The Attitudes and Practices of Mental Health Clinicians Towards Telepsychiatry at Mathari National Teaching and Referral Hospital in the Post-covid-19 Era

Abstract

Background: Despite proven advantages for the use of telemedicine in tele psychiatry, there is yet to be widespread adoption and use of tele psychiatry among mental health clinicians (MHCs). Due to the COVID-19 pandemic, many mental healthcare systems around the world were forced to massively transition most mental patient visits to tele psychiatry. MHCPs have shown deep-seated mistrust and suspicion towards tele psychiatry. MHCs have however shown deep-seated mistrust and suspicion towards tele

psychiatry. This study aims to examine the attitudes of MHCs towards tele psychiatry at Mathari National Teaching and Referral Hospital (MNTRH). Objectives: To examine the perceptions, attitudes and practice of tele psychiatry among mental health clinicians and uncover the barriers towards the adoption of tele psychiatry. Study design: Descriptive cross-sectional study. Survey questionnaire was administered online to participants. Consecutive sampling technique was utilized where 103 clinicians were included in the study. The study participants included psychiatrists, psychiatric registrars and psychologists practicing at MNTRH at the time of the study. A structured questionnaire was uploaded to google forms for data collection. Descriptive analysis was performed. Data was summarized using frequencies and percentages and presented in Charts and tables. Fischer’s exact test to determine association between respondent characteristics and modality preference. Data was analyzed using SPSS 28 data analysis tool. Significance was evaluated at 0.05. Results: The average age of respondents was 35.3±5.6 years with 80.6% of them being female, 56.3% had bachelors level qualification, 48.5% were psychiatric residents. The most commonly used tele psychiatry modality was telephone audio call (47.6%) with 40.8% using both telephone and video conferencing. Further, 7.8% and 34% rated experience with telephone audio as excellent and good respectively while 11.7% and 20.4% rated video conferencing as excellent and good respectively. Majority (58.3%) stated that telepsychiatry is not as clinically effective as face to face psychiatry with 22.2% asserting that they have ever had a bad experience, 53% were comfortable with either telephone or video conferencing. Commonest challenges identified included lack of strong engagement as face to face psychiatry (52%), concerns with confidentiality (49%), concerns with missing relevant information (43%) and limited ability to prescribe medication (37%). Conclusion and recommendations: This study on mental health professionals in Kenya revealed a generally positive attitude towards the use of telepsychiatry. Majority of participants would continue to use telepsychiatry and would recommend it to others. However, poor engagement and confidentiality issues continue to hamper telepsychiatry application. Thus, there is need to train healthcare providers on use of these modalities to enhance efficiency