Table 2.

Summary of study characteristics and identified barriers

				Barriers
	Patient descriptions	Country of origin	Telepsychiatry platform	Patient factors	Provider factors	Institutional factors
[13▪]	Children and adolescent psychiatric patients	USA	Videoconference platform (specific platform not mentioned)	Obtaining parental consentPrivacy and securitySafety monitoring	Proper training in treatment delivery via telehealthBalance between privacy regulations and meeting patient needs	Size and affiliations of the hospital made the transition more difficult
[5▪]	Psychiatric patients	USA	Zoom	Increase in screen and sedentary time (led to reduction in full day programming)Scheduling confusions	Screen-use fatigueStaff burnout	Communication between staffEthical and legal considerations
[6▪]	Children and adolescents needing psychiatric, psychological, therapy or autism services	USA	Telephone and Zoom	Internet connectivityLanguage barriers	Decisions about patient priorities	Loss of coordination with school personnelLack of full team-based evaluations
[7▪]	Psychiatric patients	USA	Epics MyChat and Zoom	Access to technologyPrivacy and security	Contacting patients under time constraints	Lack of IT support staff
[8▪]	AYA patients with problems in mental health, reproductive health, eating disorders and addictions	USA	Zoom	Patient acceptancePrivacy (lack of space at home)Access and understanding of technologyBarriers compounded by lower SES	Provider acceptance and comfortLack of experience for telemedicine in AYA fieldReduced confidence in clinical decision makingEstablish/maintain effective doctor–patient relationships	Lack of real-time availability of mental health professionals (social workers, psychiatrists, dietician)
[9▪▪]	Vulnerable populations experiencing emotional disturbances (families with lower SES; families have immigrated); most frequent population was a Latinx population of Mexican origin	USA	Telephone; Various video-conferencing platforms	Lack of access to E-mail, WiFi, smartphones, and/or computersLimited access to telephonePrivacy (lack of space and overcrowded homes)Cultural and language barriersLoss of support group programmingLoss of connection to community	Privacy (shared space with other clinicians)Lack of time for providers (i.e. mother's schooling children)Interruptions from home environments	Need for additional staff to coordinate smooth virtual visits
[10▪]	OCD patients	USA	Theranest	Lack of willingness from patientsDifficulty maintaining focus	Confidentiality and patient privacyLack of group sessionsTechnological issuesLoss of personal boundariesSpecific aspects of ERP difficult over telehealth	Loss of interaction with peers and staff
[14▪▪]	Psychiatric patients	Ireland	Telephone	N/A	Reduced confidence in clinical decision making (diagnoses, risk assessment, prescriptions)Lack of visual cues from patientsEstablishing patient–clinician relationshipTechnical issuesReduced efficacy for some patient populations (cognitive deficits, hearing deficits, language barriers)Patient confidentiality	N/A

AYA, adolescent and young adult; ERP, exposure and response prevention; OCD, obsessive compulsive disorder; SES, socioeconomic status.