Leveraging Tele-behavioral Health Modalities and Technology-Enabled Behavioral Healthcare: Emerging Trends during COVID-19

The COVID-19 pandemic greatly accelerated the uptake of telepsychiatry/tele-behavioral health platforms and digital behavioral health tools. The need for behavioral health (mental health and substance abuse) services has risen sharply during the pandemic and is projected to continue long after the pandemic begins to subside. Tele-behavioral health includes the provision of videoconferencing in real time between behavioral health providers and patients via a secured encrypted digital platform (also known as virtual behavioral care); text messaging between behavioral health care providers and patient in real time or asynchronously; the use of online digital tools such as self-paced self-management tools (e.g., mindfulness, anxiety and depression self-management apps); and remote monitoring (e.g., devices to monitor physical activity, sleep). Tele-behavioral health services and digital behavioral health tools hold the promise of reaching more people in a convenient format as well as engaging populations who historically did not seek out these services, for example, persons who have not engaged in behavioral health services before or may have subclinical levels of depression or anxiety. Since the pandemic began, men have been using tele-behavioral health platforms for psychotherapy at a greater rate than ever before, which is promising for addressing a known treatment gap for men (i.e., men typically do not engage in needed psychotherapy services at rates that women do).

Over the past five years, there is been a sharp uptick in academic research on digital behavioral health interventions as well as in venture capital backed digital behavioral health companies offering direct to consumer and direct to business virtual behavioral health services with some companies reporting improved clinical outcomes, increased patient engagement, and reduced psychiatric hospitalizations. Some companies are using remote monitoring and self-reported symptoms to help predict depression and anxiety onset and providing live behavioral health coaching or therapist outreach. Many companies are now partnering with academic researchers to demonstrate the effectiveness of their tele-behavioral health services and digital tools. However, there are limited peer reviewed studies demonstrating effectiveness of these virtual interventions. Academic research studies have shown improved patient engagement and clinical outcomes for some interventions (e.g., electronic cognitive behavioral therapy) but there is a great need to disseminate research findings on current tele-behavioral health and digital self-management services. The digital behavioral health space is ripe for vigorous research and evaluation. 

This Research Topic is intended to be a forum for the description and evaluation of tele-behavioral health services including telepsychiatry, tele-behavioral health counseling, digital behavioral health tools, and remote monitoring. Given the move to online delivery of psychiatry and psychotherapy services especially during the COVID-19 pandemic, there is a need to assemble and curate publications across psychiatry, behavioral science, psychotherapy, and substance abuse treatment that demonstrate the effectiveness in the delivery of tele-behavioral health services.  

Emphasis should be placed on articulating how evidence-based therapies provided via tele-behavioral health or digital platforms were adapted for delivery, and describing rigorous means for testing patient outreach, patient acceptability, patient engagement as well as clinical and cost outcomes. 

Questions this topic may help answer include: What are the key components of a successful tele-behavioral health intervention or digital behavioral health tool? How does the virtual intervention maintain fidelity to evidence based behavioral health interventions? What populations benefit differentially from virtual behavioral health services? What are the clinical and economic outcomes from virtual behavioral health interventions? What features of virtual behavioral health platforms resonate with patients, i.e., which features seem to increase patient acceptance and engagement? What makes a successful academic/industry partnership in the development of virtual behavioral health services? What are the emerging best practices to prepare psychiatrists and psychotherapists to delivery virtual behavioral health services?

We welcome Original quantitative or qualitative research and Case studies on:

·      academic/industry partnerships showing initial successful clinical outcomes of telehealth;

·      interventions that target combined online psychiatry and psychotherapy services;

clinical trials for specific patient populations and psychiatric disorders (especially disorders that have become increasingly more prevalent during the pandemic such as substance abuse, trauma, depression, anxiety, eating disorders).