The experience of telehealth and user involvement for patients with mental illness

Introduction: All over the world, the burden of mental illness is growing, with substantial impact on health and human rights, and major social and economic consequences for the individual and society. Severe mental illnesses are often associated with disability and barriers to treatment. To address those barriers, the use of various telehealth technologies has increased rapidly. The potential of telehealth for the treatment of people with severe mental illness is demonstrated by positive results regarding medication adherence, symptom severity, cognitive therapy and hospitalization length.

Methods: The aim of this study was to explore what meaning patient with mental illness attribute telemedicine in relation to their treatment and what influence telemedicine has on user engagement in the meeting between citizens and healthcare professionals and how this effects the therapeutic relationship. In this study we applied a qualitative design. To explore perspectives on treatment and therapeutic relationship with the healthcare professionals when telehealth is a part of the progress, patients with mental illnesses using telehealth were interviewed 3 times with months apart. 10 adults with diagnosis of schizophrenia, bipolar disorder or depression were included to elaborate on these perspectives. To analyse data, thematic analyses were applied. People with mental illness were invited to take part in the analysis of the data to increase end- user value.

Results: Use of telehealth in treatment of mental illness is very common. Patients uses both telehealth treatment options, chosen by their care facility and a variety of apps and programs they found useful themselves. Many of the patients experienced that the therapeutic relationship benefits from telehealth. Telehealth gives them an easier way to overview the agreements with their therapist and how this contributes to their overall treatment goals. Most of the patients felt empowered using telehealth, because they felt that telehealth makes it easier to engage and be involved in the treatment.

Conclusion: Telehealth has the potential to empower and engage patient with mental illness in their treatment and the therapeutic relationship, but it is important that the health professionals involve patients when the telehealth solution is chosen.

Implications for applicability/transferability, sustainability, and limitations: This study does not provide specific guidelines in how to involve patients in the choosing of telehealth or how to integrate telehealth in the treatment, it merely gives ideas of how patients with mental illness in Denmark experience use of telehealth in their treatment, which could be considered a limitation for this study.