Background Telemental Health (TMH) is an effective way to increase access to mental health services. For this reason, many health care systems strive to make TMH a part of routine mental health services. TMH use has increased substantially in recent years; however, health care systems have found it challenging to implement TMH ubiquitously. Minimal literature addresses system wide TMH implementation efforts. Because previous local training efforts failed in leading to meaningful uptake in TMH use, a quality improvement project guided by implementation science methodology was used to design and implement an innovative TMH training program across a large service line.
Methods PARiHS criteria (i.e., Evidence, Context, Facilitation) was used as a framework to design, communicate, and implement a TMH training program aimed at providing task-specific training and culture change. The Evidence included incorporating established telehealth literature on TMH acceptance and efficacy. The Context included leadership support to prioritize training sites. RE-AIM guided the evaluation outcome measures used. The Facilitation was guided by Implementation/Facilitation techniques. A total of 100 interdisciplinary mental health providers from outpatient mental health clinics participated in this training over the course of two years.
Results Overall, providers reported satisfaction with the training program, and found that it increased their TMH knowledge and competence. The number of providers using TMH and patients who received it nearly doubled in the two years after the launch of the TMH training compared to the two years preceding.
Conclusions Implementation science methodology was important in creating an organizational framework to design, evaluate, and facilitate implementation of an innovative TMH training program. The program was well-received by staff and increased the number of providers and patients using TMH. Since this project was completed, the COVID-19 pandemic has significantly increased the demand for telehealth services. This training model offers specific strategies based upon implementation science that could be disseminated to and adopted by mental health programs looking to implement system wide TMH use.