From Pandemic to Progression: An Educational Framework for the Implementation of Virtual Mental Healthcare for Children
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ORIGINAL PAPER
From Pandemic to Progression: An Educational Framework for the Implementation of Virtual Mental Healthcare for Children and Youth as a Response to COVID‑19 Bridget T. Doan1 · Yue Bo Yang2 · Erin Romanchych1 · Seena Grewal1,3 · Suneeta Monga1,3 · Tony Pignatiello1,3 · Pier Bryden1,3 · Chetana Kulkarni1,3 Accepted: 30 September 2020 © The Author(s) 2020
Abstract COVID-19 restrictions have necessitated child/youth mental health providers to shift towards virtually delivering services to patients’ homes rather than hospitals and community mental health clinics. There is scant guidance available for clinicians on how to address unique considerations for the virtual mental healthcare of children and youth as clinicians rapidly shift their practices away from in-person care in the context of the COVID-19 pandemic. Therefore, we bridge this gap by discussing a six-pillar framework developed at Hospital for Sick Children (SickKids) in Toronto, Ontario, Canada, for delivering direct to patient virtual mental healthcare to children, youth and their families. We also offer a discussion of the advantages, disadvantages, and future implications of such services. Keywords Mental health · Virtual care · Covid-19 · Children · Youth · Framework
Introduction The teaching and application of child and youth telemental health has occurred across diverse settings (Pignatiello et al. 2009; Serhal et al. 2017; Thomas et al. 2018), typically showing similar parental satisfaction, diagnostic profiles, treatment adherence, and improvement in primary outcomes compared to in-person visits (AACAP 2017; Myers and Cain 2008). Traditionally, telemental health has been delivered in clinical settings with a technologically and medically optimized environment where healthcare providers, medical services, and interventions may be readily available in the case of safety or general medical concerns (AACAP 2017), often with a goal to provide access to underserviced populations. More recent data demonstrates opportunities for providing telemental healthcare in non-clinical settings such as
* Chetana Kulkarni [email protected] 1
Hospital for Sick Children (SickKids), Toronto, ON, Canada
2
MD Undergraduate Program, University of British Columbia, Vancouver, BC, Canada
3
University of Toronto, Toronto, ON, Canada
schools, residential treatment centers, correctional facilities and even patients’ homes (Myers et al. 2017). In response to the COVID-19 pandemic, clinicians who may not have regularly practiced telemental healthcare previously have been catalyzed to transition rapidly to delivering telemental health services directly to patients’ homes (Fagiolini et al. 2020), with clinicians, including trainees, also often connecting from their own homes. We define this newly catalyzed practice as direct to patient virtual mental healthcare (VMHC) hereafter. This rapid transition to VMHC presents unique considerations for clinicians, trainees and patients/families including extensive variation in access to technologie
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