Implementation of telepsychiatry in Kenya: acceptability study

Background COVID-19-related restrictions on in-person contact in healthcare, increasing psychiatric illness during the pandemic and pre-existing shortages of mental healthcare providers have led to the emergence of telepsychiatry as an attractive option for the delivery of care. Telepsychiatry has b...

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Main Authors: Loice Cushny Kaigwa, Frank Njenga, Linnet Ongeri, Anne Nguithi, Maryanne Mugane, Gathoni M. Mbugua, Jacqueline Anundo, Margaret Zawadi Kimari, Maricianah Onono
Format: Article
Language:English
Published: Cambridge University Press 2022-05-01
Series:BJPsych Open
Subjects:
Online Access:https://www.cambridge.org/core/product/identifier/S2056472422000539/type/journal_article
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author Loice Cushny Kaigwa
Frank Njenga
Linnet Ongeri
Anne Nguithi
Maryanne Mugane
Gathoni M. Mbugua
Jacqueline Anundo
Margaret Zawadi Kimari
Maricianah Onono
author_facet Loice Cushny Kaigwa
Frank Njenga
Linnet Ongeri
Anne Nguithi
Maryanne Mugane
Gathoni M. Mbugua
Jacqueline Anundo
Margaret Zawadi Kimari
Maricianah Onono
author_sort Loice Cushny Kaigwa
collection DOAJ
description Background COVID-19-related restrictions on in-person contact in healthcare, increasing psychiatric illness during the pandemic and pre-existing shortages of mental healthcare providers have led to the emergence of telepsychiatry as an attractive option for the delivery of care. Telepsychiatry has been promoted as economical and effective, but its acceptance in low- and middle-income countries is poorly understood. Aims To explore the acceptance, experiences and perspectives of patients and healthcare providers in the uptake of telepsychiatry services in a middle-income country. Method Focus group discussions were conducted on the WhatsApp platform with patients and care providers who have engaged in telepsychiatry. Data were analysed using a thematic approach. Results Three main themes emerged from the five focus groups: (a) technical access, (b) user experience and (c) perceived effectiveness compared with face-to-face (in-person) interactions. Care providers reported challenges establishing rapport with the patient, particularly for initial sessions, maintaining privacy during sessions and detecting non-verbal cues on video. Patients cited internet connectivity problems, difficulty finding private space to have their sessions and cost as major challenges. Patients also felt in-person sessions were better for initial visits. Both patients and providers reported difficulties making insurance payment claims for telepsychiatry services. Overall, participants were mostly positive about telepsychiatry, citing its convenience and overall perceived effectiveness compared with in-person sessions. Conclusions Telepsychiatry is an acceptable platform for delivery of out-patient psychiatric services in a middle-income country. Patients and providers appreciate the convenience it offers and would like it integrated as a routine mode of delivery of care.
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spelling doaj.art-56b089b338434a29befadc5eba8b792a2023-03-09T12:29:19ZengCambridge University PressBJPsych Open2056-47242022-05-01810.1192/bjo.2022.53Implementation of telepsychiatry in Kenya: acceptability studyLoice Cushny Kaigwa0https://orcid.org/0000-0002-6458-8216Frank Njenga1Linnet Ongeri2https://orcid.org/0000-0003-2330-6144Anne Nguithi3Maryanne Mugane4Gathoni M. Mbugua5Jacqueline Anundo6Margaret Zawadi Kimari7Maricianah Onono8Chiromo Mental Health Hospital, Nairobi, KenyaChiromo Mental Health Hospital, Nairobi, KenyaChiromo Mental Health Hospital, Nairobi, KenyaChiromo Mental Health Hospital, Nairobi, KenyaChiromo Mental Health Hospital, Nairobi, KenyaChiromo Mental Health Hospital, Nairobi, KenyaChiromo Mental Health Hospital, Nairobi, KenyaChiromo Mental Health Hospital, Nairobi, KenyaCentre for Microbiology Research, Kenya Medical Research Institute, Kisumu, KenyaBackground COVID-19-related restrictions on in-person contact in healthcare, increasing psychiatric illness during the pandemic and pre-existing shortages of mental healthcare providers have led to the emergence of telepsychiatry as an attractive option for the delivery of care. Telepsychiatry has been promoted as economical and effective, but its acceptance in low- and middle-income countries is poorly understood. Aims To explore the acceptance, experiences and perspectives of patients and healthcare providers in the uptake of telepsychiatry services in a middle-income country. Method Focus group discussions were conducted on the WhatsApp platform with patients and care providers who have engaged in telepsychiatry. Data were analysed using a thematic approach. Results Three main themes emerged from the five focus groups: (a) technical access, (b) user experience and (c) perceived effectiveness compared with face-to-face (in-person) interactions. Care providers reported challenges establishing rapport with the patient, particularly for initial sessions, maintaining privacy during sessions and detecting non-verbal cues on video. Patients cited internet connectivity problems, difficulty finding private space to have their sessions and cost as major challenges. Patients also felt in-person sessions were better for initial visits. Both patients and providers reported difficulties making insurance payment claims for telepsychiatry services. Overall, participants were mostly positive about telepsychiatry, citing its convenience and overall perceived effectiveness compared with in-person sessions. Conclusions Telepsychiatry is an acceptable platform for delivery of out-patient psychiatric services in a middle-income country. Patients and providers appreciate the convenience it offers and would like it integrated as a routine mode of delivery of care. https://www.cambridge.org/core/product/identifier/S2056472422000539/type/journal_articleLow- and middle-income countriestelepsychiatryacceptabilitypatient and provider perspectivesqualitative research
spellingShingle Loice Cushny Kaigwa
Frank Njenga
Linnet Ongeri
Anne Nguithi
Maryanne Mugane
Gathoni M. Mbugua
Jacqueline Anundo
Margaret Zawadi Kimari
Maricianah Onono
Implementation of telepsychiatry in Kenya: acceptability study
BJPsych Open
Low- and middle-income countries
telepsychiatry
acceptability
patient and provider perspectives
qualitative research
title Implementation of telepsychiatry in Kenya: acceptability study
title_full Implementation of telepsychiatry in Kenya: acceptability study
title_fullStr Implementation of telepsychiatry in Kenya: acceptability study
title_full_unstemmed Implementation of telepsychiatry in Kenya: acceptability study
title_short Implementation of telepsychiatry in Kenya: acceptability study
title_sort implementation of telepsychiatry in kenya acceptability study
topic Low- and middle-income countries
telepsychiatry
acceptability
patient and provider perspectives
qualitative research
url https://www.cambridge.org/core/product/identifier/S2056472422000539/type/journal_article
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