Introduction: In response to the Coronavirus Disease 2019 (COVID-19) pandemic, telepsychiatry was suddenly introduced in mental health services. Evidence concerning the efficacy and viability of these interventions in child and adolescent population is lacking. This study aims at developing a thorough understanding of family caregiver experiences with phone consultations, at the beginning of the pandemic.
Material and Methods: We interviewed adolescent's caregivers under psychiatric follow-up, that were assisted at a phone consultation between April and June 2020. We used a semi-structured interview, that compared phone to physical consultations, regarding different dimensions: 1) accessibility and availability of care; 2) effectiveness of communication (concretely, in the sub-dimensions of expression by oneself, understanding by the doctor and understanding by oneself); 3) therapeutic relationship (specifically, in the sub-dimensions of one's own posture in the relationship, empathy / respect for the doctor and trust in the doctor); 4) therapeutic results; 5) satisfaction with care and 7) confidentiality.
Results: Out of the 50 interviewed adolescent's caregivers, 34 (68%) consider there is an increment in access and availability with phone consultations. To 28 caregivers (56%), the way of expressing themselves has been affected and 33 (66%) believe that the doctor understands them in just the same manner. The majority considers there is no difference in doctor's empathy/respect (n=34, 68%), neither in reliance on the doctor (n=44, 88%). More than a half refers the therapeutic results are inferior (n=27, 54%) but the same number mentions satisfaction with the care provided (n=27, 54%). Confidentiality and trust in doctor seem to be the same, in telephone consultations, to 40 (80%) caregivers, while 8 (16%) said it is more difficult, due to impaired communication and doubts about maintaining privacy. Curiously, 2 parents (4%) consider that this aspect is superior in the telephone consultation, because face-to-face consultations are for the adolescent, and this is a way of having an exclusive and private time for them.
Discussion: One of the findings to be highlighted is the benefit of phone consultations in terms of accessibility and availability of care (due to the absence of travel and less time spent). Communication seems to be impaired in phone consultations, which was mainly justified by the absence of body language and eye contact. However, due to increased access and availability, in the face of public health contingencies, most patient's caregivers were pleased with the care received.
Conclusion: Telepsychiatry has emerged as a promising treatment option in the pandemic context. Nevertheless, to be a viable complement and/or alternative to physical consultations, it demands further training and investigation. It could also be important to evaluate the perspective of the adolescents and health professionals themselves, crossing it with that of caregivers, for a complete assessment of the experience from different point of views.
No conflict of interest