Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

The pandemic has created significant challenges in accessing and providing secondary mental health services in England.

THIS Institute worked with leading mental health charity the McPin Foundation and with the University of Cambridge Department of Psychiatry to conduct a study to understand service user, carer and NHS staff experiences of secondary mental health services during the COVID-19 pandemic.

Developed in consultation with six experts-by-experience and informed by peer research methods, this project sought to understand service user, carer and NHS staff experiences of secondary mental health services during the COVID-19 pandemic.

During the first phase of the study, 69 in-depth participant interviews were conducted to gather views and experiences of access and service provision.

The introduction of remote care was one of the key themes emerging from the interviews. Participants’ experiences of remote care were varied. While remote care was seen as helping to maintain some basic level of access during pandemic conditions, all three groups – service users, carers, and staff – expressed concern about aspects of care provision using phone or video. They reported that it was more difficult to establish therapeutic relationships and that assessments were more difficult. People who did not have facilities such as private space for calls and who could not afford mobile phone or broadband bills were likely to be disadvantaged. There was a strong sense that mental health services should take a tailored approach to the use of remote care during and beyond the pandemic.

Experiences of service users, carers and staff during the pandemic

• There’s something that… has that sacredness about the [consultation] room. (Service user)
• [The psychiatrist] was really great across the phone… I was quite worried that the phone appointment was going to be terrible because I’ve always had it in person, but he was really good. It was almost like he was in the same room as me. (Service user)
• Before COVID, probably in face-to-face meetings there [was] more of an opportunity to observe body language and assess mood from the physical presence of somebody that you’re sitting with. I don’t think that can be really captured over the phone. (Carer)
• I hope it doesn’t go the other way and we end up cutting the face-to-face services too much. I do fear that in a way. I think the technological things would be the main positive change. I just hope that it doesn’t come at the expense of saying, oh well, the face-to-face doesn’t matter, or you can cut that, which in the context of older people is especially important. (Trainee psychiatrist)