HEQ speaks with Kara Connect’s Thorbjorg Vigfusdóttir about the benefits of remote consultation in providing mental health treatment to young people.
Thorbjorg Vigfusdóttir, a cognitive psychologist by training, spent 12 years as a politician in her native Iceland with the goal of directing her knowledge on the development of the brain into education and public policy. After leaving politics to form a company providing remote speech therapy in Icelandic schools, she founded Kara Connect, an online consultation platform enabling therapists and clinicians to provide remote care and treatment, which was recently adopted by the National University Hospital of Iceland (Landspítali).
Vigfusdóttir tells HEQ about the significant benefits of telehealth for meeting patients’ needs during the COVID-19 pandemic.
What are the key benefits of remote treatment for young people in need of mental health support?
Young people now are digital natives: they find it useless to go into a physical waiting room and wait to see somebody that they don’t know; they prefer to do it this way. The threshold for getting help is easier when technology is involved; and many young people feel a degree of stigma about accessing mental health support, so it can help to connect online at least in the first instance, before you meet. It helps to build trust between the patient and therapist, for example if somebody is isolated or bullied, or if they need to build trust with child protection services, the technology grants them easier access. It also eliminates the issue of transport: they don’t need to pay for the bus or spend time in a waiting room filled with older people; it’s a completely different access point for these young people.
How can patients be adversely affected by needing to travel long distances for treatment?
Before the pandemic began, we were focusing on giving professionals a broader reach to be able to meet the clients who were unable to come to their clinic. Regular professionals normally have a specific background or a specialisation; and it is really hard to get everyone with the issues specific to their field to come to their office. Telehealth helps clinicians to reach further geographically, but also enables them to engage with people who are unable to travel or are very isolated – both in the sense of social isolation and people who just want to live far away from the city. We do not have equality of access for patients living in different locations. COVID-19 has changed the world a little bit; and I think most professionals now see that they have to change the way that they work.
Has the unprecedented onset of a global pandemic significantly affected the mental health of young people? Are you seeing a higher uptake in mental health services?
Yes, we are. There has been a documented increase in students at school and university reporting anxiety and depression. Many school psychologists and counsellors are adopting remote consultation technologies to reach these kids, to keep them going to school, and to allow them to talk to someone about how they’re feeling. I think it’s really important that schools, which may not be opening in autumn, again, keep in close touch with these kids: the mental health of young people is effectively another pandemic right now; and the increase will act as a strain on the system as a whole, because we don’t have enough mental health professionals. It may be that, using telehealth technologies, we can enable therapists to offer shorter sessions more often; and to use more of their time of these professionals on conducting sessions than on administration. Currently, mental health professionals are doing a lot of administration and seeing a lot of cancellations; if we optimised the time and workflow of this professionals, we could both increase access to them, and also give them a bit of relief and additional time to spend on research.
In delivering mental health treatment, particularly for people whose mental health has been affected by COVID-19, is there a difference in approach? This pandemic is so unprecedented – there are no previous use cases, as there are in the case of traditional mental health treatment – where do you even start?
Talk therapy is a basic idea, just talking about how you feel. I don’t think that approach will change radically, it’s just that more people need help. With technology, our problem was there beforehand: a lot of people that needed to seek help were resilient enough to walk into a clinic, but we had a lot of people that didn’t do that; and this group is growing. So we do need technology to reach this group, the people that are not talking to us, and try to reach them and build trust; and then maybe meet them face to face when the trust is built up. Basically it’s about trust.
Have the national lockdowns precipitated by the COVID-19 pandemic accelerated uptake of digital communication, in particular telehealth platforms? Do you think telehealth will continue to be a priority once lockdowns are eased?
There’s a joke going around in my sector: who has driven digital change the most – A) your CEO; B) your digital partners; or C) COVID-19? And everybody chooses COVID-19. Because to enact real change to workflows, you do need some type of immediate crisis or you need to wait a very long time. Before we saw an uptake people were looking into this, especially systems that really had a problem with increasing numbers of individual patients who wouldn’t go out of their houses or couldn’t leave some for some reason; and I think these managers are really using this opportunity to go ahead and finish what they started there. A lot of professionals are out there using unsecure tools and teams which are not compliant with sensitive information, so once things relax a bit, they will have to look harder for the right kind of solution.
I think the use of telehealth during lockdowns will become a use case: professionals do need to learn about etiquette, how we speak to clients in remote consultations; as well as the security issues specific to remote treatment. Clinicians and therapists will see the benefits for their clients; and they are all about that – they work all day to figure out what is best for the clients, and once they have realised during COVID-19 that this actually could help a different segment of clientele, they will absolutely adopt these technologies. We anticipate a dramatic shift.
This article is from issue 14 of Health Europa. Click here to get your free subscription today.