Evidence base for Tellehealth?

[Mathew76]

I have an interesting question about telehealth.  It just appeared overnight, because of COVID. 

It is now very expencive for what one gets. It is also like the wild west further exacerbating the hit and miss nature of a counselling relationship. One can waste a huge amount of time and hope with a therapist or counselling that does not quite fit and some people do not really have the skills to practice for a variety of reasons. 

My question is there really an evidence base that it works? 

[Captain24]

I like Telehealth @Mathew76 

I have a dietitian that I see through Telehealth. She is in Sydney and I’m rural so with out if I wouldn’t have the opportunity to have a dietitian. 

I also see my psych through Telehealth mostly. She is 4 hours away and I met her while I was in hospital. She is fantastic and without Telehealth I wouldn’t be able to see her. 

I think it has its place especially when living rurally. 

[Mathew76]

You are so lucky to have met your psych. You can build on that relationship if you know that person is real or you have not spent 24 hours in a virtual waiting room as was the practice with a particular crowd operating out of Tasmania. 

The initial idea of Telehealth was that with the NBN was that your GP could access a telehealth specialist at the same time as seeing you, and all could get the benefit of expert advice. Its was a fine idea but never worked in reality.  

[Mathew76]

It is good that you have had a good experience with telehealth services. But it is a personal opinion, not evidence base which is not really answering the question. 

Tellehealth is now the norm for people living in cities. 

[Captain24]

Well the evidence for me is that it’s helpful @Mathew76 

Sorry you disagree 

[0ddsidian]

Hey @Mathew76 

I assume you're referring to telehealth counselling services, as opposed to other types of digital mental health supports (e.g. groups, Forums, apps etc)?

[0ddsidian]

@Captain24 @Mathew76 I asked someone on SANE's research team whether they had any journal articles / research about this topic. This is what they sent me:

The clinical effectiveness of telehealth: A systematic review of meta-analyses from 2010 to 2019 - C...

The effectiveness of telehealth versus face-to face interventions for anxiety disorders: A systemati...

JMIR Mental Health - Telehealth Versus Face-to-face Psychotherapy for Less Common Mental Health Cond...

Overall, telehealth supports appear to be just as effective as face-to-face supports, however this can depend on the presenting problem and demographic.

At SANE, we use both quantitative and qualitative data as evidence for whether our digital mental health supports are effective, and anecdotal evidence (like you shared Captain) is incredibly important to us. It reminds us of the humans behind the numbers, you know?

Hope this helps 😀

[Mathew76]

That is helping with the question.  I shall have a good look at those links. As consumers of services it is in my humble opinion we need to educate ourselves about the effectiveness of the services we support. 

Regarding Telehealth, it is also my own opinion that a face to face meeting is necessary once or twice,  augmented by telehealth and this is an ideal, or should be a standard. 

Its is a worry that as consumers we are accepting and supporting a process simply because we are told to.  

There will always be opinions, and it is reassuring and proper that SANE is using evidence based process.

Incidentally and to underline a point, I also have a good collection of expencive crystals and would love to get a health care grant or a medicare rebate or even an NDIS contract, to fix the desperate. 

[0ddsidian]

@Mathew76 I definitely get where you're coming from. If the option is available to me, I typically prefer face-to-face supports for my mental health supports. I find that it's easier for me to pick up on body language and facial expressions when I'm F2F, but I do recognise that F2F isn't an option for everyone, unfortunately.

That being said, given the research seems to indicate that both F2F and telehealth services have similar effectiveness, I would love to see everyone have a choice over whether they want to engage with F2F or telehealth.

At SANE, we have a bunch of research and data nerds (including myself!), so having our services underpinned by evidence (as well as lived experience) is incredibly important. We also have the Anne Deveson Research Centre, which is an initiative of SANE's > Research

I also have quite a few crystals, however I just like how they feel and how they look. I currently use some as sensory tools for myself 😀

[Mathew76]

First survey, The clinical effectiveness of telehealth: A systematic review of meta-analyses from 2010 to 2019 - C... is a meta analysis of 38 areas 7 of which are psychology.  "Telephone was excluded as it was not considered a common mode of telehealth."


Second article:

The effectiveness of telehealth versus face-to face interventions for anxiety disorders: A systemati...

is behind a pay wall, we can not read it.  


Third article:.
JMIR Mental Health - Telehealth Versus Face-to-face Psychotherapy for Less Common Mental Health Cond...
"Conclusions:With regard to effectively treating less common mental health conditions and physical conditions requiring psychological support, there is insufficient evidence of a difference between psychotherapy delivered via telehealth and the same therapy delivered face-to-face. ''



My conclusion.  
You got to read and article it before you flick it, or its a bit like mystification. 

AI can generate a very convincing list to prove any question one asks...

Sorry, Oddsidian, more work required to convince us on this very important question.  Perhaps I should not get rid of my healing crystals quite yet.