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Telehealth Training May Address Shortages for Pediatric Mental Health Services

Original article written by Michael DePeau-Wilson for MedPage Today

An initiative designed to cross-train social work students to provide mental health services remotely to children and adolescents increased confidence and interest in providing those services after graduation, a small study showed.

The trial initiative -- which involved one professor and 10 volunteer social work students -- found that 90% of students could successfully conduct a telemental health visit, reported Kimberly Bailey Dexter, DNP, of Virginia Commonwealth University Health Systems in Richmond.

Created and run by nurse practitioners, the training was designed to be incorporated into the curriculum of interprofessional students but focused on social work and nursing programs, Dexter said in a presentation at the 2022 Neuroscience Education Institute Congress.

Social workers were selected because they're essential to support the growing need for mental health services and they're allowed to become licensed mental health therapists, she noted. There's a projected shortage of more than 10,000 social workers in the future, which may strain current workforce and leave children without crucial resources, Dexter pointed out.

In Virginia, for example, 4,720 social workers were employed as mental health professionals in 2018, which meant that each social worker carried a caseload of 30 children, Dexter said. In the U.S., children have a disproportionate rate of delayed mental heath services, she added: in rural and underserved areas, only 7% of children will get mental health appointments.

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 be able to go out and start providing telemental health services," Dexter told MedPage Today. "Would they even consider working and doing telemental health as part of their career or training or part of their job?"

Telemental healthcare could be a long-term answer to address workforce shortages, she noted. "What I found is that healthcare professionals upon graduation weren't prepared for or had any way of providing care to children or patients with serious mental illnesses in rural areas," she said.

"All interprofessional students, doctors, nurses, pharmacists, social workers, nurses should have telemental health training as they're going through and obtaining their degrees," she stated. "It's a cost-effective solution for providing care for children in rural and underserved areas.”

The researchers recruited 10 participants for the trial program, which was designed as a quality improvement initiative to evaluate perceptions of telemental health training. They used the Coalition for Technology in Behavioral Science framework, an evidence-based, measurable approach, to determine the competency of participants after training, and the Activity Theory framework to determine participants' readiness for change, engagement, and telemental health technology.

Seven participants reported having novice competency and three reported proficiency. Six participants said they would consider becoming telemental healthcare providers. Nine stated they could successfully conduct a telemental health visit and said were willing to consider working in rural and underserved areas. All 10 participants said the training was a beneficial skill for their profession.

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

"For instance, in my current position, I work in any emergency room, but I can telemental health out to our partner hospitals and not actually be on site," she said. "So, that was the conclusion: that it's an efficient way [to provide these services] and that we should actually have some sort of telehealth training incorporated into all teaching curriculums."

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