Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19
BackgroundLong wait times for mental health appointments have been a chronic dilemma for academic medical centers. This problem intensified worldwide with the onset of the COVID-19 pandemic. Approximately 70% of mental health services experienced pandemic-related disruption in care provision, while...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.989838/full |
| _version_ | 1797979102935777280 |
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| author | Kristina McMahan Karli M. Martin Melissa J. Greenfield Pamela Hay Madison Bates Redwine Rachel Fargason Kristine Lokken |
| author_facet | Kristina McMahan Karli M. Martin Melissa J. Greenfield Pamela Hay Madison Bates Redwine Rachel Fargason Kristine Lokken |
| author_sort | Kristina McMahan |
| collection | DOAJ |
| description | BackgroundLong wait times for mental health appointments have been a chronic dilemma for academic medical centers. This problem intensified worldwide with the onset of the COVID-19 pandemic. Approximately 70% of mental health services experienced pandemic-related disruption in care provision, while simultaneously experiencing a substantial increase in patient demand. Wait times for mental health appointments also increased, varying across populations from 3 to 18 months. As prolonged wait time is positively associated with severity of psychiatric symptoms and negative outcomes, the authors implemented a novel rapid intake telemedicine clinic model to shorten wait time and increase patient access to psychological care at an academic medical center.MethodsTo address an overwhelming influx of mental health referrals and a growing wait-time-until-first appointment at an academic medical center serving as a lone safety net hospital during the COVID-19 pandemic, a 5-provider Psychology Rapid Intake Team was established using a hybrid of telehealth and in-person appointments based on patient preference. Data on new patient volumes, wait time for 1st appointment, and wait time to begin therapeutic intervention were compared during the same calendar 3-month period immediately prior to and following implementation of the rapid intake clinic.ResultsA paired-samples t-test was conducted to compare new patient volumes pre- vs. post- intervention. Results revealed a significant increase in the number of new patients the providers were able to accommodate in the post-implementation (M = 62.00, SD = 7.21) compared to the pre-implementation (M = 31.00, SD = 2.61) condition; t(2) = −8.60, p < 0.05. There was a significant decrease in the average wait times for 1st appointment post-implementation (M = 24.99, SD = 2.38) compared to the pre-implementation (M = 37.32, SD = 1.47) condition; t(2) = 5.56, p < 0.05. In addition, days to begin therapeutic intervention decreased dramatically (394%) from the pre- (M = 142.50) to post-implementation (M = 28.84) period.ConclusionThe COVID-19 pandemic strained a mental healthcare system which led to increasingly long wait times for intake appointments and delayed psychotherapy interventions. The Psychology Rapid Intake Team initiative served to improve access, reduce patient risk related to prolonged wait times, and accelerated patient engagement with psychotherapy services. The model can serve as a unique, sustainable infrastructure for behavioral health delivery for low acuity mental health problems in large health care systems. |
| first_indexed | 2024-04-11T05:34:41Z |
| format | Article |
| id | doaj.art-64d614b0ed354bd292b2857a17d79dcd |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-11T05:34:41Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-64d614b0ed354bd292b2857a17d79dcd2022-12-22T15:04:29ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-12-011310.3389/fpsyt.2022.989838989838Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19Kristina McMahan0Karli M. Martin1Melissa J. Greenfield2Pamela Hay3Madison Bates Redwine4Rachel Fargason5Kristine Lokken6Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United StatesAlabama Psychiatry, Helena, AL, United StatesDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United StatesDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United StatesBackgroundLong wait times for mental health appointments have been a chronic dilemma for academic medical centers. This problem intensified worldwide with the onset of the COVID-19 pandemic. Approximately 70% of mental health services experienced pandemic-related disruption in care provision, while simultaneously experiencing a substantial increase in patient demand. Wait times for mental health appointments also increased, varying across populations from 3 to 18 months. As prolonged wait time is positively associated with severity of psychiatric symptoms and negative outcomes, the authors implemented a novel rapid intake telemedicine clinic model to shorten wait time and increase patient access to psychological care at an academic medical center.MethodsTo address an overwhelming influx of mental health referrals and a growing wait-time-until-first appointment at an academic medical center serving as a lone safety net hospital during the COVID-19 pandemic, a 5-provider Psychology Rapid Intake Team was established using a hybrid of telehealth and in-person appointments based on patient preference. Data on new patient volumes, wait time for 1st appointment, and wait time to begin therapeutic intervention were compared during the same calendar 3-month period immediately prior to and following implementation of the rapid intake clinic.ResultsA paired-samples t-test was conducted to compare new patient volumes pre- vs. post- intervention. Results revealed a significant increase in the number of new patients the providers were able to accommodate in the post-implementation (M = 62.00, SD = 7.21) compared to the pre-implementation (M = 31.00, SD = 2.61) condition; t(2) = −8.60, p < 0.05. There was a significant decrease in the average wait times for 1st appointment post-implementation (M = 24.99, SD = 2.38) compared to the pre-implementation (M = 37.32, SD = 1.47) condition; t(2) = 5.56, p < 0.05. In addition, days to begin therapeutic intervention decreased dramatically (394%) from the pre- (M = 142.50) to post-implementation (M = 28.84) period.ConclusionThe COVID-19 pandemic strained a mental healthcare system which led to increasingly long wait times for intake appointments and delayed psychotherapy interventions. The Psychology Rapid Intake Team initiative served to improve access, reduce patient risk related to prolonged wait times, and accelerated patient engagement with psychotherapy services. The model can serve as a unique, sustainable infrastructure for behavioral health delivery for low acuity mental health problems in large health care systems.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.989838/fullCOVID-19pandemicmental healthbehavioral healthtelehealth |
| spellingShingle | Kristina McMahan Karli M. Martin Melissa J. Greenfield Pamela Hay Madison Bates Redwine Rachel Fargason Kristine Lokken Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19 Frontiers in Psychiatry COVID-19 pandemic mental health behavioral health telehealth |
| title | Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19 |
| title_full | Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19 |
| title_fullStr | Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19 |
| title_full_unstemmed | Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19 |
| title_short | Using a tele-behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during COVID-19 |
| title_sort | using a tele behavioral health rapid intake model to address high demand for psychotherapy at an academic medical center during covid 19 |
| topic | COVID-19 pandemic mental health behavioral health telehealth |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.989838/full |
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