Fact sheet 05-2021

Video consultations in mental health care

The use of video consultations in mental health care increased dramatically across Norway during the Covid-19 pandemic. Research in this part of the health service, is necessary to better develop and adapt this tool.

In Norway, there is a strong focus on the development of digital health and citizen services, including the introduction of distance-based treatment using video consultation. Among other things, it is about giving patients equal access to good health services, regardless of where they live in the country.

The hospitals in Finnmark, the northernmost county in Norway, have for several years used video consultations in meetings with patients in mental health care, both children and adults, in a relatively large volume. Several therapists with different backgrounds have extensive experience with the use of video consultations. These experiences are important to bring into the further development of services regionally and nationally, as new tools can lead to a fundamental change in how mental health services are being organized and delivered.

13 therapists and one manager in mental health care were used as informants in two different studies between March and May 2020. Some of them had adult patients, while others worked with children and young people.

Important positive findings

The most important feedback from those who started with video consultation during the pandemic is as follows:

Video consultations contribute to a closer follow-up and an increased continuity in treatment. The collaboration internally in the clinic and with other agencies via video consultations, is positive for getting started quickly and maintaining flexibility in the treatment process.

In a short-term perspective and in less demanding patient situations, the use and implementation of video consultation is worth the effort, both for the therapists and the patients. But the therapists are clear: There is a need for consultations both on video and physically. This variety is necessary to maintain good contact with the patients and a healthier working day for the therapists.

Several of those who tested the tool during the pandemic, believe they will use more video consultations. Especially together with patients who live far away from the therapist’s office, because this allows them to have a much closer contact.

Technical and ethical challenges

The findings also show challenges.

The therapists find it difficult to maintain security and to be trusted if the technology does not work. Technology can also be an ethical challenge for the therapist to make good clinical assessments of the patients' condition, and to ensure that they offer professionally sound services.

The therapists report that it is difficult to make assessments of interaction via video ‒ especially regarding relationships, for example in family mapping between children and parents. The screen can become a filter that makes it challenging to exercise a clinical judgment. The therapist experiences a loss of important information about the patient's condition.

In addition, it is difficult to know if there is someone else is in the patient’s room, whom the therapist cannot see. For example, a controlling partner. There is great uncertainty about whether video communication can maintain relations as well as physical encounter between the patient and the therapist.

The use of video consultations in mental health care has exploded during the Covid 19-pandemic. The Norwegian Centre for E-health Research had a research project on video consultations ready to begin in March 2020.