatry.2020.0894 Published online April 03, 2020. - DOI - PubMed
    1. Santesteban-Echarri O, Piskulic D, Nyman RK, Addington J. Telehealth interventions for schizophrenia-spectrum disorders and clinical high-risk for psychosis individuals: A scoping review. J Telemed Telecare (2020) 26(1-2):14–20. 10.1177/1357633X18794100 - DOI - PubMed
    1. Sharp IR, Kobak KA, Osman DA. The use of videoconferencing with patients with psychosis: A review of the literature. Ann Gen Psychiatry (2011) 10(1):14. 10.1186/1744-859X-10-14 - DOI - PMC - PubMed