Telepsychiatry in child and adolescent mental healthcare: clinicians’ perspectives on lessons learned during the COVID-19 pandemic

Throughout the COVID-19-pandemic, clinicians were forced to immediately adapt their former in-person treatments into remote care for youth with severe psychiatric problems in Child-and-Adolescent Psychiatry (CAP). For the first time, telepsychiatry was implemented on a larger scale than ever before. In this post-COVID-era, as the use of telepsychiatry has shifted from being necessary to elective, it had become increasingly important to understand its advantages and disadvantages. There is an unequivocal call for further research to establish for whom and which types of treatment telepsychiatry may or may not be suitable. Responding to this call, this qualitative study aimed to assess CAP clinicians’ perspectives on the suitability of patient groups and types of treatment for telepsychiatry. Data were collected in five specialised CAP centres in the western and northern provinces of the Netherlands. In total, 288 clinicians participated in an extensive web-based self-report questionnaire and were included in the study. Thematic analysis of the data was performed with ATLAS.ti version 22. The results were divided into five categories: Patients’ disorders, Patients’ characteristics, Patients’ environment, Types of treatment and Characteristics of treatment. Clinicians reported mixed views regarding the suitability of specific disorders or treatments. Specifically, they indicated that patients who were motivated, disciplined and open to telepsychiatry were more likely to be suitable for its use, particularly when presenting with conditions that were mild, stable and less complex. Our findings suggest that telepsychiatry should be approached from a personalized-medicine perspective, taking into account each patient’s individual circumstances and determining suitability in collaboration with patients and their families.