Telehealth training can address shortages in pediatric mental health services

COLORADO SPRINGS, Colo. – An initiative designed to cross-train social work students to provide remote mental health services to children and adolescents increased confidence and interest in providing those services after graduation, a small study shows.

The pilot initiative — which involved one professor and 10 social work student volunteers — found that 90 percent of students could successfully conduct a telemental health visit, said Kimberly Bailey Dexter, DNP, of Virginia Commonwealth University Health Systems in Richmond.

Created and administered by nurse practitioners, the training is designed to be incorporated into the curriculum of interprofessional students, but focuses on social work and nursing programs, Dexter said in a presentation at the Institute for Neuroscience Education’s 2022 congress.

Social workers were chosen because they are essential to helping the growing need for mental health services and are allowed to become licensed mental health therapists, she noted. There is a projected shortfall of more than 10,000 social workers in the future, which could strain the current workforce and leave children without important resources, Dexter said.

In Virginia, for example, 4,720 social workers were employed as mental health professionals in 2018, meaning each social worker carries a caseload of 30 children, Dexter said. In the U.S., children have a disproportionate rate of delayed mental health services, she added: in rural and underserved areas, only 7 percent of children will receive mental health screenings.

The training was developed to meet the Institute of Medicine’s recommendation that all educational institutions add telemental health training for professions that provide mental health services.

“I wanted to know if social work students would declare that my training made them competent to go out and start providing telemental health services,” Dexter said MedPage today. “Would they even consider working and doing telemental health as part of their career or training or as part of their job?”

Telehealth could be a long-term answer to addressing workforce shortages, she noted. “What I found was that health professionals upon graduation were not prepared or had any way to provide care to children or patients with serious mental illness in rural areas,” she said.

“All interprofessional students, doctors, nurses, pharmacists, social workers, nurses should have training in telemental health as they go through and receive their degrees,” she said. “It’s a cost-effective solution for providing childcare in rural and underserved areas.”

Researchers are recruiting 10 participants for the pilot program, which was designed as a quality improvement initiative to assess uptake of telemental health training. They used the Coalition for Technology in Behavioral Science’s framework, an evidence-based, measurable approach, to determine participants’ post-training competency, and the activity theory framework to determine participants’ readiness for change, engagement, and telemental health technology.

Seven participants reported having novice skills and three reported proficient. Six participants said they would consider becoming telehealth providers. Nine said they could successfully conduct a telemental health visit and said they were willing to consider working in rural and underserved areas. All 10 participants said that learning was a useful skill for their profession.

That training could be added to the curriculum of more interprofessional programs, Dexter said.

“For example, in my current position, I work in every emergency room, but I can send telemental health to our partner hospitals and not actually be on site,” she said. “So that was the bottom line: that this is an effective way [to provide these services] and that we should actually have some kind of telehealth training included in all curricula.”

  • Michael DePew-Wilson is a reporter on MedPage Today’s Entrepreneurship and Investigative team. It covers psychiatry, ongoing covid and infectious diseases, among other relevant US clinical news. I follow

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