High-level of interest in telepsychiatry from Irish clinicians, study reports

Barriers to a successful rollout of an Extension for Community Health Care Outcomes (ECHO) model in Child and Adolescent Mental Health Services (CAMHS) were outweighed by perceived benefits, a new Irish study is reporting.

ECHO was originally developed in the US state of New Mexico to address a lack of access to clinical services for those with Hepatitis C living long distances from centres of care.

Given the increased use and acceptability of telepsychiatry during the Covid-19 pandemic, coupled with the positive support offered by attendees, researchers said consideration should be given to formally piloting a CAMHS/ECHO service in this country.

Writing in the January 2021 edition of the Irish Medical Journal (IMJ), Rooney et al said the ECHO model was developed to “improve access to care for persons with complex health needs that were being underserved with the aim of democratising knowledge from specialist medical hubs out into the community”.

Initially designed for management of medical illnesses, ECHO has subsequently been successfully extended to include neurodevelopmental and mental health (MH) disorders, they added.

In Ireland, however, ECHO has exclusively been used in to advance specialist knowledge and services for chronic physical illness.

The aim of their study, they said, was to explore the feasibility of an ECHO programme for CAMHs while also identifying perceived barriers and enablers to developing such a service.

To do so, a qualitative research design incorporating a CAMHS:ECHO seminar and workshops was adopted which included 29 healthcare professionals working in primary care/ mental health services.

Participant consent was received, and thematic analysis conducted on rapporteur notes.

The results indicated that there was a high level of interest in the project from clinicians.

Perceived opportunities included potential reduction in CAMHS waiting lists, opportunity for shared care of ADHD, improved time management, clinical skills, and access to advice on referrals.

The perceived challenges, researchers said, included the issue of clinical governance, increased workload for general practitioners and the issue of incentives.
“The current Covid-19 pandemic has brought unprecedented challenges for health care delivery,” researchers concluded.

“Telepsychiatry has come into its own and anecdotal evidence has shown it has been effective and welcome by both providers and patients.”

IMJ; Vol 114, No. 1, P241.