A review of risks, adverse effects and mitigation strategies when delivering mental health services using telehealth

J Ment Health. 2023 Mar 3:1-24. doi: 10.1080/09638237.2023.2182422. Online ahead of print.

Abstract

Background: This paper presents a scoping review of the peer-reviewed literature regarding reported risks, adverse effects and mitigation factors related to providing mental health services using telehealth.

Aims: The paper aims to describe risks and risk management strategies.

Methods: Publications were included if they reported upon risks, adverse events or mitigation factors experienced, hypothesised or discussed for: any population (any country, any age), service (any mental health services), intervention (telehealth), English language, 2010 to 10 July 2021, any publication type (commentary, research, policy), excluding protocol papers, and self-help tools. The following databases were searched: PsycINFO (from 2010 to 10 July 2021), MEDLINE (2010 to 10 July 2021) and the Cochrane Database from 2010 to 10 July 2021.

Results: The search strategy resulted in 1,497 papers and after exclusions a final 55 articles were selected. Results of this scoping review are presented in terms of types of risk, risk by client population, risk by modality (eg group therapy using telehealth) and risk management.

Conclusions: Recommendations for future research include gathering and publishing more detailed information regarding near-miss and actual adverse events when delivering mental health assessment and care using telehealth. In clinical practice, training is required for potential adverse events, and to prevent them and reporting mechanisms in place to collate and learn from these.

Keywords: COVID-19; Telehealth; adverse effects; adverse events; mental health; mitigation strategies; quality; risk; risk management; safety.