TABLE 2.

Barriers to Engagement With Telemedicine

Less personal	“You're not having no face-to-face, no visual with them. No looking at them eye-to-eye. You can learn a lot about a person from the way they sit in a chair or talk or look at you eye-to-eye.”
Poorer quality	“If you are looking at a person, you have a tendency to be more honest with them, then over the phone, you know what I'm saying? I'm speaking for myself. I cannot speak for everybody else. When you can see a person's demeanor, look at it the way they sitting or whatever, you can tell something's going on with them, compared to just talking to the telephone.”
Too many distractions	“I was doing therapy and we were seeing each other, but then we got to COVID and we had to do virtual. And when I was going virtual with her, she was talking to her family in the background, arguing with her [partner]. And I'm this cannot be real, no way. How are you going back and forth with him. Tell him to leave. You're at work. So, I just hung up and stopped going. So that interrupted a lot…I do not like the zoom thing. I really do not. It does not benefit me. I'd rather be close contact with somebody, but I know we cannot do that in a lot of places...During the Zoom, I'll probably be on my phone. When notifications pop, I'm paying attention to that.”
Difficulty establishing new relationships	“My psychiatrist left in January, which was really hard for me. It was before we knew about COVID, but COVID was sort of happening. He left in January and I got a new psychiatrist. I have a meeting with her on the phone once a month for med management…I've never met her…She keeps asking what's your social security number? How old are you? What's your date of birth? And she does not know very much about me.”
Lack of privacy	“Oftentimes I would have to wake up my partner and be like, ‘Hey, I have an appointment in like 5 minutes. Can you skedaddle?’…When you are in a doctor's office, like with your psychiatrist or something, and it's very clear that this is us and it's not anyone else listening in on us. And to have the possibility of someone could be like sitting in the other room and like listening to your conversation, it's like very weird to have that like element to a doctor's appointment.”
Provider uses telephone	“[The attending physician] asked the question to the resident. ‘You mean to tell me you have been treating her all this time and you have never seen her face.’ So, [the attending physician] was a little perturbed by that. And she said, next time it has to be tele, because you have to be able to see a person to read their face and their body language. And that's when I said no more of that. Let me go to [another mental health clinic].”