Author Name: Lavanya Kaushal Qualifications: B.A. (Hons) Psychology, M.A. Applied Psychology (specialization in clinical psychology) Designation: Consultant Psychologist, ACRO Mental Health Services.
Word count: 554
Reading time: 5 minutes
Reviewed by: Aishwarya Krishna Priya
This pandemic and the subsequent lockdown have led to an increased demand for mental health services, as evidenced by Rajkumar who found that anxiety and depression, as well as increased stress have become more common among the general population ever since the lockdown started (1).
The COVID-19 pandemic has created a need to shift businesses to an alternate medium.
In this era of social distancing and working from home, tele-counselling and tele-psychiatric services have become more prominent, keeping in mind various stressors like fear of getting COVID and infecting others, loss of employment, emotional isolation, among other issues (2).
E-mental health services serve as excellent alternatives for face-to-face sessions, with significant reduction in travel time and effort required to go for consultation. Clients can seek help from the comfort of their homes. Moreover, it may even serve as beneficial to some clients who may not want to seek help due to fear of stigma related to mental health, which explains why the percentage of Indians who experience mental health issues is severely underreported (3).
E- mental health services offer great convenience to clients as well as practitioners.
However, it is not that such services come with no issues or concerns of their own. In a study done by Hawdon and Ryan, it was found that after a traumatic incident, those who received face-to-face care and interactions reported significantly better well being than those who received the same via virtual mediums like video calls or emails, mainly because of the lack of actual human presence (4). Likewise, clients may experience a sense of remoteness and a lack of connection via a remote medium, which can potentially harm the therapeutic relationship. However, more recent evidence suggests that the effectiveness of these mediums is actually a function of the client’s personality, and whether the therapist is able to use supportive techniques effectively, than the medium of interaction itself (5).
Tele mental health practice may create a sense of isolation and disconnection.
The next issue is with monitoring behaviour via such mediums. An in-person session with the doctor or psychologist allows the practitioner to look at other cues, such as body language and reading the room, to understand the client more accurately (6). The lack of these cues means that such services can be misused and may give an opportunity for the client to hide some crucial information (7).
Dealing with emergency situations also becomes challenging. For instance, working with clients who are suicidal or suffering from trauma is especially risky, since it is likely that the client may switch off their phones or internet, leaving the practitioner being unable to intervene. This may also have legal implications for the practitioner if necessary measures are not taken (such as a detailed and stringent informed consent) before commencing a session (8).
It is difficult to intervene in cases of clients who might have urgent and severe concerns.
Finally, the use of these services with special populations like the elderly (who are often not acquainted with using these technologies), children and people with developmental disorders (who might find it challenging to adapt to the screen either due to a short attention span or cognitive deficits) must be done with careful consideration (7).
Therefore, whether or not e-mental health services are useful ultimately boils down to the comfort of the practitioner and the client. Like offline sessions, it provides significant advantages in practice but major disadvantages too. However, as long as a decision is made with the parties discretion, e-mental health can potently support client well-being. Discuss with your mental health service provider to see what suits you the best.
 Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry, 52, 1-22.
 Pfefferbaum, B., & North, C. S. (2020). Mental Health and the Covid-19 Pandemic. New England Journal of Medicine, 1-2.
 Gaiha, S. M., Salisbury, T. T., Koschorke, M., Raman, U., & Petticrew, M. (2020). Stigma associated with mental health problems among young people in India: a systematic review of magnitude, manifestations and recommendations. BMC Psychiatry, 19(6), 338-346.
 Hawdon, J., & Ryan, J. (2012). Well-being after the Virginia Tech mass murder: The relative effectiveness of face-to-face and virtual interactions in providing support to survivors. Traumatology, 18(4), 3-12.
 Dolev-Amit, T., Leibovich, L., & Zilcha, M. S. (2020). Repairing alliance ruptures using supportive techniques in telepsychotherapy during the COVID-19 pandemic. Counselling Psychology Quarterly, 1-14.
 Gladding, S. T., & Batra, P. (2007). Counseling : A Comprehensive Profession. New Delhi: Pearson.
 De Sousa, A., Shrivastava, A., & Shah, B. (2020). Telepsychiatry and Telepsychotherapy: Critical Issues Faced by Indian Patients and Psychiatrists. Indian Journal of Psychological Medicine, 1-8.
 Martin, A. C. (2013). Legal, clinical, and ethical issues in teletherapy. In J. S. Scharff, Psychoanalysis Online- Mental Health, Teletherapy and Training (pp. 75-84). London: Karnac Books.
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